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Posted by Chris Liebenthal on May 10, 2010

From Milwaukee County First:


That is the word that the Milwaukee Journal Sentinel quotes County Board Supervisors and mental health advocates having used to describe Behavioral Health Division Director John Chianelli’s excuses for how a female patient at BHD was allowed to be repeatedly sexually assaulted and impregnated.

From the article:

Milwaukee County’s top mental health administrator intentionally houses female patients with men known to be dangerous “because the presence of women reduces the likelihood of the men being violent,” according to a county supervisor’s letter obtained by the Journal Sentinel.

John Chianelli, administrator of the county’s Behavioral Health Division, told county supervisors during a closed-door session last month that segregating men and women would result in more violence.

“It’s a trade-off,” he said. “Putting 24 aggressive male patients into a male-only unit would increase the level of violence in the unit.”

These comments were made in a closed session in which members of the County Board questioned Chianelli regarding the reports of repeated sexual assaults being allowed to happen.

The Board apparently thinks that the main reason for these sexual assaults are simply because patients are in co-ed units.  Chianelli is feeding into these perceptions by trying to say that sexual assaults of female patients is an acceptable trade off for a higher level of physical aggressions if they were housed in an single-gender unit.

They are both wrong.

Chianelli is obviously wrong in stating that sexual assaults is somehow more acceptable than having pure physical aggressions.  First of all, sexual assault is a form of physical violence, one that is much worse than just getting punched or kicked.  But in a mental health facility, neither form of violence should be found acceptable.

The Board is wrong if they think that the units have to be segregated to prevent sexual assault.  All that would happen is you would have more physical assaults as well as more same-gender sexual assaults.

The problem at BHD was laid out for all to see years ago.  In another article from the Milwaukee Journal Sentinel, it was reported that there was a 50% jump in attacks on staff.  The problem was clearly identified:

Reasons given for the violence upsurge include sicker patients admitted for shorter stays, and mixing of patients whose needs vary widely. That means more one-on-one staffing for unstable patients, creating staff shortages elsewhere, county officials said.

The stressed environment at the complex has also led to increases in overtime and the amount of family leave some staffers are taking to recoup, they said.


So far, the county has agreed to hire an additional five nurse managers, 25 nurse assistants and five registered nurses, though few have been hired yet. Even with that extra help, the complex remains dangerously understaffed, according to the nurses union.

The union also is pushing for the hiring of another 20 nurses. Hill said the county probably could not afford those positions and would have difficulty recruiting that number. The jobs pay $44,100 to $64,400 a year.

Other actions advocated by the union and agreed to by the county include hiring six more private security guards for the complex, at a cost of $112,000 a year, and establishing a staff team to investigate all employee injuries.

Ever since coming into office, Walker has continuously cut services and staff at BHD, shrinking the amount of available beds and the number of people to care for the patients filling those increasingly rarer beds.

By pure triage, these fewer beds needed to go to the most severe patients, increasing the likelihood of problems occurring.  Even though the County Board approved a number of new staff to be hired, Walker did not hire as many as were approved, thus not really fixing the problem.

To add to this, Chianelli has proven himself to be a singularly ineffective leader.  Not only does he have all of the pertinent issues surrounding this case and the attempted cover-up, Chianelli was also single-handedly responsible for a $3 million shortfall at the end of 2009 which put the entire County into a precarious fiscal situation.

Sadly, the bad news does not end with what is in today’s newspaper.

I have learned that the female patient in question was not sexually assaulted by the one man, but had been sexually assaulted by a number of other patients.  Likewise, this young woman was not the only victim of the sexual predatory behaviors of the man.  In fact, I have heard that the reason he is in a state facility is because of the sexual assault of a different woman.

I have also heard some of the preliminary findings of the review being done by Disability Rights – Wisconsin, which is even more disturbing than anything previously reported.  I have not confirmed these findings yet, but expect that they will be made public soon.

I have also learned that part of another study being done has shown that BHD is getting hit with multiple (possibly in the hundreds) violations regarding the physical structure of the building.  Many of these violations are minor things, like a broken ceiling tile or a chip in a ceramic tile.  Other violations are more substantial, such as having to replace many doors.’

These violations are directly related to deferred maintenance as well as staffing shortages and furloughs.  It is reported that the remaining maintenance workers have had their furlough days suspended (at least temporarily) and that they are putting in massive amounts of overtime as they try to deal with the high number of repairs and maintenance work that needs to be done.

Again, all of these problems stem from Walker’s “money saving” schemes.  But are they really saving Milwaukee County tax payers any money?

Just from these few things listed above, any money that Walker can claim to have saved over the years is long gone.

There is the expense related to the audits, including one that County Board Chairman Lee Holloway ordered last week.  There is also all the lost work hours as staff prepares for the audits and works with the auditors.

There is the expense related to all the overtime that the maintenance workers are putting in to try to make up for the years of neglect and deferred maintenance that Walker oversaw.

There is the private law firm, charging hundreds of dollars per hour, that BHD had to hire years ago when a patient was allowed to starve to death and a second patient came close to doing the same thing.  The same law firm will now be defending against the inevitable law suits from all of the patients and their families who were harmed due to the sexual assaults that Walker and his administration allowed to occur.

There is the cost that tax payers will have to bear as the female patient’s child is placed in the care of the Bureau of Child Welfare.

And those are just the financial costs.  Even more overwhelming is when one considers the human costs involved.  The patients either came to or were brought to BHD in the expectation that they would be given a safe environment while their mental health issues are addressed.  Instead, they are victimized and mistreated.

There is also the staff that come to work in order to help their corner of the world, and don’t know if they’ll make it through the day uninjured or burnt out from not having enough staff to do the job properly.

Walker needs to take some immediate steps to resolve this issue in a responsible manner:

  • He needs to ask John Chianelli for his resignation or fire him out right.
  • Walker needs to apologize to the patients at BHD and to the community in general for allowing this situation to go on for so long.
  • Walker needs to make sure that enough staff and resources are put into BHD so that these sort of issues are minimized with the goal of eliminating them altogether.

Failure to do these things and do them immediately would indicate that Scott Walker finds the situation at BHD, including the sexual assaults of patients, as being acceptable.

And that is not acceptable.  It is deplorable.


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