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04-07-2010, 03:36 PM


Job losses, transfers to hit Fulton State Hospital


The Fulton Sun
Posted: Tuesday, Apr 06, 2010 - 10:20:18 am CDT


As part of a statewide realignment of the Missouri Department of Mental Health, more than 200 employees of Fulton State Hospital learned early Monday many of them will be shifted to other positions or lose their jobs during the next two years.

A tentative Department of Mental Health plan calls for closing current mental health units at the Guhleman Forensic Center in Fulton and three units at the Hearnes Forensic Center during the next two years.

The plan is designed to shift all acute mental health care provided from the state to private agencies, which can receive federal Medicaid reimbursement for the costs.

The Fulton job losses and transfers are scheduled to begin in September and be completed during the next two years. At the end of two years there will be a reduction or transfer of 211 full-time jobs at the two mental health units in Fulton.

The first step in Fulton will be three wards of the Guhleman Forensic Center in Fulton will be closed and 85 patients there will be moved to the Southeast Missouri Mental Center in Farmington. This will mean a reduction or transfer of 104 employees now working in the unit.

In January of 2011, a high-security satellite Sexual Offender Rehabilitation Treatment Service program will be created at Fulton State Hospital to handle the overflow from a similar unit at Farmington. This will create some jobs in Fulton and enable current employees to transfer to the new unit. The sexual offender program has been growing at a rate of about 17 offenders a year, an agency spokesman said.

The state had planned to construct a new $77 million facility at Farmington for sexual offenders but now that building plan has been dropped.

Briefings of Fulton State Hospital employees began Monday morning on a realignment of the Department of Mental Health forced in part by state budget cuts caused by declining state revenue.

Bob Bax, a spokesman for the Department of Mental Health, said the reconfiguration of the Department of Mental Health affects many of the department's facilities statewide and includes shifting of patients throughout the state.

Bax said many of the reductions will come not from job losses but through not filling open positions and transfers to other jobs.

If approved as presented, Bax said the department's plan affecting Fulton employees and other psychiatric employees throughout the state would save from $7 million to $10 million a year.

Bax said Gov. Jay Nixon asked the Department of Mental Health and other state agencies to develop plans to reduce the size of state government and present them to the Missouri General Assembly. "Overall, the state has to cut about $500 million from next year's budget," Bax said.

Bax said at this point the department wants to make all employees aware of planned cutbacks.

"When the legislature completes its budget in a few weeks, we will have a better idea about how much of this will go into effect. Many things in the plan depend upon other things happening first," Bax said.

The plan still includes a request by the department for a new 300-bed maximum and intermediate security facility to be built at the Fulton Sate Hospital. It would be financed through appropriation-backed revenue bonds issued in 2013 or 2014 to replace the Biggs Forensic Center, a maximum security unit that houses patients prosecuted for murder or other violent crimes and have been found not guilty by reason of mental defect or disease.

A copy of the department's plan for a statewide downsizing of the state operated inpatient psychiatric system that was distributed to employees Monday has been obtained by The Fulton Sun.

The first step in the downsizing of the state-operated psychiatric system begins in July of this year when 20 voluntary patients will be moved to intensive community services with no staff layoffs.

The next major step is the movement of 85 patients from Fulton to Farmington and the loss or transfer of 104 jobs in Fulton.

Then in January of 2011, the Sexual Offender Unit will be established in Fulton, creating or transferring 34 full-time jobs in Fulton.

In June of 2011 the two remaining units at Guhleman Forensic Center and the three units of the Hearnes Forensic Center will be closed and 108 patients will be moved to state mental health facilities in St. Louis and Kansas City.

In October of 2012 or 2013, the department will ask for construction of a 300-bed high security psychiatric facility at Fulton State Hospital financed by state revenue bonds.

Overall, the Department of Mental Health anticipates the two-year plan will have an overall reduction of 300 full-time state mental health employee jobs through the downsizing process. But far fewer employees will lose their jobs.

