Losing faith in mental health services

John Christensen
The Chronicle-Express

Part one of a series on mental health care in Yates County.

Penn Yan

A longtime crisis in mental health care availability in Yates County has only worsened during the COVID-19 pandemic.

Soldiers & Sailors Memorial Hospital is in the process of giving up their designation for mental health care.

Last week, Sheriff Ron Spike presented his reports to the County Legislature’s Public Safety Committee, which noted that Sheriff’s Deputies responded to 14 mental hygiene calls in July 2020, double the number for July 2019. An examination of the report shows 49 calls for the mentally ill were answered by Deputies from Jan. 1 through July 31, 2020, representing a 48.5% increase over the same period in 2019 when there were 33 calls. The Sheriff’s Office is not alone. The Penn Yan Police Department made 36 mental hygiene arrests since Jan. 1. 

The crisis for mental health care in Yates County, however, predates the pandemic. Law enforcement and families have been expressing dissatisfaction with the mental health services at Soldiers & Sailors Memorial Hospital since they came center stage with the murder of Dr. Magda Daoud and the killing of her dog by her son, Paul Khouzam two years ago.

Khouzam, then a 38-year-old man with a violent criminal history, had been evaluated by a physician, a psychiatrist, and others at Soldiers & Sailors emergency department, and was released just hours before his brutal attack on his mother. Magda Khouzam-Daoud, M.D. a former employee of Finger Lakes Health, the health care system that owns Soldiers & Sailors Memorial Hospital—clung to life in a Rochester hospital until her death Oct. 18, 2018. 

The Federal Critical Access Hospital Allegation survey was conducted Aug. 13 and 14, 2018 after media reports of the case came to the attention of officials in Rochester. Inspectors concluded that the allegation that Khouzam should not have been discharged from the emergency department could not be substantiated and no citations were issued to the hospital.

Despite that finding, in the years since that murder, police have seen the mentally ill and suicidal subjects they have brought to the hospital released after brief examination and without any notice to police or families.

Earlier this summer, one suicidal case was released and returned to his parents’ home set a large hay barn on fire in an attempt to kill himself, and was apprehend by police as he ran naked around the burning barn. Other cases included several attempted suicides at the trestle near Seneca St. in Penn Yan, one who had been released after being taken by Penn Yan Police to Soldiers & Sailors just hours before.

In July, Penn Yan Police Chief Thomas Dunham issued a mental health facility memo to PYPD officers:

“Effective immediately the Penn Yan Police Department will no longer be taking subjects arrested for mental hygiene to Soldiers & Sailors Hospital in Penn Yan. All officers making a mental hygiene arrest will transport arrestees to Clifton Springs Hospital in Clifton Springs, N.Y. Once on scene at Clifton Springs Hospital, officers will complete all appropriate 9.41 paperwork and any other additional paperwork deemed necessary by Clifton Springs Hospital for admission. Once you have transported a mental hygiene arrestee to Clifton Springs and have completed all necessary paperwork for intake, you may then respond back to Penn Yan. We will not be responsible for transporting mental hygiene arrestees back to Penn Yan. Clifton Springs Hospital has assured me they will work with patients and local transportation options to ensure they make it home. 

“The only exception to the above would be if a mental hygiene subject had a more urgent medical emergency requiring immediate attention i.e. a mental hygiene subject taking 200 pills of oxycodone to kill themselves. That person should be brought to S & S for immediate medical treatment then, when medically cleared, transported to Clifton Springs Hospital for an evaluation. 

“This change in policy is due to the fact that Soldiers and Sailors Hospital is losing its 9.39 designation and has been inconsistent in their ability to treat mental health patients.”

Soldiers & Sailors responds

When asked to answer for Soldiers & Sailor’s status as a mental healthcare provider, Finger Lakes Health’s Vice President for Community Services Lara Turbide, responded, “Soldiers & Sailors Memorial Hospital initiated a process to discontinue providing inpatient psychiatric services in February 2019 which has been reported on previously in much detail.

“As part of this process, we submitted a closure application in 2019 and have been working with the New York State Office of Mental Health (NYSOMH) and the New York Department of Health (NYSDOH) to follow the appropriate channels, as they make the final determination related to whether we can discontinue these specific services. As such, we are in the final phases of this process, and as anticipated as part of this change, if we are approved to discontinue these services, there would also be a change in our 9.39 status.”

Turbide took issue with the PYPD memo. “I felt this was important to clarify as this memo is inaccurate. This change, again if approved, would be in response to our facility’s closure request application and is not related to anything otherwise. Our facility’s application to discontinue inpatient psychiatric services, if ultimately approved, will result in a termination of the 9.39 status. The change in 9.39 status (which I emphasize is not yet finalized and is rather still pending approval) will be determined by the N.Y. State Office of Mental Health and is based on Soldiers & Sailors Memorial Hospital’s application to discontinue inpatient psychiatric services. We are still in the midst of this process with steps currently being taken as recommended by OMH including working with local government and other stakeholders to prepare in advance for such potential termination.”

When pressed to comment on the release of mental hygiene cases who then went on to endanger themselves and others, Turbide declined to offer anything further.

Clifton Springs and CPEP

Sheriff Spike says that in August, the YCSO initiated its Crisis Intervention Team (CIT) working closely with the Comprehensive Psychiatric Emergency Program (CPEP) based at Clifton Springs Hospital.

Crisis Intervention Team (CIT): A group of members specially trained to deal with emotionally distressed individuals in a variety of situations within the Yates County community. These situations may include suicidal persons, persons exhibiting irrational behavior, handling psychiatric patients, the homeless, various mental health concerns and/or referrals, and any other situations that deal specifically with the needs of the mental health community and emotionally disturbed persons. YCSO Deputies also have the ability via iPads to communicate with CPEP from the field and if necessary conduct an actual telepsychiatry conference with CPEP staff to better assess with the immediate need of the patient. 

Part two will examine the role of CPEP in mental hygiene calls in next week’s edition of The Chronicle-Express.