Milwaukee mental health administrator defends sex crime risk
By Steve Schultze and Meg Kissinger of the Journal Sentinel
Milwaukee County's top mental health administrator intentionally houses female patients with men known to be dangerous "because the presence of women reduces the likelihood of the men being violent," according to a county supervisor's letter obtained by the Journal Sentinel.
John Chianelli, administrator of the county's Behavioral Health Division, told county supervisors during a closed-door session last month that segregating men and women would result in more violence.
"It's a trade-off," he said. "Putting 24 aggressive male patients into a male-only unit would increase the level of violence in the unit."
Chianelli's remarks came during a County Board committee called into closed session on April 14 to find out why there are reports of an increasing number of sexual assaults at the county facility, including the rape of a 22-year-old pregnant woman last summer.
His comments are detailed in a four-page letter by Supervisor Lynne De Bruin recapping points he made at the closed session. Two other supervisors who attended the meeting of the County Board's Health and Human Needs Committee verified the account.
The Journal Sentinel obtained the letter through a request under the state's open records law.
The comments were sharply criticized as "deplorable" by patient advocates and county supervisors. They said they were offended at Chianelli's characterization that sexual assault is a lesser harm than other physical assaults.
"What a horrendous thing to say," said Mary Neubauer, co-chairman of the Milwaukee Mental Health Task Force and the consumer representative on a county committee to study more effective ways to treat psychiatric patients. "John needs to apologize for those remarks to the whole community."
Chianelli said in an e-mail to the newspaper that he was declining to comment on the advice of his lawyer, Mark Cameli.
The county's Behavioral Health Division hired Cameli, a private lawyer, in 2006 after Journal Sentinel reports about Cindy Anczak, a patient who died from complications of starvation at the complex.
Barbara Beckert, director of the Milwaukee office of Disability Rights Wisconsin, said Saturday that the county needs to make the psychiatric hospital safer all around.
"Many patients at the Mental Health Complex are survivors of trauma, including sexual abuse and assault," Beckert said. "We must ensure that they are not further traumatized by being exposed to sexual aggression and, in some cases, assault at the very hospital where they have come seeking help."
Her organization has been designated as the watchdog agency for patients at the county facility. She and her staff have reviewed patient records there from the past year and are expected to release a report on conditions at the hospital.
Lawmakers and mental health advocates have expressed alarm in recent weeks at the accounts of physical and sexual assaults on the complex's four acute inpatient wards. Earlier this year, federal inspectors threatened to withhold federal funds until the complex corrected deficiencies that led to the rape of the 22-year-old patient.
Her attacker, a man described by a medical supervisor as "a very devious sexual predator," had been charged with multiple assaults, including another sexual assault. Still, he was housed in the same unit as the woman, where bedroom and bathroom doors are unlocked.
Chianelli defended mixed-gender units as a way to reduce the likelihood of violence by male patients against other male patients. He also conceded that such units at the Mental Health Complex "cause more sexual problems," De Bruin's letter says. Chianelli reviewed medical literature and found, "Going to gender-based units trades violence for sexual assaults."
County supervisors called Chianelli into a meeting to discuss that case and the overall policy of sexual contact between patients.
According to De Bruin's letter and the remarks of other supervisors at the meeting, Chianelli told them that patients had a right to express themselves sexually. De Bruin agreed but said that right ends when they are placed in the county's acute psychiatric unit. A large majority of those patients are involuntarily committed.
Supervisor John Weishan Jr. told a reporter that he was astonished at Chianelli's remarks.
"I couldn't believe he was saying this," Weishan said. "It was just mind-boggling. Saying we either accept a level of sexual assault or we accept a level of physical violence. Why can't we have no sex assaults and no violence?"
Weishan and Supervisor Christopher Larson confirmed De Bruin's account of Chianelli's closed-door testimony.
De Bruin further chastised Chianelli in her letter.
"How could a responsible administrator tell elected officials that this was the reason gender-based units might not be a good idea," De Bruin wrote. "The county has an obligation to prevent both types of violence, not to trade one for the other."
She said that she was concerned that the decision to stick with mixed-gender psychiatric wards was a cynical one aimed at minimizing legal risk to the county rather than enhancing patient safety.
"This 'trade-off' you spoke of, not only unacceptably trades sexual violence for other physical violence, it benefits the county legally and improves our record with regulatory agencies," De Bruin said.
A federal inspection in January was triggered by a sexual assault complaint. Inspectors then found multiple instances of improper patient sexual contact, including the August attack.
A comprehensive inspection of the complex by the state and a county audit began last week. In addition to the Disability Rights Wisconsin investigation, state legislators are pressing for a state audit. State Rep. Sandy Pasch (D-Whitefish Bay) said she was concerned the county audit might not be sufficiently thorough.
When the rape occurred last August, the woman was six weeks pregnant by the same man, whose room was located in the same 24-bed unit. The woman remains a patient at the Mental Health Complex.
The 23-year-old male former county patient has been charged with three sexual assault counts and has been ordered to have no contact with the woman. His case has been suspended, however, and he's been transferred to the Mendota Mental Institute in Madison.
Both have mild retardation and are severely mentally ill, court records and a federal inspection report say.
"If the county is going to detain patients, the most important right these patients have is their right to be safe within our facility," De Bruin wrote.
De Bruin also accused Chianelli of evasiveness when he was asked direct questions about sexual assaults at the complex that led to a threatened cutoff of federal aid. That threat has since been rescinded.
Chianelli acknowledged just one "problematic case," apparently the patient who became pregnant, during his closed-door testimony, De Bruin's letter says.
The county's four acute psychiatric units are all mixed-gender, which is permitted under both federal and state laws. Chianelli apologized for his remarks when De Bruin met with him last week, but didn't back away from them, De Bruin said.
She said she accepted his apology but has lost faith in Chianelli's ability to serve as director of the mental health facility.
"Words don't fix this," she said. "Actions do."
(To read original article, visit this Journal Sentinal link.)