Guest Opinion: Taunton State Hospital Forensic Unit should be expanded, not closed

Gov. Deval Patrick released his budget for Fiscal 2015 on Jan. 22. Deputy Commissioner Cliff Robinson from the Department of Mental Health in Boston made the trek to Taunton the following day. Robinson announced the Patrick Administration's "re-allocation" of mental health resources on Thursday, Jan. 23 to Taunton State Hospital's staff.

The plan includes the transfer of the remaining 45 patients from TSH to The Worcester Recovery and Wellness Center. Patrick intends to develop five respite centers for psychiatric patients in local inner cities and suggested that displaced state workers would be absorbed into the new "reallocation" of mental health care services. The DMH intends to maintain the census of 626 state funded mental health care in-patient beds. The governor's model is to decrease in-patient stays and place clients into the community. Robinson failed to address questions of availability and access to mental health care services by the most chronic and difficult patients currently receiving services at TSH.

There have been a number of tragic school shootings and other public acts of violence that have transpired over the past two years. After each horrific and tragic event the general public has responded by suggesting better access to increased mental health care services and earlier intervention of care and treatment.

Patrick's administration has responded to public outcry by attempting to shutter Taunton State Hospital. He has eliminated forensic psychiatric services in the southeastern Massachusetts area. Clinicians specializing in this cutting edge and advant garde treatment have left Taunton to practice psychiatry in other state hospitals that are not currently being "picked on" by Patrick. None is practicing in forensic psychiatry.

Taunton State Hospital's forensic services provided care and treatment to 25 patients sent to the units by the court system. A review of cases treated by TSH's forensic care services indicates that patients once treated by these units have been rerouted into incarceration subsequent to their care and release from Taunton State Hospital. As a forensic patient of TSH, I kept detailed, comprehensive notes and documentation of my experience on Chambers II South, the Forensic Unit.

I have followed the care of my fellow patients by monitoring their subsequent arrest records published over the Internet. I expressed concern that patients will be incarcerated and resituated in squalid homeless campsites when I spoke at the First Parish Church and the Gardner Auditorium of the Statehouse in 2012. My projection has been realized two years after Patrick's initial decision to downsize Taunton State Hospital.

Taunton provides care and treatment to the most difficult patients. Clients present with compound psychiatric illness as defined by the DSM-V (Diagnostic and Statistical Manual), sociopathy under the auspices of the discipline of criminology and intellectual deficits resulting in developmental disabilities. Many of Taunton's patients also suffer from physical disabilities affecting motor function. There are a number of patients treated that have committed infanticide, child molestation and sexual assault. This hardly runs the gamut of violent offenses seen at Taunton State Hospital. A mature and reasonable approach from the Department of Mental Health is indicated. Patients with such compound and complicated psychological presentation cannot be effectively treated by community based services.

TSH could best be utilized by reopening forensic services and providing continuing care services to such patients. Harm reduction theory, as suggested by sociologist Edith Springer, could be realized if older buildings were renovated to provide housing to patients graduating from the Department of Corrections and the forensic units. Training and education could be made available to ex-convicts with narcotic afflictions and non-violent offenses.

Taunton needs to take on the most difficult challenges and provide services to the sickest among us. My co-patients had achieved optimum wellness when discharged from TSH and were deemed no longer dangerous by clinicians specializing in forensic services. I saw the miracles myself. Their prognosis was short-lived. Patients discharged from the forensic unit were sent back into the community with insufficient support and lack of availability of specialized forensic care.

It's time for the voting public and taxpaying citizens to demand more, not less of such psychiatric services. It's time to reopen forensic psychiatric services at Taunton State Hospital and expand, not eliminate such efforts. The world would truly be a better place and a safer place if these issues were addressed and treated rather than ignored and eliminated. The end result is paramount. We need to ensure protection of our progeny and restore hope for those once thought to be hopeless.

Mary Clements, RN, of Taunton, is a former patient of Taunton State Hospital.

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