The state’s psychiatric hospital in Pueblo, while it strives to meet mandates to release more of the “criminally insane” in its custody, also faces a wave of escapes and questions about its security standards.
Six patients have escaped from the Colorado Mental Health Institute over the past seven months, two of whom remain at large.
At least one state legislator is calling for a review of the hospital’s operations in light of a legal settlement requiring quicker release of its patients, some of whom have committed killings and other violent acts but have been deemed not guilty by reason of insanity.
Others say the hospital isn’t moving fast enough to release those no longer deemed insane because they’ve completed their treatment plan.
In Colorado, as in most states, people who commit crimes – even murders – while unable to differentiate right from wrong can be found not guilty by reason of insanity.
And the Colorado Mental Health Institute, where many of these defendants are sent, is geared toward healing rather than punishing the state’s most dangerous criminally insane patients. The ultimate goal is to send them home as quickly as possible while keeping the community safe.
Patient freedom carries risks
That approach explains why Douglas Comiskey, 30, lives in a cottage with the freedom to walk the hospital’s unfenced grounds and hold a job in Pueblo, 11 years after he fatally slashed two elderly Catholic priests. Had he been convicted of murder, he could have expected execution or life in prison.
Comiskey has been a model patient and medication has silenced the “voices” that once warned him to kill, authorities say.
The hospital’s healing mission also explains why Tyrone Jones was permitted to walk unshackled across the grassy hospital campus just 18 months after his first escape and after amassing dozens of write-ups for violence, drug use and alleged sexual assaults at the hospital.
When Jones bolted eight days ago, two unarmed employees had to stay with two other patients, so they called security but didn’t give chase.
Critics argue that the hospital takes too many safety risks while trying to rehabilitate patients. In Jones’ case, his mother and two patients who are friends of Jones’ say the hospital overlooked behaviors that experts consider possible precursors to escape.
In the past several decades, people who escaped from the hospital have raped and killed. William Mathews fled the hospital four times before he ran away a fifth time in 1998 and kidnapped and strangled Wanda Pitts, 18, in Shenandoah, Texas. And Edward Benge killed a Colorado Springs man in 1990 when he lit a bar on fire.
Since 2004, 16 patients have fled the hospital, according to hospital reports. Since 1990, 66 patients have escaped, including 11 who had killed before being sent to Pueblo.
John Ramos, a head of ward security at the hospital who retired in July after more than 25 years, believes the recent rash of escapes is partly the result of a lawsuit settlement that mandates speedy release of patients before they’re ready for lower security levels.
The 1999 federal class-action lawsuit on behalf of criminally committed patients sought sweeping changes at the institute and the release of dozens of patients “warehoused” there.
The hospital settled the lawsuit in 2002, agreeing to cap the average daily population at its forensic unit at 278.
It also promised to keep the ratio of direct-care staff members to patients at 1.35 to 1. That’s higher than previous staffing levels. Previously that ratio had been as poor as 0.9 to 1.
The hospital also agreed to stop using about 20 medium- and maximum- security beds, and shifted personnel to lower security areas.
Kathleen Mullen, an attorney for the plaintiffs in that lawsuit, said a renewed settlement was negotiated between the parties in 2004, requiring the institute to release a certain number of patients in a set time frame. Exact terms of that settlement were not readily available last week.
Mullen said she sought specific targets because the institute was not moving quickly enough to meet recognized treatment standards.
She said the negotiated release targets were reasonable and she doesn’t think they forced the hospital to push patients toward lower levels of security before they were ready.
“I really, honestly don’t think they were moving people too quickly,” she said.
Security levels stepped down
But according to Ramos, the hospital administration responded to the lawsuit by changing the levels of security of whole wards, first from a locked-down maximum-security level to medium security.
When a lead psychiatrist at the hospital complained that even more freedoms were justified, patients were shifted to an even lower level of security, which allowed them to walk on the grounds of the hospital, Ramos said.
The settlement, said Ramos, mostly benefited those who weren’t mentally ill and had faked their way into the hospital, he said. Jones, Benge and two other patients whose medical records indicate they fit that category have escaped since the lawsuit.
“The antisocial personalities, they benefited from the lawsuit, whereas the truly mentally ill that were really sick and suffering from chronic schizophrenia, they did not benefit,” Ramos said.
He said antisocials in many cases have been released before they were ready.
“They still had a lot of criminal behavior in them and criminal thoughts and action,” Ramos said. “They were able to express themselves and say, ‘I jumped through all the hoops and hurdles, and I’m ready to go to the next level.’ It was manipulation.”
Hospital chief defends actions
Hospital Superintendent John DeQuardo, interviewed Friday, denied that the settlement has put undue pressure to advance patients faster than they are ready. He said hospital staff are more careful than ever in deciding who is prepared to safely leave the hospital.
“It changed the hospital’s crime and-punishment orientation to a treatment-oriented hospital,” DeQuardo said, adding that six escapes in seven months is probably not statistically telling.
Meanwhile, Mullen, the attorney for the lawsuit plaintiffs, said the institute has met the settlement requirements, but too many defendants still languish at the hospital.
“The problem … at the hospital for years and years and still is, to some extent, is that people stay there for a long time,” Mullen said. “There are still many … people there who have been there for 10 years or more.”
State Rep. Buffie McFadyen, D-Pueblo West, whose district is near the hospital, said that the legislature should “make sure whether how we reacted to the lawsuit is appropriate for the public safety of the state.”
DeQuardo said he would welcome a state review because he is convinced it would substantiate the positive changes the hospital has made.
Mullen said she thinks one reason some patients escape is that they lose hope. “What happens is people give up because they’re not seeing the light of day,” she said.
Signs that Jones, who escaped for four months in 2005, would escape again were abundant, his mother said.
She said he began at an early age to get in trouble with the law. From his preteen years to the present, he has been in jail, prison or the state hospital nearly the entire time.
“They were playing mind game after mind game,” Sadie Jones said. “He couldn’t take that anymore.”
Jones started missing group- therapy sessions and the staff began giving him antidepressants, said patient Gary Hilton, whom Jones described as his best friend in a letter to DeQuardo before his escape.
“He was getting into arguments with staff,” Hilton said in a phone call from the same ward where Jones had been housed before his escape.
Nevertheless, Hilton said Jones received on-grounds supervised privileges two months ago.
He said Jones has called him since his escape: “He said he’d much rather be dead than spend another day in this hospital.”
Staff writer Kirk Mitchell can be reached at 303-954-1206 or kmitchell@denverpost.com.