"Job reductions will be modest," the report to employees states "due to moving patients from Fulton State Hospital to St. Louis and Farmington. Attrition and transfer to other state positions will be used to avoid as many layoffs as possible. A majority of the full-time job reductions will occur at the Fulton State Hospital during the two-year conversion period, but full-time jobs at the Fulton State Hospital will gradually return to current levels over the next 10 years as the Sexual Offender Rehabilitation Treatment Services (SORTS) satellite program expands."

The statement to employees also notes the state has been trying to end or transfer to private agencies all acute psychiatric inpatient care now provided at Hearnes and Guhleman units "because federal regulations prohibit Medicaid reimbursement to state psychiatric hospitals for otherwise eligible persons between the ages of 22 through 64. Private community hospitals that provide both medical and behavior inpatient services are not subject to these limitations. To partially address the loss of state-operated acute inpatient beds, the Department of Mental Health will request (spending) up to $5 million of the savings for community-based crisis services in the two affected areas."

02-17-2012, 01:56 PM
Alabama Plans to Close Most Hospitals for Mentally Ill


ATLANTA — Alabama will shut down most of its mental health (http://topics.nytimes.com/topics/news/health/diseasesconditionsandhealthtopics/mentalhealthanddisorders/index.html?inline=nyt-classifier) hospitals by the spring of 2013 in a sweeping plan to cut costs and change how the state’s psychiatric patients receive treatment, state officials announced on Wednesday.

The decision to close four hospitals and lay off 948 employees is a bleak reminder of Alabama’s shrinking budget. But it is also the latest example in a longstanding national effort among states to relocate mentally ill patients from government hospitals to small group homes and private hospitals.

Mental health advocates believe patients often get better care in smaller, less isolating facilities. Since the 1990s, Alabama has closed 10 other mental health treatment centers.

“What’s unusual is how many hospitals in Alabama are being closed so fast,” said Bob Carolla, a spokesman for the National Alliance on Mental Illness (http://www.nami.org/). “The trend has been to downsize much more gradually.”

By May 2013, the state plans to have two remaining state mental health hospitals, one for criminal suspects and another for geriatric patients. Nearly all of the 524 other mentally ill patients will get treatment at group homes and community centers, which are less expensive and give them more freedom, state officials say.

The announcement, by the Alabama Department of Mental Health, was made against a dire financial backdrop. Since 2009, the state has reduced financing for mental health services by 36 percent, the second-highest rate in the country. And next year, the Legislature says, the budget for those services could be cut an additional 25 percent, or $29 million.

“Given that we are facing potentially a $29 million decrease in our budget, we have to be able to come up with that money,” said David Jackson, the department’s chief operating officer.

Mental health advocates were torn. While many have criticized state-run hospitals as isolating patients and stigmatizing mental illness, they worry about the state’s having group homes to accommodate the closings.

“In general, we think it’s a good thing, considering the budget,” said Robert Hermes, the executive director of Wings Across Alabama (http://www.wingsalabama.org/), an advocacy group. “The hospital tends to be an alienating environment. You often get warehoused and institutionalized. But we need to make sure there are enough community centers for these patients.”

07-30-2013, 10:49 PM
Nixon cites Mo. hospital in defending tax cut veto

Associated Press
Tuesday, July 30, 2013


FULTON, Mo. (AP) — Missouri Gov. Jay Nixon defended his veto of tax-cutting legislation Tuesday while touring the state mental health hospital and asserting lawmakers cannot simultaneously support a veto override and investments for the facility.

Nixon said the Fulton State Hospital needs to be improved for the safety of staff and health of patients and that it cannot be done if the tax cut is enacted. The governor announced in late June the freezing of $400 million for state services, education and construction because of concerns the veto could be overridden. The spending restrictions include $13 million for planning and designing a new facility at the hospital.

“This is an old, antiquated rambling campus that is both unsafe and unfitting to the responsibilities that are carried on here,” Nixon said.

The legislation would reduce tax rates for individuals and corporations and create a new deduction for business income reported on individual tax returns. Legislative projections estimated the bill would reduce state revenues by more than $700 million annually after it is fully implemented. Some of the tax cuts are contingent upon growth in state revenues.

