Officials at Virginia's Western State Hospital today blamed patient abuse, homosexual assaults and other problems at the huge mental institution on the state's failure to provide adequate funds and staff for the 1,050-patient facility.
Members of a special legislative subcommittee heard a parade of witnesses, many of whom acknowledged that patients on some of the hospital's wards had been subjected to assaults and other violence. Most contended that shortages of doctors, psychologists, nurses and other professional staff as well as lack of adequate community-based mental health facilities were the ultimate cause of conditions here.
"If a private, nonprofit psychiatric hospital needs to charge $150 to $200 per day plus physicians fees, laboratory fees and medication costs, how is Western State Hospital expected to provide comparable services at a total cost of $55 per day?" asked Glenn Yank, Western State's medical director.
Other witnesses who appeared before the legislature's Joint Mental Health Oversight Subcommittee also supported increased funding, but said the hospital suffered from other problems.
"It's not just a lack of resources but some management problems as well," said Edward Hogshire, president of the Charlottesville-Albemarle Mental Health Association. That group's review of Western State concluded last week that the hospital's administration had been slow to correct overcrowding and the improper mixing of chronically ill patients with accused felons and other aggressive patients.
The legislative panel today also heard Brendan Buschi, Western State's recently fired social work director, testify that conditions at the hospital have worsened in recent months. Buschi cited recent incidents, including the death of a heavily sedated male patient in solitary confinement and the beating of an elderly patient in the hospital's geriatric center.
"We believe the situation is worse now than ever before and that it will continue to deteriorate until someone acts in a responsible manner," said Buschi. He and seven other hospital workers were fired after publicly accusing Yank and Western State Director William Burns of negligence and patient abuse.
The eight contend their dismissals resulted from speaking out publicly and have filed a federal lawsuit seeking reinstatement. Hospital officials have denied the charge.
Today's hearing followed a Washington Post series last May on conditions at the hospital, the largest state mental facility for Northern Virginia. Hospital officials previously have conceded serious problems existed at the institution but contended they were being corrected.
Today, those officials took a different tack, saying that long-term improvements could only come about with considerably more staff members than currently are employed. Medical Director Yank said he needed 50 percent more doctors than the 19 presently working at the hospital. Nursing Director Lucy Smith said she needed twice as many registered nurses than the 55 she has.
Yank recalled taking his daughter to a local hospital for surgery recently and discovering the hospital had four nurses on its late shift. "It occurred to me that there were more R.N.s in that room for that shift for four children than there were for all of Western State Hospital," he said.
Western State officials also criticized the lack of adequate outside facilities such as nursing homes and mental health centers. Lawrence Sutker, a psychiatrist in the hospital's geriatric center, said at least one-fourth of the center's 420 patients could be better treated elsewhere were facilities available.
Subcommittee Chairman Del. Frank Slayton (D-South Boston), contended in an interview that the austerity policies and hiring freeze enacted by Republican Gov. John N. Dalton were to blame for the problems. Under administration directives, Western State was ordered last year to reduce its staff from 1,460 employes to 1,312.
"The money's there for adequate staff but the administration has refused to transfer it," said Slayton. "If patients are suffering as a result, it's just irresponsible. It's one thing to have a hiring freeze in the highway department, it's another to have it in mental health where lives are at stake."
Dalton's press secretary Charles J. Davis responded that the administration is conducting a manpower study to see if Western State and other mental institutions needed more staff. "No one's suggesting the situation is entirely satisfactory but we're not sure quantity will automatically produce quality," said Davis.
Arlington Del. Warren Stambaugh, a subcommittee member who last week conducted a surprise tour of the hospital, called Western State's commitment hearings "a farce," saying in an interview the lawyers and hospital staff members fail to see that patients who did not need to be hospitalized are released.
As for the hospital's wards, Stambaugh said "just about all of the patients I saw were sitting around watching television or doing nothing. I can't say I saw any real treatment going on."