INDIANAPOLIS— WRTV Investigates has uncovered a gap in how the state oversees mental health facilities and protects our most vulnerable.
The law says Indiana should have a Mental Health Ombudsman— an office that can investigate and resolve complaints involving mental health treatment.
For example, Indiana has an ombudsman for:
- Department of Child Services
- Department of Correction
- Long-Term Care (nursing homes)
- Disabilities (Medicaid waiver)
WRTVDCS Ombudsman office
However, Indiana does not have a Mental Health Ombudsman despite a law requiring it—and hasn’t since June 2022.
Melissa Tomes of Bargersville struggles with alcohol addiction and says she would benefit from a Mental Health Ombudsman.
“It’s a work in progress,” said Tomes. “I am working on it.”
Tomes went to Options Behavioral Health in Lawrence, one of 34 private licensed mental health institutions in our state.
"It felt like we were behind bars," said Tomes.
Tomes filed a lawsuit alleging she fell and hit her head in the middle of the night, then woke up in a common area called the “day room.”
"My fingers were tingling, my arm was shooting pain,” said Tomes. “I told the nurse I almost bit through my tongue."
After leaving Options Behavioral Health, doctors discovered Tomes had a fractured neck, court records allege.
Tomes had surgery, which resulted in an infection and a visible scar.
“It just gets really sore, and it pops really weird,” said Tomes.
A total of 11 lawsuits have now been filed against Options Behavioral Health.
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WRTV Investigates contacted Acadia Healthcare, the parent company of Options Behavioral Health, about Tomes’ lawsuit and we are still waiting to hear back.
Tomes was concerned by her experience at Options Behavioral Health, but she wasn’t sure what to do.
"I didn't even know you could make a complaint,” said Tomes. “It's very easy to be confused about what you can do, what you can't do."
WRTV Investigates found to file a complaint against an Indiana mental health facility, you can’t do it online.
You have to call 1-800-901-1133 at the Indiana Family and Social Services Administration (FSSA), the state agency that licenses and inspects mental health facilities—specifically, the Division of Mental Health and Addiction.
Tomes was unaware of the state’s mental health complaint phone number.
“I think it's ridiculous that it has to be so hidden or so hard to do,” said Tomes.
WRTV Investigates also uncovered Indiana does not have a Mental Health Ombudsman, and the state hasn’t had one since June 2022.
By law, the state is supposed to contract with a nonprofit corporation “to advocate on behalf of mental health patients.”
"When that isn't happening, that is a big gap," said Melissa Keyes, Executive Director at Indiana Disability Rights, a statewide organization that advocates for people with disabilities including mental health conditions.
"It’s very frustrating because there’s so much need for accountability for protecting our most vulnerable," said Keyes.
Keyes explained that an ombudsman is designed to be an independent party separate from the mental health facility.
“That ombudsman can be a neutral party to be able to resolve concerns or deescalate problems or to help address problems in the moment,” said Keyes. “They are supposed to be able to investigate those complaints, analyze the complaints and then work with the facility and then work with the Department of Mental Health and Addiction to resolve that complaint. They’re also supposed to keep data and records so we can have some of that accountability piece as well.”
FSSA’s Division of Mental Health and Addiction previously contracted with Mental Health Association in Indiana INC, doing business as Mental Health America of Indiana.
However, that contract ended June 30, 2022.
WRTV Investigates is looking into why the state did not renew that contract three years ago.
"It shows a tremendous gap in the ability of our state to give proper oversight to these facilities," said Keyes.
Keyes is not alone with her concerns.
State Senator Andrea Hunley and Representative Cindy Ledbetter questioned FSSA last fall, asking in a letter “What is the process for filing a complaint? How do the ombudsmen share the complaint data?"
FSSA’s written response did not address the ombudsman.
Indiana now has a new FSSA Secretary, Mitch Roob.
Despite our repeated requests to speak with Roob on camera, FSSA told us via email, “We cannot do an interview at this time."
WRTV Investigates emailed FSSA the statute requiring a Mental Health Ombudsman.
In an emailed statement, FSSA’s Deputy Chief of Staff Marcus Barlow said the agency is working on reestablishing the ombudsman office.
"Under the leadership of Governor Braun and Secretary Roob, the Department of Mental Health and Addiction is committed to continuous improvement, and we appreciate RTV6’s dedication to advocating for Indiana’s most vulnerable residents.
In these first 100 days of the new administration, we have undertaken a comprehensive review of all programs and expenditures to ensure they align with the best interests of Hoosier taxpayers. During this process, we identified a gap in contracting an appropriate provider to serve as an ombudsman. We are actively addressing this and are currently evaluating potential partners. We look forward to announcing our new ombudsman this summer."
Rep. Cindy Ledbetter, who has raised concerns about oversight of mental health hospitals, is encouraged that the new administration will address the issue.
“I know the new leadership at the Family and Social Services Administration along with Gov. Braun are working to find the right partner to provide ombudsman services for the department to ensure our tax dollars are being used efficiently,” said Ledbetter in an emailed statement to WRTV.
Melissa Keyes at Indiana Disability Rights hopes the new Mental Health Ombudsman keeps data on complaints about specific mental health facilities.
“It’s long overdue,” said Keyes.
Melissa Tomes thinks an ombudsman would be a great resource for people like her who rely on mental health treatment.
“When they give you papers when you come in, stick something in there that gives you the number,” said Tomes. “It needs to be easier."
Carol Owens, the mother of a former patient at Options Behavioral Health, also supports the idea of a Mental Health Ombudsman.
“I think the state could use it,” said Owens. “Mental health is very broken. I researched everything I could have researched, and I think there’s no excuse to have that gap.”