Nixon says the annual cost would be higher and as much as $1.2 billion in the short term, based upon other provisions in the legislation.

The tax cut was a priority for the Republican-led Legislature and would be the first income tax rate reduction in Missouri since 1921.

Supporters of the cut have started a campaign encouraging lawmakers to override Nixon’s veto. Ray McCarty, president and CEO of Associated Industries of Missouri, said the governor has over-estimated the cost.

“The threats and the withholdings and all of that that is being employed right now, is really a game of smoke and mirrors,” he said, adding that doing nothing would likely prompt Missouri businesses to move elsewhere.

Missouri lawmakers return to the Capitol in September to consider veto overrides, which require a two-thirds majority vote. That would require the vote of every House Republican or support from some of Nixon’s fellow Democrats.

The Fulton State Hospital is the only maximum and intermediate security psychiatric hospital in Missouri. Patients include those who have been committed by the courts for evaluation and treatment. It also is the statewide treatment facility for people who have been found not guilty or unable to stand trial because of mental disease. There are more than three dozen buildings on the grounds, including several that are vacant.


08-28-2013, 10:53 PM
In-depth: Inside of the deteriorating Fulton State Hospital

by Collin Reischman, Managing Editor
August 26, 2013



FULTON, Mo. — There is a corkboard in one of the buildings at Fulton State Hospital, the state’s largest in-patient psychiatric facility. On the corkboard, patients have posted their goals of what they’d like to accomplish during their recovery.

“I want to go home, rent a restaurant and get rich,” one of them reads. It’s posted in the Guhleman building, an intermediate security facility where patients are sent once they’ve recovered enough to leave the larger, maximum security Biggs Forensic Center.

Most of Biggs was built in 1937, and as Chief Operating Officer Marty Martin-Forman points out, it is no longer an environment conducive to recovery from a mental illness.

FSH represents perhaps a confluence of three major policy issues for the state of Missouri and its lawmakers: a nearly $1 billion bonding issue — struggling to move through an increasingly-conservative legislature and stalling in the Senate in the final days of the 2013 session — fluctuating budgets for the Department of Mental Health and the lackluster level of Missouri state employee pay. All of these issues converge in Fulton, where the hospital doors first opened in 1851.

One of the several abandoned buildings on the campus of the Fulton State Hospitals.
(Photo by Collin Reischman)

‘I want to get out of this hospital’

It’s hard not to think of the Biggs Forensic Center as a prison from the inside. A huge bank of screens monitors dozens and dozens of cameras across the building and heavy, automatic sliding doors clang loudly as visitors are screened, searched and allowed in with security escorts. Bars and screens are on the windows and a 20-foot, two-layer fence topped with razor wire runs the entire exterior of Biggs. But FSH is not a prison. It is a treatment facility where individuals accused of criminal behavior but adjudicated mentally ill are sent.

“Can you imagine trying to get better, trying to improve and be treated for a mental illness, in a place like this?” Martin-Forman asks during a tour The Missouri Times participated in.

Martin-Forman might have been referring to the low ceilings, which measure at less than seven feet and are commonly ripped down by irate patients. She might have been referring to the hallways, which are so narrow that, with a pen in each hand, one could sign their own name on both walls at the same time.

She might have been referring to the intake area, where Missourians incarcerated in prisons that are pleading not guilty by reason of mental illness or defect are initially brought in. Here, orange jumpsuit and all, new arrivals sit in an open hallway with current patients passing by and describe their crime, their illness and their symptoms, all while staff and patients look on, unhindered.

“It’s just inhumane that this is how we treat these people,” Tammy Smiley, who runs one of the four wards in Biggs, said. “There is no privacy. These are clients, not prisoners, they are patients who need care, and this is not an environment that will encourage them to be honest and open with us and we need that to help them.”

Smiley also mentioned another frightening trend. According to her, it’s not uncommon for someone in the facility to be determined competent enough to stand trial, most in the state are sent to FSH to make that determination in the first place. But sometimes, as the result of slow processes or judge’s orders, competent, non-mentally ill individuals end up staying at FSH until their trial, sometimes for months at a time, leaving perfectly mentally healthy individuals in the constant company of those with sometimes severe mental illnesses and a history of criminal behavior.

