Minnesota Security Hospital is on the right path

  • Article by: Steven Pratt
  • Updated: September 16, 2013 - 12:51 PM

Minnesota Security Hospital is making strides in changing its culture.

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stplooklistnSep. 15, 13 8:17 PM

Looking at systems problems rather than finding fault has been a part of most hospitals for years. Late to the party.

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prometheus1Sep. 15, 1310:22 PM

Medical Director Pratt would have the public believe that the Security Hospital is on the path to improved patient care and better working conditions for staff because the use of restraints and seclusion has been effectively eliminated. Unfortunately, this is a position based in ideology, not sound medical practice or evidence from the real world. Use of restraint and seclusion in a facility such as Security Hospital has always been restricted to those situations where the safety of patients, staff and the public require use of these techniques. Failure to acknowledge the need for adequate use of seclusion and restraint leads to such DHS success stories as the stabbing attack on the mother of Burton Ewing while on a day pass from Security Hospital in May 2012 for which this "model" patient was just convicted of attempted murder. It has lead to rampant increases in staff injuries and assaults on staff by patients over the last 2 years. It also lead to the release of violent patient Kevin Traylor to a Salvation Army Homeless shelter hosting a day care center in Minneapolis in August 2013. As Medical Director, Pratt is personally responsible for the risk to the community Traylor's release created. Rules exist for a reason. The patients in the Security Hospital are confined to the facility because their behavior demonstrates that they REQUIRE separation from society including restraint and seclusion. The fact that Director Pratt refuses to take consideration of public and staff safety in deciding when and how seclusion and restraint should be used demonstrates the ideologically driven blindness that DHS Commissioner Lucinda Jesson's administration continues to be imposed on the people of Minnesota. How many more citizens of this state must be maimed or killed before common sense is brought to bear on the discussion of the use of seclusion and restraint? How many Minnesotans must join Dru Sjodin in death before the Dayton administration opens its eyes to the harm its DHS appointees are causing with their inappropriate aversion to the use seclusion and restraint.

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msminnSep. 16, 1310:37 PM

Prometheus1 is obviously a current or former employee of the hospital who misses being able to enforce his will on patients. A quick look at the data shows that going hands-on, i.e., restraint and seclusion, increases the danger of staff and patient injury. Taking the time to build a therapeutic relationship, finding what works well with a particular patient, and learning how to see the patients at the security hospital as people are the things that keep people safe. The security hospital is not a prison; it is not part of the correctional system; and it is not a simply a place to segregate those in our society who have mental illness that makes them a danger to others. It is a place for those people to learn how to manage their illnesses in a healthy way so that they can return to their communities in safety. It is with that goal in mind - and no other - that all employees of the security hospital should appraoch their jobs.

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owatonnabillSep. 17, 13 6:42 AM

Prometheus1 makes an excellent point. DHS, more often than not, is driven by ideology, but the SERVICES DHS provides are driven by necessity and practicality. This is precisely the same conflict of interest that has gotten Minnesota the problem we currently experience with our mentally ill people. The correct ideology was that we no longer needed large institutional-type facilities (Brainerd, Moose Lake, Faribault, etc.) as we were now gonna treat ALL mentally ill people in the community. It was the triumph of ideology over reason and ended up making things worse, instead of better, for many of our state's mentally ill people. Same at St. Peter. Of course restraint and seclusion (including chemical restraint) should not be used if there are reasonable and proven alternatives, but in cases where there are no reasonable and proven alternatives, then they have their place. Not using restraint and/or seclusion when the alternative is increased risk of injury and even death is not progressive. It is merely silly.

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machiavelli8Sep. 17, 13 6:18 PM

What's being overlooked here is the STAR TRIBUNE'S objectivity. What reputable news source allows someone in a position of power a free and well publicized "article" to publish propaganda??? Wouldn't that be better placed in the letters to the editor???

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nuthutterSep. 19, 13 4:25 AM

What is ridiculous is the concept of "no consequences" for the patients. The security hospital essentially has no rules that MUST be followed anymore. They claim that this kinder/gentler enviroment is for the good of the patient; but how interested are they in the patients health and welfare when they allow nearly unlimited calories? I'm told from staff that work there that when patients were given their breakfast portions and expressed discontent over the portion size, at first staff did what used to be their jobs and explained to the patient that this was their dietary allowance and there needed to be enough to go around for everyone. Let's say for instance the portion is typically 2 pancakes. After Dr. Pratt was involved by patients complaining to him, he ordered staff to provide whatever food the patients wanted. So now, some of those patients will get as many as 8 pancakes. Add to that several canteen runs a day where the patients spend their own money on candy bars and soda and order out delivery food a few days a week, combined with very limited activity and it's no wonder nearly all patients would qualify as obese with numerous related health repercussions like diabetes. There is a definite need for balance in DHS ideology. Yes, relationship building with patients should be a priority; but when therapuetic interventions don't work, and force is forced into play, the tools need to be there to ensure everyone stays safe and that's not happening anymore. How are we preparing any of these patients for reentry into the real world when they are not being trained to act in an acceptable manner for any civilized society. You cannot make progress towards reintegration in a consequence free environment. The patients served at Saint Peter Regional Treatment Center have "earned" their way to the facility with repeated unaceptable behavior and should not be entitled to the same treatment patients at a open, civilian based setting can expect.

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tokyogpSep. 19, 1312:26 PM

This is a very helpful and hopeful update. I am glad to learn that the medical culture is shifting from command and control to, as much as is possible with the seriously mentally ill, to engagement and empowerment. This is a very positive and powerful shift in approach. Now if the rest of medicine could catch up...

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prometheus1Sep. 21, 13 5:07 PM

MSMINN makes numerous false statements in her attack on prometheus1 because she knows she cannot refute the message. The security hospital is NOT a community environment in which the patients can come and go. It is a restricted environment complete with fences and, until recently barbed wire, whose residents cannot leave without permission...just like a prison. Many of the most dangerous patients there, those in need of seclusion and restraints would be in prison for the violent crimes they are responsible for which got them committed to the Security Hospital in the first place. Burton Ewing, for example...bludgeoned his sister to death with a hammer because she came home before his mother did. 10 years later...DHS' star patient attempted to finish the job in a public park. Public safety in these situations, including the safety of other patients and hospital staff trumps therapy...ALWAYS. Anything else is criminal negligence on the part of DHS. MSMINN knows this but would rather attack the messenger than face up to the fact that her argument has no basis in reality. This philosophy of attacking those who practice sound medicine while balancing the needs of patients with the obligation to public safety has cost DHS many qualified staff through systemic bullying and harassment. Those who have fought back have won in every instance against the state...retaining their licenses, getting their jobs back, etc. Indeed...it is the administrators who advocate Lucinda Jesson and MSMINN's philosophy who keep getting fired or retired. Perhaps its time to move the entire mental health care system to the Department of Corrections as they have a better track record of success because they are clear about the mission which society has given them.

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