Concerns raised over accountability, oversight at SC mental health facilities
A former lawmaker, a state employee and former state contractor raised concerns Friday over what they described as a lack of accountability and poor patient care in the S.C. Department of Mental Health, which they said puts patients in danger.
The criticism, which the three shared with the Mental Health commission Friday, comes on the heels of a nearly $2 million settlement against the S.C. Department of Mental Health for the death of William Avant, which the State newspaper exclusively reported in July 2019.
Avant, a 35-year-old Georgetown man, died after multiple agency employees piled on top of him and suffocated him, according to a coroner’s report and state investigation. His death was ruled a homicide, though no charges were ever filed.
The State, able to review video of the incident, reported that at least three of the employees involved in the patient’s death had not been properly trained and failed to follow agency policy against restraining patients face down, which can restrict breathing.
During the S.C. Mental Health Commission’s online Zoom meeting Friday, state employees spoke for nearly an hour and a half to praise various efforts made by the department in the community in recent months, including an add campaign aimed at reaching South Carolinians in need of their services in the ongoing pandemic.
That tone, however, shifted when three people spoke during public comment, each given between three and four minutes to speak.
Shalini Mittal, a physician at G. Werber Bryan Psychiatric Hospital just north of Columbia, took much of her time proposing ways to improve patient care at facilities. But after suggesting employees didn’t do enough to prevent the death of another patient earlier this year, she was muted by the commission as her time speaking expired.
DMH would not discuss any details with the newspaper when asked, citing patient privacy.
Another speaker, Balbir Minhas, a gastroenterologist who identified himself as a long-time contractor, questioned why his contract was terminated after he said he suggested some DMH employees weren’t properly trained to care for patients. He also was cut off when his time was up. Also limited in speaking time was former state Sen. Jake Knotts, who said DMH has systemic flaws that waste public dollars and put patients in danger.
Knotts specifically questioned the lack of accountability for Avant’s death and whether officials did enough to ensure the man’s family had justice.
One employee was terminated and several were disciplined, a State newspaper investigation showed. Mental Health was also cited for a series of violations by health regulators after Avant’s death, records show. Several of the agency’s employees were suspended, the entire hospital staff was retrained, and the department’s policy on physically restraining patients was quickly revised to ban the treatment Avant received, according to records provided by health regulators.
“If this type of incident would’ve happened at any private hospital, like Richland or Lexington Medical Center, I can assure you that a few heads would’ve turned and rolled,” the former Republican senator said. “Top leaders would have either been fired or asked to step down. I do not believe DMH took any action against the leaders running Bryan hospital.”
Commission Chairman Greg Pearce said before opening up the meeting to public comment that the commission would not discuss at the meeting whatever the speakers had to say.
In a phone interview after the meeting, Knotts told The State he was upset that he and others were cut off after three minutes, as the time restriction is at the discretion of those running the meeting. He said officials showed a lack of concern by not interacting with speakers, adding that their concerns were the most important subject brought up during the meeting.
In an emailed statement to The State newspaper, DMH leadership said patient safety is the agency’s top priority and that the department has a multitude of policies and practices to ensure concerns are addressed, including “those rare occasions when a patient in its care dies unexpectedly.” Those policies include notifying a patient’s family, law enforcement and conducting an internal review of patient care and circumstances of their death, the agency said.
“The purpose of these reviews is to critically evaluate whether there are lessons that can be learned or corrective measures put into place that may improve patient care and safety,” the email said.
State Rep. Chip Huggins, R-Lexington, who was also on the call, said he understands the complexity of issues facing DMH and its staffers, but hopes the agency and commission follow up on concerns raised during the meeting.
“We’re always trying to do everything in the world possible to prevent death and run (departments) efficiently,” he said.