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Mental Anguish at Texas West Oaks Hospital

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That was the case for Mary (not her real name) and her family, who came to West Oaks from Illinois. Mary's younger 17-year-old sister, whom we'll call Renee, had been a patient at the prestigious Mayo Clinic in Rochester, Minnesota, but had to leave. An acute-care facility, the Mayo Clinic had already had Renee there longer than the three-to-five-day standard stay. Renee had already exhausted most of the psychiatric hospitals near her home, so they had to look farther for a place where she could stay for a longer time, Mary says. The Mayo Clinic referred Renee to the also prestigious Menninger Clinic in Houston.

But Renee was too tough for Menninger, at 2801 Gessner Drive. The morning after her arrival, she grabbed a pair of scissors and injured several staff members, Mary says. Menninger said it was transferring her, and when Renee's mom put up a protest, she was told they had the right to move her without the family's consent. Mary says Menninger told them that they usually transfer to Baylor, but its beds were full, so Renee was admitted to the adolescent program at West Oaks on May 11, 2006.

What Renee's family found upon their arrival convinced them their concern was warranted. Mary describes West Oaks as dirty and dark, and as "a large cement room with a cement floor." As Mary later wrote in a letter to the Mayo Clinic, "The staff frequently laughed, joked, talked and used foul language among themselves while ignoring the needs of the children." Kids were sitting around, staring, watching some TV, but not engaged in anything, she says. This differed from other facilities where her sister had stayed, which had very structured activities. She wonders if part of the reason it seemed so disorganized was that West Oaks had an influx of adolescent patients from Hurricane Katrina.

Because of her violent behavior, Renee was assigned a one-on-one caretaker. Mary talked with her and found out she was a nursing school dropout. Mary says the woman told her she had received no training from West Oaks.

When she and her mother came to visit, Mary says the heavily medicated Renee was afraid to talk about her treatment, waiting until staff stepped away to mention anything. "She told me that they were threatening to hit her if she hit them. She was very afraid that she would get out of control and have a violent episode and not be able to control herself."

While the phone reports her family was getting from West Oaks were consistently positive, Mary says they'd arrive to find unexplained bruises and cuts on Renee's body. They found out later, she says, that Renee had gotten scissors again. They found out because Renee told them, and then the staff finally confirmed it.

Renee's back was injured when a tech wrestled her to the floor when she was acting out and got on top of her to hold her down, Mary says, adding that her 5'8" sister weighed about 110 pounds then.

Another time, Mary says, "They were moving across the room with her and they didn't have the right number of people, and they ended up dropping her. She was very banged up by the time she left."

On May 12, Renee attempted suicide in her room, using one of her shoelaces to try to hang herself. "They took that shoelace away and put it in her chart, but they left the other shoelace in the shoe in her room," Mary says. She discovered this when they had a subsequent family therapy meeting during which Renee asked when she was getting her shoelace back, because she wanted both of them. The counselor did a double take and asked if she still had the shoelace. Renee said, "Yeah, it's in my room," according to Mary.

The family was finally able to get a doctor to release Renee to the Mayo Clinic. She left West Oaks early in the morning of May 15, 2006, and was back at Mayo the next day. According to Mary, Renee got a lot worse during her brief stay at West Oaks. "There was a lot of undoing to do once she got back up to Mayo Clinic."

Caught up in dealing with a very troubled sister in crisis, Mary says she now regrets not taking more names or pressing forward more immediately with more state agencies about her sister's experiences. Months later, she contacted Menninger Clinic's Vice President for Quality Services, Pegi Pung, who wrote her that she would be forwarding her complaints to the Menninger staffers who referred Renee to West Oaks, as well as to Menninger's "clinical team who review the facilities where we refer patients." Pung wrote that she would get back to her with the results of that investigation.

A month later, when Mary received the exact same letter from Pung, she called the administrator. Pung told her she needed to call West Oaks, Mary says. When Mary protested that West Oaks was the problem, she says Pung told her she couldn't do anything about it and that Mary needed to talk with West Oaks. According to Mary, when she argued that Menninger had a responsibility because it was referring patients to West Oaks, Pung said that if Menninger has someone in an acute situation, they have to go somewhere, and if there are no beds open elsewhere, then West Oaks is the choice. Pung did not respond to calls from the Press, but another senior vice president, Shawna Morris, did on her behalf. Asked why Menninger would continue to refer patients to West Oaks when a relative was reporting bad treatment there, her response was:

"We really can't comment on it. It's not our case; it's not our patient; it didn't happen at Menninger. So I stand behind what Pegi Pung put in her letter, that Menninger cannot really get involved in another provider and the relationship that patient has with what happened at another facility. I regret that we really cannot comment any further on this case." Asked again why they would continue to send patients to West Oaks when it has been sanctioned by the state, Morris said:

"We refer patients to facilities that can provide a level of care that Menninger does not provide. So we refer patients to West Oaks, we refer patients to Kingwood Hospital, to the Methodist Hospital, to IntraCare, to all of the acute locked units. When we can't take care of the patients, we can't keep them, so we refer them out to the local hospitals."

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