Mothers emerge as a force for change at Minnesota state mental hospital

It was early on a February morning, and Lynda Hansen had raced nearly 100 miles in the predawn darkness to be at her son's side at the Minnesota Security Hospital in St. Peter, just hours after he suffered a psychiatric breakdown.

But Hansen said her attempt to comfort her 34-year-old son was cut short by a hospital administrator, who claimed the parent-son meeting had "not been approved" and demanded that she leave immediately.

"To be denied the opportunity to care for your own child in his time of need was just … I don't even know how to put in words how awful that felt," said Hansen, a teaching assistant from White Bear Lake.

The incident early this year so rattled Hansen that she decided to take action, joining other parents calling for basic changes at Minnesota's largest state-run psychiatric hospital, which specializes in patients who may be dangerous or violent. Like Hansen, these parents felt locked out of the treatment process and often treated with contempt by staff at the facility, which at times seemed more like a prison than a hospital for people with serious mental illnesses.

Now Hansen and other parents have become a major voice for change at the hospital. Since forming a family advisory council nearly two years ago, they have helped instigate a series of changes, from flowers in the courtyards to enhanced therapy methods, that are designed to make the security hospital more humane and effective for its 370 patients.

What began as a small group of mothers airing their grievances has evolved into something broader and more permanent. Between 20 and 40 people attend the council's monthly meetings in St. Peter, including family and friends of patients as well as hospital administrators. Sharing a mutual concern for patients, they have become a vital part of the hospital's efforts to improve care and could become a model for the rest of the mental health system, state officials say.

This spring, for the first time, the council stepped into the political fray, joining Gov. Mark Dayton's administration and union officials in calling for a massive increase in funding for the hospital. Armed with numbers showing that the security hospital is dramatically understaffed compared to mental hospitals in other states, relatives of patients met with lawmakers and shared the stage with the state human services commissioner at an April media event calling for improvements.

"It is hugely impactful," said Carol Olson, executive director of forensic services at the Department of Human Services. "It's powerful to hear directly from a family member who has had a bad experience. People are more inclined to take action."

The idea of a parents' council, though long discussed, gained momentum after the brutal killing of a security hospital patient in January 2014. Michael F. Douglas, 41, was found bloodied and unconscious in his room after another patient had stomped on his head as many as 30 times. State investigators later described the killing as an "unacceptable failure," the result of inadequate supervision and a lack of engagement by hospital staff.

The killing galvanized parents already concerned about violence at the campus. A few of them met after a news conference in St. Paul, where the organizer, Sue Abderholden, executive director of the National Alliance on Mental Illness of Minnesota, floated the idea of a parents' council. "I said, 'Who better to advocate for patients than their parents? They have a vested interest in their loved ones getting better.' "

The idea was also born out of decades of research on the therapeutic benefits of family intervention in psychiatric care. Research has found that relatives can help reduce the severity of a mental illness and facilitate recovery by helping patients stick with treatment and manage their behaviors.

In early 2015, parents arrived at the first meeting of the group, known as the Partners in Care Advisory Council, with few expectations and a litany of concerns. They were surprised to find nearly the entire hospital administration, from the head of psychiatry to the people in charge of food and security, in attendance. There were also psychologists, nurses and nurse supervisors who had showed up to listen after their work shifts.

From the beginning, parents voiced frustration about getting even basic information about their children's mental health. They described unreturned phone calls, frequent staff changes, demands for paperwork and unconfirmed reports of assaults on patients and staff, parents said.

One mother said she was unaware her son was at the security hospital until a staff member left a voice message on her home phone, one that added ominously that the average length of stay was seven years. The caller did not leave a return number, prompting the mother to search in vain for the hospital website, which does not exist. "It was incredibly disorienting," said the mother, who declined to be identified.

"You work in a bubble, and you can forget that [patients] have families that love them and they have a history before they got here. They were people with girlfriends and boyfriends and children and worked in the community," Novak said. "And they all deserve to be treated with dignity."

The council's imprint was immediate. After family members complained about the austere surroundings, flowers were added to the courtyards and visiting rooms were repainted with warmer colors. The hospital recently rewrote the welcome packets and other documents it sends to family members, using plain language and clear directions. And for the first time, patients are allowed to communicate online with distant relatives using Skype.

Family members have also begun filming a video, in which they share their experiences of what it's like to have a loved one with a mental illness at the security hospital. The plan is to require new employees to watch the video as part of their orientation.