“Now imagine you’re waiting to stand trial and adjudicated mentally sound,” Smiley said. “Most of these people have nothing to lose at this point, and it is not uncommon for that individual to then attack a staffer or a patient, out of both frustration and out of a desire to be re-examined and found mentally incompetent. That alone poses a huge risk to our staff and our patients and it is very common.”

In Biggs, the antiquated building was designed before basic innovations in psychiatric care came to light. The hallways are long and not centrally located near nurses stations, meaning more staff are needed to monitor patients, and the long, ominous hallways make staff tense, as attacks are not uncommon and response time, because of the building’s ancient layout, is not always swift.

“Walk to the end of the hallway and back,” Martin-Forman challenged. “Try it and tell me it doesn’t scare you a little.”

It does.

Smiley discusses attacks on patients and nurses, and how the layout of the building makes safety harder. While she does, a man at the end of the hallways does jumping jacks without stopping and another talks animatedly into the payphone. A third is pacing, ancient headphones wrapped around his head plugged into an even older Walkman.

They’re all crammed into a small day room and on bad days, or when new staff arrives, or new patients come in, the tension in the room is palpable. As for the hallways, a man is permanently stationed there with a large, black leather pad on his arm. This hall monitor is there to break up fights and eye the bathroom, which, unless you’re standing next to it, is completely hidden from the staff.

By 2009, Fulton State Hospital represented almost half of all state-employee workers compensation claims in Missouri. Martin-Forman says this statistic is largely the byproduct of a facility that is nearing a “breaking point.”

“There’s a new, modern state mental health facility in Oklahoma I recently toured and in one year alone, they cut their injuries and violent incidents in half, just by way of designing a building that is more conducive to our mission,” Martin-Forman said.

The security entrance — including a metal detector — at the Biggs building.
(Photos by Collin Reischman)

Conditions are frightening, according to Ron Lapp. Lapp is an electrician for maintenance and facilities at FSH and president of the local chapter of the American Federation of State, County and Municipal Employees (AFSCME) Council 1324.

“Right now, all of our maintenance is to keep up with our accreditation as a facility, not making significant improvements,” Lapp said. “You’ve got buildings ranging from the mid-1800s to the 1960s and on here, and it complicates the process greatly because each building is totally different.”

Lapp said the age of the buildings meant significant resources were spent on basic improvements to existing facilities, which prevents major changes in “brick-and-mortar.” It doesn’t help that Missouri state employees make the lowest average salary of any state in the nation, Lapp said. In fact, it’s a major hindrance to recruiting and retaining quality staff.

“We’ve been tagged as the most dangerous place to work in the state,” Lapp said. “And with our extremely low salaries, we have a lot of turnaround.”

In fact, wages are so low that a typical man working full time at FSH with a family of four makes under the federal poverty level, meaning that if state workers were eligible for Medicaid (they aren’t, because of their state-provided healthcare), Fulton employees would likely be in the program. This same man’s children are eligible for free and reduced school lunches, because of his wages.

One of the patient goals posted on the corkboard in Guhleman perhaps sums it up the best:

“I want to get out of this hospital.”

Fighting for funds

The Department of Mental Health as well as the FSH staff and administration know there is only one solution: major funding. Biggs is beyond repair and new designs are needed for a new facility. Even the basic design itself is severely fraud.

Lapp indicated the ‘T’ shapes formed by the Biggs building in several places cause blind spots for cameras and generally result long hallways and narrow, sharp corners — a major no-no in modern designs for mental health facilities — which put patients and staff at risk. These are walls that “can’t be moved,” Lapp said. Thought and practices relating to mental illness from 1937 are far more rudimentary than today, he said, and modern buildings can be designed that are much more conducive to the environment.

Recently, $13 million was allocated in the state budget to draw up plans for a new, modern design for a maximum-security facility in Fulton, which could house both Biggs and Guhleman patients beneath one roof. However, the $13 million was part of a more than $400 million budget freeze imposed by Gov. Jay Nixon in response to House Bill 253.

