Alaska’s only public psychiatric hospital failed to meet federal requirements for evaluating patients, didn’t provide adequate treatment and failed to investigate complaints about workplace harassment in 2020, according to a new report from the Alaska ombudsman.
The report, released on Tuesday, is based on record reviews and interviews with staff at the Alaska Psychiatric Institute. The investigation stems from an anonymous complaint in November 2020 about conditions at the hospital.
The report says the hospital did not provide active treatment to all patients or consistently create and update treatment plans, despite previous commitments to improve its services. In most cases, patients were given the same “cookie cutter” treatment plan of psychiatric nursing and medication when they were admitted, the report says. And, it noted, the hospital didn’t provide any culturally informed treatment in 2020 despite about 40% of patients being Alaska Native.
The state Department of Health and Social Services, which oversees the hospital, wrote in an emailed statement that the report looked at problems in 2020 and didn’t account for progress made since then.
“We do not minimize the concerns raised by the Ombudsman’s office but want to be clear that many of these allegations were raised over two years ago and many changes have happened at the facility since that time,” said the statement from Adam Crum, commissioner of the state health department.
Gov. Mike Dunleavy said in his State of the State address earlier this year that his administration had “turned that situation around.” He pointed out that managers had more than doubled the number of occupied beds at the hospital, from 20 to 55, since he took office.
State Ombudsman Kate Burkhart, who wrote the report, described the investigation process as an “ongoing dialogue” with the state health department. The health department agreed to implement some, but not all of the recommendations made in the report.
Burkhart said, however, that the department had also promised to implement similar changes three years ago after a different ombudsman report that also found major problems.
“In the past, the department has accepted some of those and committed to implement them,” she said in an interview on Wednesdsay. “Turns out, they weren’t all implemented, so we re-recommended them.”
She said some of the problems with the hospital seemed “intractable.”
“Over time, resources have been brought to bear and still no marked improvement,” she said.
On multiple occasions, the hospital’s CEO Scott York provided inaccurate information to investigators, according to the report. For example, York denied that he was aware of complaints about gender and racial harassment and bullying. The ombudsman found that York and others, including the deputy director of the health department, were aware of those complaints, but didn’t take “meaningful action” to fix them, said the report.
In another instance, York told investigators that there were 17 groups providing rehabilitative and social services in one unit. The ombudsman report said that was misleading, since some of the groups weren’t therapeutic. One of the groups York cited involved watching and discussing the courtroom drama “Law & Order” to educate patients about criminal proceedings.
“The evidence showed that, in fact, there were complaints of inappropriate conduct that had been substantiated about members of management. And the evidence showed that, in fact, the level of treatment described was not accurate,” said Burkhart.
Still, Burkhart said, the report didn’t find any evidence that staff had harmed patients, something it found in its 2019 report.
“There are folks that get up every morning to go to work at API to provide the best care they can,” she said. “This is an issue of management decisions and allocation of clinical resources when it comes to treatment planning and access to active treatment.”