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Rusk State Hospital procedures reviewed

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(TYLER PAPER) - Rusk State Hospital is reviewing policies and procedures in light of recent unauthorized departures, according to the Texas Department of State Health Services.

As of Sept. 10, there had been 23 unauthorized departures this year, meaning the number of times a patient has tried to leave or left hospital grounds, according to the department. That compares to 17 last year.

Department spokeswoman Christine Mann said the number of unauthorized departures varies each year, and every incident is unique, depending on a variety of factors and the specific patient involved.

For instance, she said, a patient can suddenly become homesick and decide to run away from staff when they step off the vehicle that's taking them to an area of the grounds.

She said a patient also may be on a fresh air break and decide to run, or there could be a persistent patient who decides to leave without authorization.

"They could be just leaving for a few minutes to go down the road to get a snack. It's still considered an unauthorized departure," Ms. Mann said.

Some of the most recent incidents occurred earlier this month.

Rusk Police Chief Jamie Campbell said both incidents involved the same patient, who simply did not want to be there.

He said the first time the patient left, he was found on Lanier Street, not even 500 feet from the hospital grounds, and was sprayed by a skunk.

Then the next morning, the patient decided to leave again, and was found by staff near the hospital gate with a fire extinguisher and hand saw, Campbell said.

Campbell said it's not uncommon for a patient to walk away, and 90 percent of the time, they won't give you trouble.

Out of this year's unauthorized departures, 57 percent of patients were forensic patients, meaning they are "determined by the court to be either incompetent to stand trial or not guilty by reason of insanity," Ms. Mann wrote in an email.

"Many forensic patients (those incompetent to stand trial) require stabilization on psychotropic medications and a general orientation about what to expect and how to behave in a court room," her email reads. "We also provide specialized classes to ensure patients can manage the legal system. This education takes place at the same time patients are stabilizing on medications. Patients who have their competency restored go back to court to stand trial."

Out of this year's unauthorized departures, 43 percent were civil commitment patients, meaning "those admitted to our state hospitals either voluntarily or involuntarily (through a probate court)," Ms. Mann said in an email.

She said that none of the unauthorized departures involved patients from the maximum security unit, which houses those who are considered "manifestly dangerous" or "have charges pending that involve serious bodily injury, attempt or viable threat."

When a patient does leave, the patient is gone anywhere from a few minutes to an hour, and the average time it takes to return a patient is about 30 minutes, "from time of departure to return to the unit," she said in an email.

Upon return, she said they are assessed for risk of future unauthorized departure and may be assigned to one-to-one monitoring until they are re-evaluated.

They could also end up being restricted to a particular unit, Ms. Mann said, and the hospital has a treatment team do a debriefing with the patient.

Ms. Mann said that earlier this month the patient, who left or tried to leave the hospital on two different occasions, is now restricted to a unit.

Additionally, she said, the hospital is reviewing policies and procedures to see if changes need to be made.

East Texas Medical Center Behavioral Health Center also assists mental health patients.

Marketing director Sandie Brazil-Hamilton said, for the most part, people will call, make an appointment and come in to be assessed, but there are some walk-ins.

However, she said, those who are assessed aren't necessarily admitted.

Ms. Brazil-Hamilton said some people might be considering suicide or need medication adjustment "to help them get in a better place," while another person might be suffering from depression and considering day treatment, meaning, they are hospitalized during the day and home at night.

She said that patients who are admitted through law enforcement/court order may not leave until it is determined that they are not a risk to themselves or others.

Overall, she said, it appears that the center has been able to help a lot of people.

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