Nixon — who campaigned against the tax cut in HB 253 for most of the summer — said in a statement after touring FSH last month that if his veto was overridden, the $13 million allocated for FSH planning would not be released, effectively pitting HB 253 against the fate of a massive bond proposal that will likely come back before the legislature in 2014. The measure contained $211 million for improvements at Fulton, largely related to building a new primary facility to replace Biggs and Guhleman.

And these plans represent just a potential first step.

Administrators at FSH say blueprints will take approximately 18 months to finalize and once that is done, they still need to allocate more than $200 million to build the facility.

Rep. Jeanie Riddle, a Republican who represents Fulton, said she relies on budgetary experts to find that money, but also strongly backed the bonding measure as the “most logical way,” to get the funds together quickly.

“This is a human issue, that’s what I try so hard to communicate with people,” Riddle said. “It’s a human rights issue. Not just the human rights of these Missourians under the care of the state, but also the human rights of the employees working here who risk so much and who, when they get injured, have their entire lives changed because of that.”

Riddle has had trouble getting everything Fulton needs. The politics of HB 253, she said, have slowed down the process. Nixon and his fellow Democrats have long argued that the bill will result in less money for state services, including mental health.

She says she was disappointed that Nixon announced a withholding of FSH planning funds, and that politics is drowning out policy.

And yet if Nixon’s veto is sustained, the battle is far from won.

The massive bonding proposal, which received huge support from both sides of the aisle in the House and is backed by House Speaker Tim Jones, would be one of the state’s largest, and is sharply opposed by more conservative members of the Senate.

Sen. Brad Lager, R-Nodaway County, a longtime opponent of large bonding measures, doesn’t believe the state should borrow money to make improvements like those called for at Fulton. He favors an incremental approach, funding such projects as the state finds the money to do so.

But Riddle and Martin-Forman both say there is no time to wait.

The dietary building, where all of the food is prepared for the facility’s 350-plus patients, is in major disrepair.

“It’s falling down around our ears, we have maybe two or three years before we really don’t have a choice anymore,” Martin-Forman said.

Temperatures reach and stay constistently at about 90 degrees
in the main dishwashing areas, which are pictured at the bottom.
Additionally, the gymnasium door — located above the kitchen — which cannot
be accessed because of asbestos that is too expensive to remove and
elevators that cannot be fixed because the equipment is far too outdated.
(Photos by Collin Reischman)

The building has no air conditioning or heating. In the dishwasher room, temperatures hold steady at around 90 degrees all day. The kitchen’s themselves are littered with ancient equipment, including a mixer and an oven, which both come from a decommissioned battleship from the Korean War.

Sandy Dreyer, Director of Dietary Services, said much of the equipment, like the mixers and ovens, were so old that repairs were no longer possible. One of the ovens, an older model, broke down several years ago but continues to take up space, because the cost to remove it has never been met.

Above the kitchen is the gymnasium. You can’t get there by elevator because all the elevators in the building were permanently put offline a few years ago as a result of repairs becoming impossible on the ancient equipment.

There is no access to the gymnasium because of the discovery of asbestos, but the cost of removal is too high. Under these conditions, Dreyer and her staff prepare meals approved by physicians and sometimes meeting very specific dietary needs.

Like much of FSH, the space is too large. Since some of its buildings originally opened doors in the mid 1800s, FSH’s patient size has grown and shrunk, peaking at around 2,400 and now hovering consistently at around 350. Much of this was the result of deinstitutionalization, which swept the nation in the 1960s and 1970s.

But the extra space is energy inefficient, time inefficient and staff inefficient, administrators say. FSH doesn’t need all the land it has, and abandoned buildings are common on the grounds, which contains about 70 buildings in total.

Budget cuts, payroll woes

What it would cost to properly repair FSH is unknown. Riddle and Martin-Forman will tell you that $211 million would get a new building for psychiatric patients and lower costs. But that number doesn’t account for improvements to the dietary building, asbestos removal, improvements to other buildings not in need of total replacement or the demolition of the dilapidated buildings sitting empty on the grounds.

