There were 560 patients in March at Greystone, a 450-bed hospital with cottages on the grounds that can accommodate another 60 people.
PARSIPPANY -- Patients at Greystone Park Psychiatric Hospital assaulted and injured 13 fellow patients and 12 employees during the first quarter of 2017, just as the state-run facility reached its highest capacity since opening nine years ago, according to state data released on Monday.
At this rate, the state's largest public psychiatric hospital is on course to easily exceed the 66 assaults reported all of last year, and the 39 assaults recorded in 2015, according to the Department of Human Services.
The statistics appear to bolster claims from a wide array of mental health advocates that Greystone is overcrowded and unsafe.
N.J.'s largest public psychiatric hospital has fewer doctors, more patients
Patients and employees at Greystone have confided in attorneys from the state Office of the Public Defender that the atmosphere inside Greystone is "prison-like, with the most violent patients running things," said Carl Herman, the office's director of Mental Health Advocacy. "Aggressive behavior leads to being afraid and staff members unable to respond appropriately."
With the hospital CEO on an extended medical leave and replaced temporarily by a senior official within the Human Services administration, "There is a huge leadership vacuum there, which impacts on morale," Herman said.
Members of the hospital's Board of Trustees said during a July 20 meeting that they have been inundated with letters from intimidated patients and staff who are looking for help.
"What I have heard is staff are fearful and do not want to step up when there is an incident. Patients feel like there are no consequences, and staff feels like they have no backup," said Kimberly Donnenberg, the trustee board vice chairwoman.
"We are at the precipice of something bad that is about to happen," Donnenberg said.
Plans are underway to reduce overcrowding by expediting the discharge of patients medically cleared to leave, acting Human Services Commissioner Elizabeth Connolly wrote in a letter to board President Eric Marcy on Aug. 3, acknowledging some of the problems discussed at the meeting.
Employees at all four of the state-operated psychiatric hospitals are getting trained in how to "de-escalate" volatile situations, the letter said.
Teresa McQuaid, the assistant director for the Office of State Hospital Management who was temporarily reassigned to serve as Greystone's interim CEO, intends to hire a recruitment specialist and work with Rutgers University Behavioral Health to retain psychiatrists, according to the letter.
"There are multiple initiatives underway to recruit physicians and psychiatrists, to support patient and staff safety and to continue the successful placement of patients preparing for discharge," according to Connolly's letter, shared with NJ Advance Media when the news organization asked the Christie administration to respond to the criticisms at the hospital. "It is unfortunate that these actions are not being effectively communicated to and/or supported by some staff."
Marcy said he believe the hospital's overcrowding problems were created in part by the 2012 closing of Hagedorn Psychiatric Hospital in Lebanon Township, which served a sizable number of geriatric patients.
Two years later, the Christie administration closed the Woodbridge Developmental Center and the North Jersey Developmental Center that were home to hundreds of people with developmental disabilities, including some with mental illnesses.
Not only are there more patients coming to Greystone, Marcy said, "We are moving to a more diverse demographic, and this demographic presents more difficult patients to treat."
Greystone's patient population grew from 460 in 2009 -- a year after the historic 132-year-old facility closed and a new hospital on the property took its place -- to 560 patients in March, according to state data. The facility was built for 450 with another 60 patients living in cottages on the property.
At the same time, psychiatrists and executive staff have retired or left for a better-paying private sector jobs and to avoid burnout, Marcy said. There were 30 to 28 psychiatrists in 2009 compared to 20 today, he said.
"I don't know how you can run a psychiatrist hospital with insufficient psychiatrists," he said.
Robert Davison, executive director for the Mental Health Association of Essex and Morris Counties, also blamed the overcrowding at Greystone on the "idiotic decision" to close Hagedorn. His staff who work closely with discharged patients and their families have said they don't feel safe.
"There are three to four people in a room for two, and sometimes as many as five. That concerns me," Davison said.
Davison said he contacted Valerie Mielke, the assistant commissioner for Human Services in charge of the Division of Mental Health and Addiction Services. She assured him she's hired more psychiatrists. But incremental hiring won't solve the crowded conditions, he said.
"The conditions are inhumane and demand immediate action," Davison said. "The only meaningful thing to do is alleviate the overcrowding. Hagedorn is still there - reopen that. There is no room at the inn."
Mary Moran of Allentown, Pa. said she has felt the impact of staffing shortages and escalating violence during visits with her 34-year-old son, Christopher, who was forced to leave Hagedorn and transfer to Greystone.
"Christopher has missed several of his scheduled day therapies because of 'short staffing,' " Moran said. His treatment team says a staff member must accompany Moran when she and her son want to take a walk outside, but several times they've been told to stay inside because no employee could join them, she said.
"Christopher has never been a harm to anyone but himself," Moran said. "But I was kicked last month by a patient, and when I reported it, I have not heard any update whatsoever."
Second-quarter data, from April to June, is not available, Human Services spokeswoman Ellen Lovejoy said.
Among the 25 assaults reported from January to March, all the victims required medical attention, although the report contained no details. One patient suffered a "major" injury requiring hospital care, while 12 patients and 12 staff sustained "moderate" injuries, needing either a doctor's or hospital's attention, the data said. Five of the assaults were caused by two patients, Lovejoy said.
There were no reported assaults by staff on patients, according to the data.
Susan K. Livio may be reached at slivio@njadvancemedia.com. Follow her on Twitter @SusanKLivio. Find NJ.com Politics on Facebook.
