A state task force has recommended that lawmakers consider abolishing the Psychiatric Security Review Board, which supervises people who are found not guilty by reason of insanity, because it favors public safety over patient treatment.
While members of the CVH Whiting Task Force did not agree on how to replace the PSRB, they encouraged legislators to consider proposals that would better respect the rights of patients while balancing public safety concerns. Currently, Connecticut is one of only three states that has an entity like the PSRB.
The proposal was among the task force’s recommendations the group approved Friday in a meeting televised on CT-N, during which members discussed the measures in a shared screen over Zoom. They took a vote to convene in two weeks to approve the wording of an executive summary, after which they will send their recommendations to members of the Public Health committee.
“We should reach out to the leadership of the committee, the chairs and ranking members, and ask them how they would like to proceed, and encourage them to consider drafting legislation,” said Michael P. Lawlor, associate professor of criminal justice at the University of New Haven and co-chair of the task force.
Task force members were split on whether to get rid of the PSRB entirely or reform it, but all were concerned about the lengthy periods for which people are committed to the board’s supervision. In August, a 20-year-old man was committed to the PSRB for 120 years for stabbing his grandparents to death.
“The stated purpose of the PSRB is to protect public safety; these lengthy commitments do little to further that end,” the recommendations read. “Rather, they seem to be more a mechanism to reassure the public that an individual will never get out of an institution.”
The task force indicated some support for a 2018 bill that would have reformed the PSRB. The bill, which did not make it out of committee, would have required the PSRB to balance public safety with patients’ rights to receive treatment in the least restrictive environment and expanded opportunities to be released from commitment to the board or from the hospital. In Connecticut, people who are declared not guilty by reason of insanity and committed to the PSRB are sent to Whiting Forensic in Middletown, the state’s only maximum security hospital.
Task force members also agreed that the two years patients must wait for a review of their commitment is too long, suggesting that a review be conducted every six months unless a patient waives that right.
Notably, Lori Hauser, a forensic psychologist and the only member of the task force who works at Whiting, disagreed. Hauser cited concerns for victims’ rights, saying the cases are still tied to the justice system. She agreed that patients should be allowed to petition for less strict levels of supervision, but said the decision should still be an adversarial process where state and defense attorneys weigh in before the PSRB decides.
Formed in the wake of an abuse scandal that resulted in 10 state employees being charged with harming a patient at Whiting, the task force has been meeting since April 2019. Over the past two years, its members have met with patients at Connecticut Valley and Whiting Forensic hospitals, discussed the results of an employee survey and the low morale among their workers, and suggested legislators start planning to replace the “dreary surroundings” and “stark primitive conditions” — including rats — at Whiting Forensic Hospital.
All those discussions showed up in their recommendations. They suggested the legislature consider a new maximum-security facility with a design that promotes “recovery and healing” and is more conducive to creating diverse environments and security that better fit patient’s needs, unlike the existing hospital, which has a diamond-shaped structure that the task force determined is not ideal for patients.
Task force members also proposed that “something drastic must be done” to address staffing shortages. An investigation of Whiting conducted by the state Department of Public Health found that staffing shortages compromised patient and staff safety, a finding backed up by the chief medical officer’s courtroom testimony that he was so “gravely concerned” about staffing levels that officials shut down a hospital unit to compensate for shortages.
The task force called on the “highest levels of state,” like the Department of Administrative Services, to reconsider its hiring practices and staffing requirements at the hospitals in an effort to replace employees who have left. They also said both hospitals should be exempted from state hiring freezes.
Emphasizing the overlap between the criminal justice system and the psychiatric hospitals, the task force recommended lawmakers expand diversionary opportunities for those who are arrested and in need of competency restoration. State data suggest there is a growing concentration of criminal cases that involve defendants with serious mental health conditions who do not seem able to understand the charges against them or assist in their own defense.
Recognizing that people charged with low-level crimes can end up at the maximum-security psychiatric hospital, which they wrote “seems counterproductive and punitive,” the task force proposed conducting competency restoration on an outpatient basis for those who do not need to be in a secure facility to have their competency restored.
Lawlor encouraged task force members to quickly submit the report to lawmakers, who could forward the recommendations to bill-drafters in the Legislative Commissioners’ Office.
“I think I speak for everybody when I say I hope that the legislature takes up these recommendations during the 2022 session, which begins in February, but I think it would be helpful to get the ball rolling,” said Lawlor.