A scathing report of the conditions at Northwest Georgia Regional Hospital was sent to Gov. Sonny Perdue by the U.S. Department of Justice after a settlement was reached Thursday between the department and Georgia regarding treatment of patients in the state’s seven psychiatric hospitals.

The 68-page report, requested by the Rome News-Tribune and received from the Department of Justice on Friday, states that NWGRH does not adequately protect patients from violent incidents that are generally serious, recurring “and frequently result in grave harm.”

Click here to read the settlement between the DOJ and Georgia. Click here to read the letter of findings concerning NWGRH sent to the governor.

Also, the report states Georgia mental health hospitals overuse restraint, both physical and medicinal, and seclusion as tactics to control patients.

Restraints should only be used when patients pose an imminent risk of injury to themselves or others and should only be used after less restrictive alternatives have been tried, the report stated.

The study noted that many, if not all, of the findings at NWRGH are representative of conditions encountered at the Georgia Regional Hospital in Atlanta and the regional hospital in Savannah as well. The state had agreed that the DOJ’s inspection for four of the state’s hospitals “would stand as representative of all seven hospitals in the system.”

“Specifically, we have concluded that numerous conditions and practices at NWGRH violate the constitutional and statutory rights of its patients,” the report stated.

The study also found that, despite earlier studies conducted at NWGRH, “We found that these same conditions remain unabated, despite NWGRH’s notice of the deficiencies.”

According to the report:

Significant and wide-ranging deficiencies exist in NWGRH’s provision of care. Certain conditions and services at NWGRH substantially depart from generally accepted professional standards and violate the constitutional and federal statutory rights of patients who reside there.

Many of these deficiencies stem from a system that does not have clear, specific standards of care or an adequate number of trained supervisory, professional and direct care staff, the report stated.

The report outlined recommended remedial measures to the hospital to implement measures involving patient safety and treatment that are consistent with generally accepted professional standards in the field.

Calls to Northwest Georgia Regional Hospital were referred to the governor’s office.

How Georgia is going to fund the recommended improvements to the state funded mental health care system, or even if it can, is just in the beginning stages.

“I don’t think we even have our hands around how much is going to cost (the state),” said State Rep. Katie Dempsey, R-Rome. “I’m concerned about some of the ways (the Department of Human Resources) is being divided up as to responsibilities.”

Dempsey is speaking of Perdue’s plan to realign the Department of Human Resources and create an additional separate agency to deal with mental health.

While the closure of some of the state mental health hospitals is a possibility, said Bert Brantley, a spokesman for the governor, nothing concrete has been planned.

“We have aging hospitals that are very expensive to run and have a large overhead,” said Brantley. “So of course we’re looking at everything.”

The governor is also looking at other ways to provide community based mental health services, Brantley said.

The state’s relationship with the DOJ is not adversarial, said Brantley, and some of the plans to reform Georgia’s mental health care are already in the works.

“They’ve already said we’re heading in the right direction,” he said.

The agreement with Justice officials gives the state one year to correct the most grievous conditions and within four years the state has to show marked improvements in medical and nursing care as well as a decrease in the use of seclusion or the restraining of patients.

The USDOJ conducted an on-site investigation of NWGRH on Oct. 29, 2007 through Nov 2, 2007.

The hospital serves residents of 23 counties of NWGA that have mental illness, substance abuse issues and developmental disabilities. At the time of the investigation the hospital housed 280 patients.

An investigation into Northwest Georgia Regional Hospital determined that the hospital:

Failed to ensure the reasonable safety of its patients.

Failed to provide adequate mental health treatment.

Engaged in the inappropriate use of seclusion and restraints.

Failed to provide adequate medical care.

Recommendations include:

Ensure patients receive accurate, complete and timely assessments and diagnoses.

Develop and implement a treatment planning process consistent with generally accepted professional standards.

Only use seclusion or restraints, physical or medicinal, when a patient poses an imminent risk to themself or a third party — not as a punishment or behavioral intervention.

Ensure that patients receive services in the most appropriate settings consistent with their needs and prepare the patient with appropriate services and training for discharge from the facility.