State psychiatrist reprimanded for threatening mentally ill patient with electroshock therapy
By CHRIS SERRES
May 6, 2014
A state psychiatrist has admitted to threatening a mentally ill patient with electroshock therapy at the Minnesota Security Hospital, resulting in a rare reprimand from the state agency that oversees the state mental hospital.
The psychiatrist, Dr. James Christensen, has been warned by the Minnesota Department of Human Services (DHS) that any further act of substantiated maltreatment may result in his disqualification, according to an investigation report.
The reprimand is unusual because it reverses the agency’s original finding, which cleared Christensen of committing maltreatment after an initial investigation last year. In January, Human Services Commissioner Lucinda Jesson overruled that decision, saying the psychiatrist’s behavior constituted abuse.
Mental health advocates say they hope the case signals tougher state oversight of the Minnesota Security Hospital in St. Peter, the state’s main facility for treating the mentally ill and dangerous, which has been wracked in recent years by internal dysfunction and accusations of patient abuse and neglect.
“It’s reassuring to see the department reverse course in a clear-cut case of maltreatment,” said Roberta Opheim, the state Ombudsman for Mental Health and Developmental Disabilities. “Most ordinary people would say, `You know, it’s just not right’ ” to threaten a patient with electric shocks.
The state interviewed eight people at the state hospital, including two psychiatrists, as part of an investigation last May. The professionals gave a similar account of a heated verbal exchange last April that escalated and resulted in Christensen threatening the patient with electroconvulsive therapy, also known as “ECT” or “electroshock” therapy. Despite being perceived as barbaric and primitive, electroconvulsive therapy is still used in public and private hospitals throughout Minnesota.
A health care professional at the hospital told investigators that she heard Dr. Christensen tell the patient, through the glass window of the nurse’s station, that, “You should be afraid of me. I am the one that is going to shock your brain with electricity.” The patient appeared “shocked and upset” after the comment, according to the report.
Christensen told state investigators that he was asked to assess the individual because the patient was “biting and acting out sexually.” Christensen said he explained to the patient that a court order for electroconvulsive therapy would be pursued if the patient “continued exhibiting maladaptive behaviors,” according to the memorandum.
After the incident, another licensed psychologist reportedly asked a hospital staff member, “Did I hear what I think I heard? Did [the psychiatrist] just threaten to put electricity in [the patient’s] brain?” The staff member responded, “Yes that is what you heard,” according to the investigation report.
Christensen admitted telling the patient that he was going to shock the patient’s brain, but denied stating that the patient should be afraid of him. “I was trying to impress upon the [patient] so [he or she] would not get a dangerous label,” Dr. Christensen told investigators.
The maltreatment finding comes as state officials work to rebuild the Security Hospital’s staff and change the culture. The mental hospital, Minnesota’s largest with about 400 beds, has struggled with inadequate psychiatric staffing, frequent leadership changes, and reports of physical assaults, according to a 2013 report from the Legislative Auditor James Nobles.
Though public perception of electroconvulsive therapy has been shaped by films like “One Flew Over the Cuckoo’s Nest,” which portrayed the practice as inhumane, the treatment has undergone a resurgence in recent years. Some patient care advocates say it can be effective in treating people with severe mental illness who are beyond the reach of drugs.
“To say, `Stop doing this, or I’ll shock your brain’ reinforces the negative stereotype that this [electroconvulsive therapy] is barbaric,” said Sue Abderholden, executive director of the Minnesota chapter of the National Alliance for Mental Illness (NAMI). “You should never use a mental health treatment as a punishment or a threat.”