That $211 million wouldn’t add a dime to the salaries of state employees, whose turnaround at FSH is “unbelievable,” according to Smiley. It wouldn’t cover the ever-worrisome costs of ballooning workers compensation claims and it would do little for the resources of the Department of Mental Health overall.

Lapp says employees don’t come to FSH to get a job they can retire at anymore, and training new employees is costly.

Riddle says not only continued improvements to training, but better benefits and compensation are needed to attract better staff, and both agree higher salaries would ultimately keep personnel around longer.

And then there are concerns about other Departmental functions, resources, and training.

Will the Department of Mental Health — which has seen budgets fluctuate wildly in the last decade with only a recent resurgence of support for an increase — be able to properly manage a newer facility?

Nixon, in his State of the State address, called for $10 million more for the Department of Mental Health for the coming year and the legislature granted the increase. But the unity between parties on budget priorities, and the consideration of mental health as a priority itself, is a relatively new trend. At FSH alone, budget cuts in the 10 years since Lapp’s arrival permanently halved the maintenance staff for the facility.

Administrators and staff seem to agree that FSH is doing its best to accomplish its mission, but doesn’t work as well as it could to help people recover, and money is needed in all areas: for capital improvements, for the state workers risking their livelihoods there, for the Department of Mental Health to implement better practices.

And while support in the House for FSH repairs is huge, the human need is sometimes forgotten, according to Riddle.

“Everyone here, whether staff or patient, has human rights,” Riddle said. “And if we can’t care for our ill Missourians and protect those rights, then we really have to examine how we are doing things. The situation here is dire and we need fixes now.”

Another one of the several abandoned buildings on the campus of the Fulton State Hospitals.
(Photo by Collin Reischman)

A human problem and a “logistical nightmare”

Ideal treatments would mean patients would stay for shorter periods as they recover and have more chances, while in treatment, to develop skills for the outside world. In the recreation room at Biggs — the only recreation room in the facility — a single washer and dryer are present where patients can learn the basics of doing their own laundry.

On the long, uniform tables in the room, thousands of white straps sit in piles. Here, patients make straps for masks related to construction and maintenance for the 3M Company. They are paid based on their work levels, which Martin-Forman called “amazing.”

“We have some patients who are still very ill, and who may still have a lot going on in their heads,” Martin-Forman said, “But, a simple task like this one actually improves their mood, they have a sense of accomplishment and pride because they did something. This program has worked wonders. It’s one of the ones we’ve kept for a long time because of the response we get from patients.”

But even here in the “rec” room, where Martin-Forman says recovery can begin, the room is aching for improvements. The air-conditioning system has been rigged in recent years because the room once didn’t have it. Fans are mounted on the walls, and in the back of the room behind a mesh cage, boxes are piled to the ceiling, because there simply isn’t room for storage.

Not far away, the cafeteria doesn’t fair much better. All the 180+ patients inside Biggs cannot eat at once, because the room is too small. There are shifts and on some days, lunch can take up to three hours from beginning to end.

When food is often directly tied to medication, and patient stability relies largely on routine and normality, a single patient can delay lunch for most of the others in the building, leading to fights and other incidents that ultimately put staff in danger.

“Imagine you’re ill, you’re waiting for lunch at 12:15 and someone ahead of you in line causes an issue that slows it down,” Smiley said. “Now, it’s 12:45, you’re hungry. You’re hot standing in line and you can’t eat because someone else is slowing the process down, and you’re in line with other patients struggling with their own illness. That situation can escalate and become very difficult to manage very, very quickly. It’s a logistical nightmare just to feed people.”

Administrators are quick to point out that they don’t control “the front door, or the back door” to FSH. Meaning it’s not up to anyone at FSH who is transferred into the facility’s care, or when someone gets to leave. As a hospital for the mentally ill, as well as serving as part of the Sex Offender Rehabilitation and Treatment Service and caring for a small number of the developmentally disabled, Fulton administrators will always have a patient list.

