Wastern State patient’s rights considered

By Bill McKelway, Media General News Service
Published: July 11, 2008

FREDERICKSBURG — A variance from state regulations that allowed a severely ill mental patient to be held in seclusion at Western State Hospital in Staunton expired almost a year ago.
At a hearing Friday before a state panel that examines human-rights violations of mental patients, a lawyer in the case said that César Augusto Chumil has been illegally confined without the required special amendments to state regulations since September.
“He is being secluded with no authority,” said Charlottesville lawyer Nathan Veldhuis.
The lapsed variance affects Chumil’s confinement at Western State and represents only a fraction of the 15-year period that Chumil has been confined alone behind a locked three-part enclosure within the hospital.
He has been under almost continuous forms of restraint and seclusion, his lawyers argue, for the past 22 years.
He has been diagnosed with multiple forms of schizophrenia, anti-social personality disorder and severe paranoia.
After hearings that took more than four hours Friday — portions of which occurred behind closed doors over the objection of patient advocates, Veldhuis and the Richmond Times-Dispatch — the State Human Rights Committee delayed until Aug. 1 any action on Chumil’s status.
In May, the Local Human Rights Committee that hears issues related to Western State found that the hospital is improperly holding him in seclusion. Chumil’s seclusion, his lawyers have argued, amounts to a form of punitive behavioral modification with no meaningful plan for easing conditions of his living situation.
The state panel is hearing appeals on various aspects of the May decision.
Veldhuis revealed Friday that a recent state inspector general’s investigation of Chumil concluded that seclusion is warranted and provides the least restrictive means of care.
James W. Stewart III, the state’s inspector general for mental health, declined to comment on his findings.
Comments Friday on the hospital’s behalf reiterated testimony earlier this year showing that Chumil has a history of assaulting fellow patients and staff at the hospital on almost a daily basis.
Dr. Jack Barber, Western State’s director, testified Friday that given the amenities Chumil receives and his continuing problems with violence, “we have created an environment for him in which his dignity is preserved.”
Veldhuis and the Charlottesville-based Legal Aid Justice Center have worked for two years to alter the terms of Chumil’s living conditions and possibly move him to a facility in Northern Virginia closer to his family.
Chumil has been allowed to leave the facility for brief visits with his family, they note, a factor that belies his danger. Experts have testified that Chumil’s behavior is likely affected by his isolation and inability to express himself clearly in English. The federal Justice Department cited Chumil’s seclusion in 1999 as an example of Western State’s excessive use of seclusion and restraint.
Chumil, 57, is believed to have been held in locked confinement and restraints longer than any modern-day, civil mental patient in Virginia.
Consumer advocates who attended the meeting Friday blasted a decision by the human-rights committee to close portions of the hearing to protect the privacy of Chumil’s medical records. Veldhuis said Chumil’s family favors a public disclosure of his case.
“The committee is not supposed to protect the system; it is supposed to speak for the consumer,” said Diane Engster of the Northern Virginia Mental Health Consumers Association.
She and Carol Ulrich, a member of a state commission examining state mental health laws, said Chumil is being unfairly portrayed by the hospital as a unique case in which his isolation is appropriate.
“It’s about isolation, seclusion and convenience,” Ulrich said.
Bill McKelway is a staff writer for the Richmond Times-Dispatch.