Mentally ill, dangerous patient languished for months without proper care; judge wants explanation
Judge Jay Quam wants assurance others won't be left to languish without proper care.
Craig Lassig for City Pages.
Linda Desonpere had no business being at the University of Minnesota's Fairview Hospital after August 27.
That's the day a Hennepin County judge deemed Desonpere "mentally ill and dangerous" -- the most restrictive form of commitment in Minnesota -- and ordered her transfer to the St. Peter Security Hospital.
At 24 years old, Desonpere had a long history of violent behavior stemming from Schizophrenia and mood disorder, according to court records. Most recently, on July 11, after arguing with a staff member at an adult foster care facility, Desonpere set a fire on the building's porch. The staff extinguished the flames before anyone was hurt, but the incident led to a petition for her civil commitment.
Upon evaluation, a Hennepin County court examiner determined it was inevitable that Desonpere would try to hurt someone again -- or worse.
"It is only a matter of time before she kills someone," he predicted.
But despite the judge's order, Desonpere did not go to St. Peter that day. Due to a lack of beds and poor communication among those in charge of her transfer, Desonpere sat at Fairview for another two months waiting to be moved, court records show. Perhaps not coincidentally, her transfer came the day after the judge issued an order to show cause to the Department of Human Services, the government arm that oversees St. Peter.
Now, Judge Jay Quam wants an explanation, and assurance that others won't be left to languish without proper treatment as Desonpere was. Quam ordered the Department of Human Services to submit a written report on changes to the way they place patients earlier this month, which will be discussed at a hearing in his courtroom tomorrow.
As Quam emphasizes, Desonpere's case is only a symptom of a much larger problem: Hennepin County's civil commitment system is overburdened and under-resourced, and the process too frequently comes to a screeching halt on the way to proper treatment.
"The Desonpere case is a sad example of how our mental health system breaks down under the weight of limited resources, and how those in charge of the system need to be reminded of their responsibilities to the mentally ill and to the public despite those limited resources," says Quam in a statement to City Pages. "At least Ms. Desonpere was in a hospital; too often, mentally ill persons are left to languish in jail while waiting for the treatment they need and to which they are entitled."
Not an isolated case
In cases like Desonpere's, the cost to the public is high. In his order, Quam estimates her stay at Fairview racked up $150,000 in unnecessary expenses. But as the judge notes, Desonpere also paid the price -- she may have been receiving medication, but not appropriate care -- as did the hospital staff not equipped to deal with the dangerous patient.
The unfortunate case is similar to that of Ronald Brewer, which we documented in our March cover story on the dysfunctions of civil commitment in Hennepin County, "Unfit for Trial."
In July 2010, police arrested Brewer outside Country Bar in Uptown for illegal possession of prescription pills. Brewer suffered from major depressive disorder, and threatened to commit suicide in his cell, but it still took months for the civil commitment process to begin, according to court records.
A judge eventually found Brewer incompetent to stand trial about four months later, but he spent another month in jail awaiting transfer.
Quam held a series of three hearings with the Department of Human Services in early 2011, where it was resolved patients would be transferred within seven days of commitment. If for some reason this wasn't possible, the department would have to provide an explanation.
Now almost two years later, Hennepin County Sheriff Rich Stanek says it's still taking too long to transfer mentally ill offenders from his jail.
Stanek estimates about 35,000 to 40,000 mentally ill people come through the jail each year. Once civilly committed by a judge, Stanek says it's of dire importance that the offender is moved to a mental health facility immediately.
"I run a facility for those who are awaiting criminal procedure," says Stanek. "If you are deemed mentally incompetent or mentally ill, the courts have ordered you transferred out of that jail setting. And we expect the health and human services commissioner then to make that transfer order as soon as possible."
Stanek questions the legality of the jail continuing to incarcerate someone once they are deemed incompetent to face criminal charges.
"Where is the constitutional side of this that says that someone can be held in a jail that is not convicted criminally or awaiting a trial?"
"It all falls apart"
Anne Barry, Deputy Commissioner of the Department of Human Services, agrees that patients should be moved to proper treatment in a timely manner.
"We want to get a person into the right place," says Barry. "Clearly, jail isn't the right place."
But Barry says cases like Desonpere and Brewer are in the minority. In the past year, she says, only two patients have failed to be transferred within the seven-day grace period.
"I would say, overall, we are making good on that commitment that we made about two years ago," she says.
But Barry recognizes that people like Stanek are still frustrated that the system is not moving fast enough. She has concerns of her own, namely that some patients are staying in treatment facilities longer than necessary, when they should be discharged back to the courts or their communities. Barry and Stanek will appear in Quam's courtroom tomorrow to discuss issues surrounding civil commitment, and how to move patients through the process in a speedy manner.
"We fully understand what's wrong in this system, and that so many things take time," says Barry. "I think what we've said all along though is that if any part of the system isn't working, it all falls apart. Because people need to be transitioned and moved as quickly as possible."
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