State Decries County Care of Mentally Ill Woman : Health: The Mental Health Services staff neglected patient for hours, report says. Reforms are under way.

A mentally ill woman was denied access to water and a toilet and left to languish in seclusion for hours while under the care of Ventura County Mental Health Services in May, according to a report issued this week by a state licensing agency.

The report is the result of an investigation conducted in November and December by employees at the local licensing and certification office of the state Department of Health Services.

It details violations by county staff in the case of Rhonda Renee Murrieta, 28, of Ventura. Murrieta has been in and out of county care since her diagnosis eight years ago as a paranoid schizophrenic, said her mother, Sally Hubbard.

The mental health department has promised state officials to make numerous reforms in response to the investigation, including demoting two shift supervisors and hiring a new director of nursing, the report says.

“This is an unusual and serious situation,” said Randall Feltman, director of the county’s mental health department. Although he said part of the problem stemmed from improper documentation, “we did do some things wrong and we have taken steps to correct them.”

According to the report and a letter Murrieta wrote to her family, Murrieta arrived for treatment at the department’s in-patient unit May 23. Murrieta writes in her letter, dated June, 1993, that she arrived in the morning asking for someone to talk to but after some heated exchanges with staff members, ended up tied in restraints and in seclusion.

The department’s own rules require staff to check on a patient in seclusion and restraints every 15 minutes, to offer them liquids, allow them to move their limbs occasionally and allow them trips to the bathroom if they request them, Feltman said.

In Murrieta’s case, staff members largely left the patient alone from 12:55 to 5 p.m. and allowed her to urinate on herself during the time she was in restraints, the report said.

“So there I am tied down and I yelled, ‘I have to go to the bathroom,’ (but) they paid no attention to me,” Murrieta writes in her letter.

Feltman said that, in fact, staffers did check on Murrieta that afternoon, but not as frequently as they should have and neglected to note each check on a chart, in accordance with department policy.

Most of the trouble stemmed from one improperly trained worker, Feltman said. “We have since found that there are some employees here who were not well-informed of some of the policies, though we have a 2-inches-thick policy manual,” he said.

*

“We agreed to basically expand our orientation and in-service education and training for new staff, so they would understand the policy more quickly.”

L. Edward Shuck, chairman of the county’s Mental Health Board, said Wednesday that he was surprised to learn of the document’s existence.

However, county Supervisor Susan K. Lacey, who sits on the board, said a staff member of hers had seen the report and discussed it with mental health officials.

The mostly volunteer board, which meets once a month in open session, is charged by the supervisors with reviewing and critiquing the county mental health department, Feltman and board members said.

Feltman said he has not had the time in the past week to produce a written explanation for most board members of what took place, adding that the bureaucratic language in the 12-page report might confuse the lay board members. He did not mention the issue at Monday’s board meeting because he felt it was a personnel and procedural matter rather than a public issue, he said.

Hubbard, Murrieta’s mother, says the department’s violations of her daughter’s rights extend well beyond the May 23 incident.

After that incident, Hubbard said, the mental health doctor assigned to Murrieta refused to give her any more medication until she quit drinking alcohol. Hubbard said Murrieta drank beer in an attempt to dull the side effects of the powerful medication.

Department case workers did not offer Murrieta treatment for her alcohol addiction, however, and without her medication, the voices brought on by her illness grew harsher and more upsetting, Hubbard said.

Mental health officials said they could not comment on the specifics of Murrieta’s case because of patient confidentiality laws.

On July 23, Murrieta, characterized by Hubbard as increasingly confused and distraught, set fire to her mother’s attic and was subsequently jailed and charged with felony arson.

Late in November, a county Superior Court judge ruled that Murrieta could not understand the nature of her charge, due to the severity of her illness, her mother said. Murrieta was taken Dec. 16 to Patton State Hospital in San Bernardino County, where she will remain until she is well enough to stand trial on the arson charges.

*

Murrieta’s family members are asking county board members to investigate Murrieta’s stay at the jail, arguing that no mentally ill person should spend 5 1/2 months in jail, where the facility and staff are not well-equipped to deal with mental illness.

Board members say they are anxious to do such an investigation as soon as someone obtains a letter from Murrieta waiving her right to privacy.

“They like to treat them like they are throwaways, crazies,” Hubbard said of the county’s treatment of her daughter and other mentally ill people. “But they are not. They have a purpose.”