Interim Director of Mental Hospital Quits After 1 Month

Citing frustration with his failure to recruit psychiatrists, the interim medical director of the county’s troubled mental health hospital abruptly resigned Friday, a month after he took the job in an effort to improve conditions at the much-criticized Hillcrest facility.

Dr. Thomas Henley returned Friday to his former post as a staff psychiatrist at the county’s mental health center in Oceanside.

Henley’s resignation prompted renewed complaints from employees at the hospital, known as CMH, that county administrators, including Henley, have been vindictive toward hospital professionals whose allegations of mismanagement and poor patient care prompted several independent investigations this year.

Henley, in a prepared statement released by the county, said his departure was voluntary.

“I leave . . . with no pressure from either administration or staff,” Henley said. “I feel that, although the experience was educational and rewarding, there were too many important and sensitive issues outside of my control that require strong, immediate action.”

Henley said the county’s failure to recruit qualified psychiatrists to work evenings and weekends contributed greatly to his decision to leave the job.

“Even though this county recently raised M.D. salaries, we are still not competitive enough on the ‘open market’ to attract and keep full-time psychiatrists,” he said. “My extensive recruiting efforts the last few weeks have proved this without any doubt.”

In a separate statement read to the hospital’s staff Friday morning, Henley, 42, hinted that his superiors in the county Department of Health Services had reneged on a pledge to pay him more money.

“I am unable to go forward without the necessary staff and resources to carry out the program, including the compensation for me agreed upon prior to my taking this position,” Henley said in the letter, which was read to the staff by Dr. Harold Mavritte, who is the department’s clinical director and Henley’s supervisor.

Henley declined further comment, but Mavritte blamed red tape in the county’s personnel system for holding up a pay raise he had promised Henley. Had Henley stayed in the medical director’s job, he would have been paid less than he will be earning when he returns to Oceanside, Mavritte said.

Now Mavritte, for the second time in two months, will take over as the hospital’s acting medical director. He served in that position for three weeks in June after the transfer of Dr. Warren H. Higgins, who had worked in top administrative posts at the hospital for almost two decades.

Higgins was relieved of his duties at CMH amid allegations of mismanagement and poor patient care at Hillcrest, problems that also contributed to the resignation of Chief Administrative Officer Clifford Graves, who quit under pressure July 3.

The hospital has been the subject of recent investigations by the county grand jury, the state Department of Health Services, the state auditor general, and the Board of Medical Quality Assurance. The San Diego County Psychiatric Society is reviewing several cases in which improper patient care has been alleged.

The grand jury’s report said James Forde, director of the county Department of Health Services, was “out of touch with what is going on at CMH.” The report said the hospital suffered from an unclear chain of command, lax supervision and poor record-keeping. It also said doctors either refuse to accept patients who belong at the hospital or fail to care properly for those who are there.

The auditor general’s report, the result of an investigation requested by a state assemblyman who had received complaints from hospital staff members, concluded that at least three recent deaths of patients who were treated at CMH “may have been preventable.”

The county has consistently denied charges of serious lapses in patient care, even as Graves proposed a massive budget increase and reorganization to deal with many of the problems.

Henley’s arrival was part of that reorganization, and Mavritte credited him with implementing a treatment program designed to ensure that a team of professionals will closely follow each patient’s progress.

“It’s a setback to our program,” Mavritte said of Henley’s resignation. “He’ll be sorely missed.”

But several CMH employees said in interviews Friday that conditions at the hospital have failed to improve despite the administrative changes. They said that Henley, in his short tenure at Hillcrest, never asserted himself as a leader, and instead implemented orders Mavritte handed down to him.

“He was a puppet,” said one employee who asked not to be identified. Morale at CMH, the employee said, is as low today as it ever was under Higgins.

“I thought it was bad before, when all this stuff started to hit the fan,” the employee said. “But since it’s hit, it’s bounced off the walls and gotten worse. There’s a lot of garbage going on.”

Another employee said professionals at CMH have been harassed for talking to the press about the hospital’s problems.

“The climate has remained a repressive one,” the employee said. “It’s like a dictatorship. If anyone questions anything, they are considered disloyal. There is a lot of fear here, fear of reprisal.”

Henley also was criticized for implementing without objection Mavritte’s decision to integrate the sexes in Hillcrest’s wards, a practice common in private mental hospitals but considered by some employees to be dangerous at CMH, which was not designed for it.

Although there were occasional reports of sexual conduct between patients before the sexes were integrated, another such incident Wednesday night has prompted renewed criticism of the move.

Pat Stalnaker, a spokesman for the hospital, said the incident was reported through proper channels but was not something that troubled the administration.

“These things happen,” Stalnaker said. “They are not common, but they do happen. Sexual interplay is fairly regular. It’s watched, but you can’t be everywhere every minute.”

Thursday night, according to employees, a hospital staff member was assaulted by a patient and might have been seriously injured had another patient not pulled the attacker away. One employee said the attack was the result of tension within the staff that is “picked up on” by the patients.

But Stalnaker downplayed that incident as well.

“Nobody got hurt; it was not a big thing,” Stalnaker said. “It was such a minor circumstance that the staff person did not even fill out an incident report.”

Mavritte said he believes that conditions are improving at the hospital, and he attributed his staff members’ complaints to a natural resistance to change.

“All of us agree on what our goal is and what we want to accomplish,” Mavritte said.