A grand jury report returned last week accused officials with Western Psychiatric Institute and Clinic of failing to cooperate with law enforcement officers into investigations of sexual assaults, failing to understand their responsibilities in the mandatory reporting requirements for minors who are abused and of misconstruing privacy regulations in state and federal law.
Although the 63-page grand jury report, dated July 10 and filed of record last week, does not recommend any criminal charges, it does make specific recommendations for training, as well as suggested changes to state law.
“Arguably, some, if not all, of these failures of the staff and administration of Western Psychiatric Hospital constitute the crime of obstructing administration of law,” the report said. “However, as an investigative body we are not convinced that the conscious objective of the staff and administration of Western Psychiatric Hospital has been to thwart or to interfere with criminal investigations or that any articulated institutional policy or protocol has been specifically crafted towards that goal.”
Instead, the report continues, the conduct “seems to be the product of a misconception by the staff of the Privacy Rule of HIPPA and the misapplication of the confidentiality provisions of the Mental Health Procedures Act, combined with a complete absence of official policies and procedures of Western Psychiatric Hospital relating to pending criminal investigations.”
Western Psych's diagnostic and evaluation center provides 12,000 emergency psychiatric visits annually, and it operates a 312-bed inpatient program averaging 5,000 admissions each year.
The report enumerated problems the grand jury found: “(1) failing to contact law enforcement when a patient alleges that he or she has been sexually assaulted; (2) failing to share the identity of the alleged perpetrator with law enforcement; (3) failing to provide law enforcement with information relating to any and all witnesses to these alleged crimes; (4) failing to preserve physical evidence; (5) failing to allow law enforcement access to the alleged crime scene; (6) failing to allow law enforcement access to the alleged victim; (7) failing to allow law enforcement access to the alleged perpetrator; (8) failing to allow law enforcement access to alleged witnesses; and/or (9) failing to share information obtained through Western Psychiatric Hospital's internal investigation with law enforcement.“
A 14-page response filed by UPMC in the Allegheny County Court of Common Pleas says the report "casts a much needed light upon a long-standing source of friction — and occasionally confrontation — between law enforcement authorities and mental health professionals."
In the response, UPMC calls for the state legislature to address and amend the "out of date" Mental Health Procedures Act, which it says "protects all patient information in the possession of WPIC."
"UPMC and WPIC also appreciate the Grand Jury’s recommendations regarding possible modifications to WPIC policies and training protocols and will carefully evaluate those recommendations in collaboration with law enforcement authorities," the response states.
The WPIC response said the facility does not believe it should stop conducting its own internal investigations, but that it will be "more mindful of the parallel responsibilities of law enforcement."
Attorney John C. Conti, who filed the response, said via email, "We will be working in collaboration with the District Attorney's office to address the recommendations set forth in the report." UPMC spokesman Paul Wood declined comment.
According to the report, the grand jury investigation began in April 2013 after administrators and staff failed to cooperate in a case in which an 8-year-old patient was sexually assaulted in a community playroom at Western Psych.
As the grand jury’s work continued, it revealed a "history of interference and non-cooperation" with police investigations and recounted the circumstances of six other assaults at the Oakland campus dating back to April 2007. Those involved four other minors who were sexually assaulted, as well as two adult victims.
“[P]olice investigators were generally denied access to both physical and testimonial evidence of alleged incidents at WPIC when police inquiries were made. Instead, on these occasions, an ‘internal’ investigation was conducted by members of the staff of WPIC, the results of which were considered ‘confidential’ by WPIC, and no results of such internal inquiries were ever disclosed to either law enforcement officials or even to the families or representatives of the patients affected by the criminal incidents.”
There was a misconception “that the internal investigations at WPIC ‘cure all evils’ and constituted a preferable resolution to the incidents, while keeping the ‘dirty little secret’ of sexual assaults that were occurring at WPIC away from the public eye.”
In its response, UPMC said that when patient-on-patient sexual assaults are reported, staff have a responsibility to the accused perpetrator and alleged victim, "including some of the most stringent obligations of confidentiality imposed under law.“
In the case that prompted the grand jury investigation, an aide discovered the 8-year-old girl in a playroom with the door closed with a 14-year-old male patient. The girl’s pants were down, and she said the boy had subjected her to forcible oral sex.
A video recording taken from a surveillance camera in the playroom showed the boy entered the playroom and was inside alone with the girl for more than six minutes, during which the alleged assault can be seen.
The staff member then enters the room and finds them. The two patients are separated, but four minutes later, the girl is taken back into the playroom by two female staff members and is "seated within reaching distance of the actor."
"Immediately thereafter, Jane Doe #5 is seen pulling her pants down and her shirt up as if describing the incident to the staff members in front of the actor. The actor is then seen exiting the playroom,” the report said.
The staff members then left the girl alone in the room for almost three minutes.
According to the grand jury, investigators learned later from the boy’s mother that she had previously warned the staff about her son’s “hypersexual behavior.”
After the charges were filed against the boy in juvenile court, a detective who asked to photograph and video record the sixth floor crime scene was denied access, the report said. Further, Western Psych's risk manager denied his request for the names of employees who had been assigned to that floor.
A caseworker with CYF assigned to investigate the case said it could not be completed within the required 30-day time period because Western Psych would not cooperate. It took an additional 26 days before an attorney for UPMC called the caseworker.
It was only two days before the extended 60-day deadline that the caseworker got final approval to interview the Western Psych staff member who was on duty and doing observation check on the day of the girl's assault.
The grand jury report noted that since the beginning of its investigation, Western Psych administration has "begun to change its practices relating to cooperation with police in their criminal investigations and reporting allegations of on-site child abuse, particularly sexual assaults, to ChildLine."
It continues, however, that there have been no changes to written policies or procedures and that the staff seems to be unaware of the new practices.
"District Attorney Stephen A. Zappala Jr. has had discussions with the general counsel for UPMC about this report and the goal now is to ensure that all facilities within Allegheny County that take part in psychiatric treatment are in compliance with the recommendations made in the report," said Mike Manko, a spokesman for the DA's office.
Zach Zobrist, executive vice president of SEIU healthcare, which represents about 200 employees at the hospital, said he was not aware of the grand jury investigation, but knew there were a handful of serious incidents of violence and sexual assault against patients by patients that concerned employees.
"The culture is the employees are discouraged from sharing anything like this with law enforcement," he said. "... I'm confident that there is a feeling there that is ingrained that they should report to their manager, and their manager should handle" further reporting, he said.
A worker who was on duty when a patient-on-patient sexual assault occurred said she declined to talk to a lawyer when approached. She said she and her coworkers stay quiet because they are afraid of losing their jobs.
"People should have voices in the system to say, 'This isn't right,' " said the woman, who said she did not want to have her name used for fear of losing her job.
Mr. Zobrist said the union believes in transparency and getting to the root cause of the issues, such as understaffing.
Since the March 2012 shooting at Western Psych that left two people dead, new management has been trying to change the culture, though it "clearly needs to change more," he said.
The report suggests that there must be a balance between Western Psych's internal review process and the need for a criminal investigation.
An added benefit of cooperation, the report continues, is that it would lessen "any public perception that WPIC's primary concern is not the welfare of its patients but rather the avoidance of potential civil liability.”
Paula Reed Ward: firstname.lastname@example.org or 412-263-2620. Lexi Belculfine: email@example.com or 412-263-1878.