Mental Anguish

Rescuing the mentally ill has brought millions to the Mental Health Corporation of Denver--as well as complaints of coercion, mismanagement and neglect.

Robertson admits she told that resident that if he left again, he couldn't come back--because, she explains, his return would mean he'd been evicted over another violent episode, as has happened in the past. "If he gets put out of another place for hitting somebody, he can't come back here," she says. "And if nowhere else will take him, his alternatives are [state mental-health agencies at] Fort Logan or Pueblo. And Fort Logan is out of the question; the waiting list is enormous."

In recent months the feud between the homes and MHCD has been further complicated by the arrival of the BLC Group, a change of private practitioners who've sought to offer on-site health services to Valdez residents at the invitation of the boarding home's owners. Under the Goebel arrangement, MHCD is charged with supervising the psychiatric care and medication of the clients and brokering other medical services, and the corporation didn't take kindly to BLC's effort to take over those functions.

The situation quickly devolved into a testy exchange of letters between attorneys, with MHCD ordering the interlopers to cease and desist from endangering its clients, and the BLC Group--which includes a couple of psychologists, a psychiatrist, a physician and a nurse's aide--hollering that MHCD was interfering with its clients' right to choose their own health provider. A truce was reached last month when both sides agreed that MHCD would continue to be the sole prescriber of medication at Valdez, while BLC would be allowed to offer other medical services.

"We had to work with attorneys to get a stipulation that they would stop medicating our clients," says McGuirk. "We've had to take a hard look at honoring client choice, on one hand, and not being able to allow another group to provide services when our staff has similar responsibilities."

McGuirk claims that a BLC doctor overmedicated one of the Valdez residents--a charge hotly denied by BLC psychologist M.J. Philippus, who says MHCD has failed to see that the boarding-home residents receive regular physical exams and dental care.

"These people are wrecks," Philippus grumbles. "Mental Health has never done a damn thing except give them pills."

Philippus's partner, psychologist B.L. Cordova, says the group has encountered a series of rotten teeth, bad feet and weak eyes at Valdez; many of their clients are indigent, he adds, and wary of hospitals and doctors' offices. "We've had to hustle things," he says. "We have a guy who needs teeth, and we found a dentist who was willing to forgo the exam fee."

Attorney Mullen says her own review of medical records indicates that MHCD hasn't done "sufficient followup on dental services" for its boarding-home clients. At the same time, she wonders if the folks at Valdez are in a position to give their "informed consent" to a change in their health service. Nothing in the Goebel plan addresses the notion that other health providers might want to compete with the state's contractor for the right to treat the mentally ill.

The turf war has left some Valdez residents confused about who is doing what for them--and to them. Probably no one is more frustrated than Raymond Lyle, who's battled paranoid schizophrenia for decades. Committed to the state hospital in Pueblo after an assault conviction in the 1970s, Lyle later won conditional release and has spent most of the last fifteen years quietly at Valdez. In late 1993, after another stint in Pueblo, he was again allowed to return to Valdez.

But a few weeks ago MHCD requested that the terms of his conditional release be changed. Lyle's case manager told him that she had a court order requiring him to leave Valdez.

"They said I had to move out or go back to Pueblo," says Lyle, the brother of heavyweight boxing great Ron Lyle. "They never explained their reasons. They just said they had a court order. It got me all upset."

McGuirk says the decision to move Lyle was based, at least in part, on BLC's presence at Valdez. "Our medical director is legally responsible for the care of this client in the community," he says. "If we perceive that the clinical care is inappropriate, then we're going to look at changing the circumstances."

Recently, though, Lyle's case manager told him he wouldn't have to move--at least not for now. "They tell me one thing one day, something else the next day," Lyle says. "It's kind of getting on my nerves."

Even more curious than the flip-flop was the kind of placement MHCD was requesting for Lyle; they wanted to move him to another large boarding home, Monarch Manor. Although Monarch isn't one of the four homes specifically targeted in the Goebel settlement, it's hardly an improvement over Valdez or La Bonte. Mullen says the idea of moving Goebel clients from one large home to another doesn't constitute "appropriate placement" under the plan.

Robertson says she knows of other Valdez residents who've been relocated to other boarding homes by MHCD. In one case, she says, a man came to Valdez from a homeless shelter only to be returned to the shelter. McGuirk says it's not MHCD policy to seek placements at either sort of facility, and he denies that the corporation is waging some sort of campaign to drain Valdez of all its residents.

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