“They don’t go away,” Martin-Forman said. “We could do nothing about this place and let it all fall down, but these people, they aren’t going away. We’ll always have a need for a facility like this. We might be coming to our time here. This population will always be here. Let’s not forget that most of these patients are Missourians. They are ill and they have some basic human rights. We have to serve them.”

11-01-2013, 11:00 PM
Man attempts suicide in court

By Marshall White St. Joseph News-Press
Posted: Thursday, October 31, 2013 10:34 am | Updated: 11:12 am, Fri Nov 1, 2013.


A Buchanan County courtroom witnessed a disturbing disruption Thursday when a jail inmate slashed his wrist and said he wanted to die.

Court marshals already had an eye on Richard Brittain, 59, when they picked him up at the jail. A scruffy-looking Mr. Brittain refused tennis shoes, socks and a coat before being brought to the courthouse for arraignment on a charge of stealing. Wearing only his jail uniform and flip-flops, he shuffled across Faraon Street in the drizzle to be arraigned in front of Circuit Judge Daniel Kellogg.

Mr. Brittain was scheduled for an 8:30 a.m. appearance. While sitting in the jury box, after his handcuffs were removed, he started rocking in the chair, moving his hands back and forth in his lap and mumbling.

Court Marshal Ron Fisher, who was about eight feet away, told the man to calm down. Then a probation officer sitting nearby said the defendant was bleeding.

Mr. Brittain started shouting that he wanted to die and continued slashing at his wrists, drawing blood. He appeared to be using a piece of metal. Court marshals later found two small pieces of metal the defendant had hid.

Mr. Kellogg quietly moved the five or six inmates sitting at the other end of the jury box out of the courtroom.

Mr. Fisher, moving closer to the man, repeatedly told Mr. Brittain to “stop it.” He reached out to grab a hand but Mr. Brittain shook and twisted away.

“Stop it. If you don’t, I’m going to Tase you,” Mr. Fisher warned.

Mr. Brittain remained focused on continuing to slash his raw and bloodied wrists.

Mr. Fisher fired his Taser, at Mr. Brittain, causing him to collapse.

Mr. Fisher kept his eye on the inmate while using his radio to call for backup. Attorneys, court staff and about 20 people sitting in the courtroom watched as the drama unfolded.

Two more court marshals arrived and Mr. Brittain was handcuffed and taken away.

Mr. Kellogg asked for someone to call maintenance and wipe down the chairs. A county maintenance employee showed up, dressed as a clown, and began to wipe down the chairs.

“It just kinda fits into Halloween morning,” Mr. Kellogg said with a laugh.

The tension in the courtroom evaporated. The judge called the next name, and it was Mr. Brittain’s. The arraignment will be rescheduled.

Marshall White can be reached at marshall.white@newspressnow.com. Follow him on Twitter: @SJNPWhite

jewplin Glob
02-07-2014, 11:46 PM
Keith Schafer, guest columnist: Fulton Hospital is state’s moral responsibility

By Keith Schafer, Director of the Missouri Department of Mental Health (http://www.sos.mo.gov/BlueBook/2011-2012/6_MentalHealth.pdf)
Special to The Globe
February 5, 2014


— Fulton State Hospital, built in 1851, is the oldest state psychiatric hospital west of the Mississippi River. For the past 163 years, Fulton Hospital has treated patients with serious mental illness who pose a threat to themselves and our communities.

In the past five years, the facility has taken in over 1,000 admissions from 99 Missouri counties and the City of St. Louis. The staff at Fulton Hospital provides care for these patients and in turn keeps the rest of us safe.

As Missourians, we have a moral responsibility to these patients and their caregivers to provide the best possible environment — one that is safe, secure and conducive to healing

But today, the patient wards are old, deteriorating, dark and cramped with low ceilings and concrete cinderblock walls, ceiling and floors. They are exceedingly noisy, which creates significant problems for people with serious mental illness. This creates a dangerous environment for patients and staff. Support services buildings on campus are also a major problem. For example, the kitchen uses equipment left over from the Korean War.

