County attorney, state hospital fight over patient’s admission

Dispute recently resolved

Posted 11/14/19

A fight between the Park County attorney and administrators at the Wyoming State Hospital — over whether a local man should be sent to the facility for mental health treatment — spilled …

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County attorney, state hospital fight over patient’s admission

Dispute recently resolved

Posted

A fight between the Park County attorney and administrators at the Wyoming State Hospital — over whether a local man should be sent to the facility for mental health treatment — spilled into public view last month before being quietly resolved.

In early October, District Court Judge Bill Simpson ordered that a 22-year-old Cody resident be committed to the state’s mental health facility involuntarily, or against his will.

However, records show state hospital officials refused to accept the man as a patient, in part because they questioned whether he was still suffering from psychiatric problems. The hospital’s medical director said he felt it would be “grossly inappropriate” to accept the man as a patient.

Park County Attorney Bryan Skoric then asked Judge Simpson to issue a peremptory writ of mandamus. Such a writ would have basically overruled the Wyoming State Hospital’s objections and commanded its administrator, Bill Rein, to admit the Cody man as a patient.

In an Oct. 25 filing, Skoric asserted that “the law not only authorizes the [state hospital] to admit the patient for treatment, but the law requires it.”

The state hospital and Simpson never filed a response to the petition, but Skoric said Friday that, “from the position of the state and through my office, the issue has resolved itself.”

He declined to share further details, citing patient confidentiality.

When a county attorney seeks to have someone involuntarily committed to the state hospital in a so-called Title 25 case, the proceedings are closed to the public and all of the court records are sealed.

Skoric provided some redacted records from the 22-year-old’s confidential case in support of his public request for peremptory mandamus. For instance, an order is included in which Simpson wrote that the man “suffers from a mental illness that is a physical, emotional or behavioral disorder which causes him to be dangerous to himself or others and requires treatment.”

However, the public records gave almost no details about the circumstances that led to the man being seen as a candidate for involuntary hospitalization.

Whatever the concerns were, they apparently led to the man being detained in mid-September and taken to the Park County Detention Center in Cody. State law discourages authorities from holding people in jails if they’re solely being held in connection with a mental health crisis, allowing such people to be detained in jail “only during an extreme emergency.”

In ordering the man’s hospitalization on Oct. 7, Judge Simpson said the patient could continue to be held at the detention center until he was transported to the Wyoming State Hospital — or, if he was eligible to be released from detention, he could be placed at Cody Regional Health.

However, three days later, the Wyoming State Hospital notified Simpson that they were refusing to accept the man as a patient.

Amy Pauli of the Wyoming Attorney General’s Office explained in a filing that the hospital was declining to admit the man “due to the serious nature of [his] medical needs and the inability of the [Wyoming State Hospital] to provide for the necessary medical needs of the patient.” Pauli said the man appeared to primarily need treatment for a bleeding disorder. (Skoric, however, produced medical records indicating the man had been dealing with the issue for years — and that the problem was not life-threatening or particularly urgent.)

Dr. David Carrington, a psychiatrist and the state hospital’s medical director, wrote an affidavit saying he did not believe the man met the criteria for involuntary hospitalization.

Carrington cited a Sept. 24 mental health assessment, apparently conducted about a week after the man was first checked into the jail. At that time, a counselor reported that the man “was calm and cooperative, denied any hallucinations, denied any thoughts or plans of harming himself or others and his mood and affect were neither depressed nor manic.”

Drawing on that report, Carrington said there was “no indication from the available records that [the man] has active symptoms of a mental illness, nor that he is an imminent danger to himself or others.”

However, Skoric noted that district court officials considered the counselor’s findings before ordering that the man be hospitalized.

Skoric also faulted state hospital officials for not actually speaking to the patient; he says the law requires the hospital to admit patients for at least seven days to determine the extent of their mental illness.

“This refusal to admit the patient was in direct contradiction to not only the court order, but also the evaluations of two (2) separate examiners who met with the patient in person and [an] M.D., who reviewed the patient’s information and mental evaluations,” Skoric wrote, adding, “Clearly, medical staff performed a cursory review of scant medical records and then hand-picked a benign statement from one of the written evaluations in an attempt to justify their refusal to admit a patient that this court legally found to have a mental illness.”

While the dispute between Skoric and the state over this particular patient wound up being resolved, the issue isn’t going away; Skoric expressed continuing frustration with several different aspects of the state’s Title 25 process on Friday.

“Wyoming’s system is not working, in my opinion,” he said.

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