DATE: Sunday, April 13, 1997                TAG: 9704100013

SECTION: COMMENTARY              PAGE: J4   EDITION: FINAL 

TYPE: Editorial 

                                            LENGTH:   50 lines

INVESTIGATION NEEDED THERE IS SO MUCH TO BE LOST FROM UNWILLINGNESS TO LOOK SQUARELY AT SHORTCOMINGS OF THE STATE'S MENTAL-HEALTH SYSTEM.

The U.S. Justice Department's decision to launch a full investigation of Central State Hospital is, unfortunately, warranted.

The deaths in recent years of two patients who were strapped to their beds is cause for alarm in an era when mental institutions increasingly are forgoing use of such restraints.

The staff psychiatrist for one of those patients, Gloria Hundley, a 31-year-old who died last June 29, had warned that the use of restraints could have lethal consequences. Even so, records show that she was strapped to a bed while in solitary confinement for 300 hours in the last month of her life.

This is in contrast to Eastern State Hospital, where administrators are operating largely without the use of restraints. At the Northern Virginia Mental Health Institute, restraints are used for only a few hours monthly. Such changes have come about in conjunction with earlier federal investigations at those institutions.

Wisely, the attorney general's office and state mental-health officials are cooperating with the federal probe. There is nothing to be gained, save perhaps momentary face, and much to be lost from unwillingness to look squarely and honestly at the shortcomings of the state's mental-health system.

Patient advocates say understaffing and inadequate training are at the root of many problems. In Huntley's case, for instance, psychiatrist Dimitrios Theodoridis wrote compellingly a year before her death of the difference sensitive handling could make.

``It is imperative that staff members who lack sufficient emotional endurance to cope with the difficult challenge of this patient must not participate in her care,'' he wrote. ``. . . a restrictive approach will be viewed as punitive by this patient who has experienced alienation and trauma from others through most of her life.''

When allowed as many freedoms as possible, ``the patient showed commensurate improvement,'' he wrote. Restrictive approaches ``increased her maladaptive outbursts and led to more dangerous incidents.''

Theodoridis' conclusion was that, without the sort of treatment he prescribed, death was likely. He removed himself from the case when his warning went unheeded. Time proved him correct.

However ill, however fractured from society, the patients in the forensic unit at Central State Hospital are human beings. Every available resource, whether local, state or federal, must be marshalled to ensure that they are treated accordingly. The investigation, by uncovering the reasons for recent failures to live up to that standard, may help to prevent less than humane treatment in the future.

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