It’s time to build a new Fulton Hospital to meet our moral obligation to the staff and patients within its walls and to ensure the safety of communities across our state.

The Missouri Department of Mental Health has done everything it can to move less dangerous patients to other state psychiatric hospitals and maximize existing space on the Fulton campus to house patients. But we have run out of options, and we are running out of time. We need a new Fulton Hospital, and we can’t afford to wait.

I strongly believe that a new high security facility is a critical investment for improving patient care for people with serious mental illness; for reducing serious employee injuries and turnover of our employees; for creating major economic opportunities for the region; and ultimately, for better protection and safety of all Missourians.

Keith Schafer is the director of the Missouri Department of Mental Health.

06-24-2016, 10:45 PM
Fulton State Hospital makes progress with reconstruction

Thursday, June 23, 2016 2:04:00 PM CDT in News
By: Meg Hilling, KOMU 8 News Reporter


FULTON - Phase one of Fulton State Hospital's massive reconstruction project is officially complete.

The hospital's new Energy Control Center and Services Building opened it's doors to the media during Governor Nixon's tour of the facilities Monday morning.

The new building comes as part of a $211 million project to scrap and rebuild the oldest state psychiatric hospital west of the Mississippi.

Designed to house 300 patients, CEO of the hospital Bob Reitz said be able to see progress made has been very rewarding.

"Actually seeing this going from a discussion to architectural plans, to fruition we actually have a building in which to work has been tremendous," Reitz said.

The new facility houses the kitchen services, workshops, and security center for the hospital.

Using biometrics, motion detectors, and various other security measures, the building aims to keep both the intermediate to maximum security level patients and the surrounding community safe.

According to Reitz, one of the major construction objectives of the new facility was creative an working environment that attracted staff.

"People are going to work in an environment that feels modern, people are going to work in an environment that feels safe. People are going to work in an environment were they kind of want to come to work everyday. And I think that, more than anything else, is probably the biggest thing we are looking forward to," Reitz said.

Phase two of the mass project, which consists of the construction of the residential spaces and administration offices is already underway.

Construction is expected to be complete by Fall 2018.

jewplin Glob
08-18-2016, 10:47 PM
Defendant unfit to stand trial in bow shooting
Man committed to Missouri Department of Mental Health for life

BY JEFF LEHR, jlehr@joplinglobe.com
Page 5A August 10, 2016


MOUNT VERNON, Mo. — A Lawrence County judge has ruled a defendant accused of shooting another man in the stomach with a bow and arrow permanently incompetent to stand trial.

Circuit Judge Jack Goodman ordered Dwight L. Simpson, 60, committed to the Missouri Department of Mental Health for the remainder of his life at a hearing Monday in Lawrence County Circuit Court.

The judge ordered Simpson committed to the department in December until deemed fit to stand trial on charges of first-degree assault, armed criminal action and unlawful use of a weapon.

On Monday, the judge granted a motion that was filed by the state attorney general’s office in July seeking to have the commitment made permanent.

Simpson was accused of shooting Joseph Comer in the stomach with a bow and arrow Nov. 12, 2012, at the Blue Bird Motel in Aurora.

Police and emergency medical responders found Comer lying on a sidewalk outside one of the motel rooms with a broken arrow protruding from his stomach and Simpson sitting in a room with a knife in his hands.

Police arrested Simpson, and Comer was flown to a Springfield hospital where he underwent surgery.

According to a probable-cause affidavit, Simpson told police that he had consumed three 30-packs of beer over a two-day period that culminated in a dispute with Comer.

He said he was upset with Comer because he had been “bumming” beer off him while he was drinking with a woman friend. He said he had asked Comer to leave several times but that he refused to go. Simpson told police that he pulled out his bow and arrow and pointed the weapon at Comer, who scoffed at him and told him that he “didn’t have the nerve” to actually shoot him.

According to the affidavit, Simpson admitted that he then shot Comer and tried to pull the arrow out because he wanted it back “so he could kill a deer.”

Another motel guest reported seeing Comer on the sidewalk and Simpson standing over him with a piece of an arrow in his hand.