Survey of Staff at Taunton State Hospital, Along With Numerous Reports From Across the State, Reveal a Growing Trend of Dangerous Conditions and Poor Care Following Years of Funding Cuts
CANTON, MA—The Commonwealth’s system of care for the most vulnerable mentally ill patients is "nothing less than disgraceful, given years of cuts in services and funding that have led to a rapid deterioration in the quality and safety of care in our state’s hospitals for the mentally ill," according to Bill Fyfe, RN, President of the Massachusetts Nurses Association chapter comprising more than 1,800 state employed health care professionals, also known as Unit 7.
The Executive Board of the MNA Unit 7, voted yesterday to make public its concern for the care and safety of clients of the state system in the wake of the release of the Governor’s budget, which includes no increase in funding to improve the care to those requiring acute and long-term mental health care, following years of cuts in funding for the care of the mentally ill.
"We can no longer sit silent, while the Governor and policymakers work under the assumption that years of neglect of the mental health system in our state is not having a negative impact on the people they are supposed to be caring for," Fyfe added. "The people we serve are not people who have access to high-priced lobbyists, they are often the one’s in our society no one wants to talk about. As clinicians who have given our lives and our careers to the care of these patients, we feel obligated to speak out on their behalf as they deserve to be treated with dignity and compassion – something that is becoming nearly impossible in the current climate."
The Executive Board was incensed by an email from Mental Health Commissioner Elizabeth Childs issued to DMH employees on Jan. 28th which praised the Governor’s "maintenance budget, which would allow the department to operate at current service levels," calling the budget "good news."
The MNA has made repeated requests to meet with Childs to discuss their serious concerns over the deplorable staffing conditions at the state’s DMH facilities, but she has consistently refused to meet with them.
"This may be good news for the Governor and the Commissioner, but it is horrible news for those suffering from serious mental illness. It is not good news to place patients and staff in a state of constant danger. It is not good news to have people languishing in our state’s hospitals because there is no viable community placement for them."
The MNA’s claims of poor care are supported by hundreds of official reports of unsafe staffing submitted by professionals at a number of the state’s facilities in recent years. This includes the results of a recent survey of staff in one of the state’s largest mental health facilities at Taunton State Hospital (TSH).
The survey found:
- 97% of the professional staff at Taunton State Hospital reported that their units were dangerously understaffed some or most of the time.
- 95% of the professional staff at Taunton reported staffing levels have been chronically inadequate for the past two years.
- 89% of the Taunton professionals believe current working conditions force them to provide a level of care below their professional standards.
- And 100% of the Taunton professionals report they lack the sufficient time to provide the level of care their patients require.
Additional surveys of professional staff at other state-operated facilities in DMH are in the process of being evaluated.
The health professionals at Taunton State Hospital have already taken their case to the media in their community, hoping to push their administrators to do something to improve their conditions.
They have reviewed staffing records at the facility over the last four years and have presented their administration with documented evidence of the decrease in staffing and the impact on nurses.
"We’ve discussed all of these issues with key TSH administrators numerous times over the last two years," said Fyfe, who is also a nurse at TSH. "After multiple meetings with management, the message is always the same: there’s no money in the budget to hire the staff needed to fix the problem. Administration consistently tells us that they are limited by the constraints placed upon them by the Department of Mental Health. If that’s the case, than TSH is part of a larger problem that is in need of urgent repair. And until that happens some of our state’s most at-risk citizens will continue to suffer the consequences."
As staffing levels have been cut, nurses and other professionals throughout the DMH system have been regularly assigned mandatory overtime, a demoralizing practice that exhausts the staff and endangers the patients. As a result of the deplorable conditions, hundreds of nurses are leaving the state system, where they are paid as much 30 % below their counterparts in the private sector.
At Taunton State Hospital, more than 30 nurses have left in the last year alone, and more than 50 over the last two years. In addition, because of the understaffing, the level of assaults by patients against nurses has increased dramatically.
Recommendations for Action
In addition to taking their case to the public, the Unit 7 Executive Board will be advocating within the legislature for the following actions to be taken:
- An immediate increase in the DMH budget to restore staffing and service levels to what they were in 2001 as a means of stabilizing the system.
- An independent audit of the staffing conditions of all DMH facilities and an analysis of the impact on mortality, injuries, medication errors, readmissions, and other outcomes for patients.
- An independent analysis of the cost of providing a safe standard of care to the clients of the mental health system in acute care, long-term care and community settings, along with an independent needs assessment of the number of beds required to care for the mentally ill in the state, both now and in the future as the population ages.
- An analysis of the budget required to provide adequate staffing in all state-run facilities, which takes into account salary ranges for staff that remain competitive with the private sector.
"We can no longer allow people with severe mental illness to continue to receive a diminished level of care in an under-funded system," Fyfe concluded. "It is our ethical and professional obligation to advocate for our patients and that is what we intend to do."
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