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Confidence in Dorothea Dix questioned as state probes murder suspect’s escape

Posted July 12, 2011, at 11:58 a.m.
Last modified July 12, 2011, at 3:33 p.m.
The Dorothea Dix Psychiatric Center in Bangor.
The Dorothea Dix Psychiatric Center in Bangor.
Linda Abernethy, superintendent of the Dorothea Dix Psychiatric Center in Bangor speaks Friday, July 8.
Linda Abernethy, superintendent of the Dorothea Dix Psychiatric Center in Bangor speaks Friday, July 8.

BANGOR, Maine — To law enforcement, William L. Hall was a murder suspect; a dangerous man who confessed to strangling an acquaintance and then throwing him to his death out a second-story window.

To the staff at Dorothea Dix Psychiatric Center, where Hall was undergoing an evaluation to determine his mental competency, he was just another patient; a young man with a profound mental illness that may have contributed to his criminal behavior.

Although that contrast exists for many suspected criminals who also have a mental health diagnosis, Hall’s escape last month from the Bangor psychiatric hospital has sparked a discussion about how communities can safely handle such individuals.

William Stokes, head of the Attorney General’s Office criminal division, said the incident casts serious doubts about Dorothea Dix’s ability to keep potentially dangerous suspects.

“We may not have confidence in Dorothea Dix going forward,” Stokes said in an interview last week. “I think we may be a little more cautious about having people go there.”

During a brief tour of the facility late last week, Dorothea Dix Superintendent Linda Abernethy said the 100-bed state-run psychiatric hospital is secure in the sense that every effort is made to ensure that patients and staff members are safe.

But Dorothea Dix is a hospital, she said, not a fortress. There are no bars on the windows or razor wire on the fences. There are no armed guards or tracking dogs. In nearly all cases, those security measures are not needed.

Hall’s escape, however, has prompted the state to take a closer look at the hospital’s policies and procedures to see if any changes need to be made. That review is ongoing but so far has not uncovered any immediate jeopardy at the hospital, Abernethy said.

Penobscot County Sheriff Glenn Ross already has said candidly that Hall never should have been housed at Dorothea Dix in the first place. He hoped the man’s escape would draw attention to what he sees as systematic deficiencies in how the state deals with “forensics patients.”

“When something bad happens, the normal reaction is to point the finger, and in this case it’s at Dorothea Dix,” Ross said late last month. “If [Hall] had stayed at Penobscot County Jail and something happened or he committed suicide, we would have been blamed.

“But finger-pointing does not fix the system. The state needs to address this.”

Abernethy said she could not comment specifically on Hall’s case or even confirm that he was a patient. Asked whether she agreed with Ross’ assertion that a patient like Hall should not be sent to Dorothea Dix, though, she said she could not disagree.

“He’s looking at the legal side, whereas I’m looking at it from a health perspective,” she said. “Sometimes, we’re treating individuals whose behaviors are informed by a really bad illness.”

—•—

Hall, 29, was first taken to Dorothea Dix on June 9, the same day police discovered Melvin Abreu, 28, dead in a driveway behind a Fourth Street apartment where Hall lived.

In an interview with police, Hall admitted that he choked Abreu with his bare hands and then tossed him out a second-story window. Witnesses confirmed the same sequence of events, according to court documents.

Once he was officially charged in Abreu’s murder, Hall was booked into Penobscot County Jail. He made an initial court appearance by videoconference from the jail but was then promptly returned to Dorothea Dix.

Sheriff Ross said the man simply needed psychiatric care that the jail could not provide.

Whether Hall was getting that care at Dorothea Dix is between his doctors and his lawyers thanks to patient confidentiality laws. But while his treatment is protected, his escape was very public and is the only reason the recent conversation is taking place.

While enjoying smoking privileges inside a fenced-in outdoor area on June 28, Hall eluded staff, climbed a fence and ran free from the psychiatric facility.

Although he was found the next day before he could harm himself or others, Ross said the situation could have ended much worse. The county sheriff, who for years has battled the state on where to house forensics patients, said it’s irresponsible to send them to a facility that is not equipped to handle them.

But housing criminal suspects at a psychiatric facility before their case is settled in court is not uncommon, Stokes said.

Depending on a patient’s diagnosis, he or she might end up in a private facility such as The Acadia Hospital in Bangor or at one of the state’s two public psychiatric facilities — Dorothea Dix and Riverview Psychiatric Center in Augusta.

In most all cases, a criminal patient is sent to Riverview, which is newer and better equipped to handle dangerous patients.

But not always.

“In [many] cases, Riverview is full,” Ross said. “When that happens, we have to keep them at the hospital or find another place for them.”

Mary Louise McEwen, superintendent at Riverview, confirmed that the 20 beds at her facility that are set aside for patients awaiting some sort of criminal trial are typically full.

McEwen, who was superintendent at Dorothea Dix for many years before transferring to Riverview, said she didn’t want to comment on the differences in security at the two state-run facilities. Many officials agree, though that Riverview is superior to Dorothea Dix when it comes to security.

After Hall was captured about 14 hours after his escape from Dorothea Dix, he was taken to Penobscot County Jail. Less than 24 hours later, jail officials said, he had been transferred to Riverview.

—•—

So why not just keep a forensics patient in jail, particularly if they are a suspected murderer with a violent past?

In some cases, that happens. Ross said when an inmate is admitted to Penobscot County Jail, he or she is evaluated by staff. If the inmate hasmental health needs, they typically can be addressed right there at the jail. Sometimes, though, the jail is not equipped to care for the inmate, Ross said.

When that happens, the inmate is taken to the emergency room atEastern Maine Medical Center for another evaluation. A crisis team at EMMC then makes the determination about what to do with the inmate, according to Ross.

That’s where facilities like Dorothea Dix come in, but there are practical and legal reasons for sending a criminal suspect there. In order for the courts to move forward with any criminal matter, a suspect needs to be competent and suspects are more likely to be restored to competency at a psychiatric hospital than at a jail.

Once a patient is admitted to Dorothea Dix, Abernethy said, her staff treats the illness. It doesn’t matter if they have been suspected of a violent crime or if they have been convicted of a violent crime. Besides, under the right circumstances, she said, a patient with no criminal history could be twice as dangerous as one suspected in a crime.

Staff at Dorothea Dix have no weapons or advanced training to subdue patients who might become violent. Employees are trained to use nonconfrontational methods to calm patients but use hands as a last resort, according to Abernethy. So, chances are, when Hall bolted from the smoking area on June 28, staff could not have stopped him even if they tried.

And even though Riverview is considered a more secure facility, Superintendent McEwen said it is still a hospital and lives by the same protocol as Dorothea Dix.

Luckily, cases of escape are rare. Sgt. Paul Edwards with the Bangor Police Department said his officers respond occasionally to cases where patients elope, or walk away without permission, from Dorothea Dix. In almost all instances, though, those calls involve patients who have been admitted voluntarily and who are not suspected of crimes like murder.

Edwards said he could not remember the last time a forensics patient has escaped from Dorothea Dix, even when it was known as the Bangor Mental Health Institute.

Even if there is never another escape from Dorothea Dix or from Riverview, Stokes said Hall’s case still needs to serve as a lesson for the state moving forward.

Abernethy said she will keep accepting forensics patients as long as the state sends them to her. If the ongoing state review determines that Dorothea Dix should no longer accept forensics patients or that changes need to be made, Abernethy said she will adjust accordingly.

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