In December, WRTV Investigates requested data for the FSSA complaint hotline for mental health facilities, including the number of calls and a breakdown of facilities, but we still have not received the information.
"Comments received through the Consumer Service Line about services and providers are confidential,” responded an FSSA spokesperson.
FSSA does not post inspection reports or summaries online for mental health facilities as they do for childcare facilities.
In fact, if the public wants to view inspection reports for a mental health hospital, they have to request copies through a formal records request under the Indiana Access to Public Records Act.
It took WRTV Investigates four months to receive inspection reports for Options Behavioral Health. We requested them on July 15 and received two reports on November 13.
Mother Carol Owens says the state needs to improve transparency.
“If actions had consequences, then they wouldn’t do some of the things they did,” said Owens. “My daughter was over-medicated when I got her out there. She was worse than she had ever been.”
Owens filed a lawsuit against Options Behavioral Health, bringing the total number of lawsuits to 11.
ACADIA HEALTHCARE STATEMENT TO WRTV:
Acadia Healthcare previously provided the following statement to WRTV in response to lawsuits:
While we cannot discuss specific patient situations due to patient privacy laws, the dignity and well-being of our patients is at the center of all we do, and we have a zero-tolerance policy for behavior that could endanger our patients and staff. As is our protocol, Options actively collaborates with our regulators to ensure ongoing compliance with regulatory and clinical care requirements.We understand the trust and responsibility placed in us to uphold the highest standards, and Options continues to serve patients and the community by providing the very latest in evidence-based behavioral healthcare.
STATEMENT ON ACADIA HEALTHCARE WEBSITE:
To be clear: we patently reject claims that Acadia places profits over patients – including inferences that we systematically hold patients longer than is medically necessary for financial reasons.
Here are some important facts you should know:
- Patient care decisions, including whether treatment is necessary and for how long, are medical decisions made by licensed providers, based on medical necessity and adhere to all associated legal requirements.
- The average length of stay at Acadia’s acute hospitals is in line with national averages.
- In most cases, the decision to involuntarily commit a patient for psychiatric evaluation in a behavioral health hospital is initiated by emergency room providers, law enforcement personnel, or other individuals as designated by state statutes. Those independent third parties make the initial determination that a patient requires hospitalization and evaluation.
- Our hospitals are highly regulated and are required to meet policies and standards set by federal, state, and local governments. Acadia’s acute care hospitals have been inspected and surveyed by The Joint Commission (TJC), the Centers for Medicare & Medicaid Services (CMS) and various state agencies nearly 300 times per year on average over the past five years.
- It is widely recognized within the medical community that discharging patients too early can result in catastrophic consequences, including serious injury – and even death – for the patient or others. Determining the appropriate level of care for acutely ill patients is a complicated and highly individualized decision that psychiatrists across the industry face every day.
Acadia follows industry-standard, clinically driven admission and discharge criteria
To reiterate: we patently reject claims that Acadia places profits over patients – including inferences that we systematically hold patients longer than is medically necessary for financial reasons. Notably, the average length of stay at our acute hospitals is in line with national averages.
Average Length of Stay in Days: Acadia Acute Hospitals vs Industry*, FY2023
*Healthcare cost reporting information system (HCRIS) from CMSPatient care decisions, including whether treatment is necessary and for how long, are medical decisions made by licensed providers, based on medical necessity, and adhere to all associated legal requirements.
In addition, multi-disciplinary teams work with patients, guardians, and family members during their treatment and in preparation for discharge. Discharging a patient too early can result in catastrophic consequences, including serious injury – and even death – for the patient or others. When making discharge decisions, physicians lead with the best interests of our patients and weigh a variety of factors including ongoing treatment needs and the risk of discharging before adequate stabilization.
Acadia is proud of the support we provide to those requiring acute psychiatric care
In 2023, 81% of our patients who responded to a survey – including involuntarily admitted respondents – reported feeling hopeful as a result of the care they received in our hospitals. Since 2016, Acadia has provided over $500 million in uncompensated care to help deliver the best outcomes for patients regardless of ability to pay. We remain steadfast in our commitment to ensuring patients, families, and their communities have access to the highly specialized treatment delivered at our hospitals.
Acadia hospitals are highly regulated, independently accredited and uphold stringent standards
Our hospitals are highly regulated and are required to meet policies and standards set by federal, state, and local governments. All 54 of Acadia’s acute hospitals are licensed in each state, accredited by TJC, and overseen by independent, respected third-party organizations and government entities such as CMS. This oversight helps ensure compliance with policies governing reimbursement and care quality, including from all government healthcare programs.
These independent bodies regularly visit – unannounced – to evaluate our compliance and ensure we provide high-quality, effective care for our patients. Acadia’s acute care hospitals have been inspected nearly 300 times per year on average over the past five years. In addition, we are routinely subjected to other federal, state, and local inspections as well as independent audits by third-party firms. We also regularly welcome third parties into our hospitals on a daily basis – from case managers to payors and other independent healthcare professionals – to review patient progress and collaborate in discharge planning.
Recent media reports lack important facts and context about involuntary commitment cases
Involuntary commitment to a psychiatric hospital is a complex issue with profound implications for individuals and their families. While some stories have portrayed commitment as a means of trapping individuals against their will, the process is far more complicated. In most cases, the decision to involuntarily commit a patient for psychiatric evaluation in a behavioral health hospital is initiated by emergency room providers, law enforcement personnel, or other individuals designated by state statutes. Those independent third parties make the initial determination that a patient requires an urgent psychiatric assessment. Once admitted, a psychiatric evaluation is then conducted to determine a treatment or discharge plan.
It is important to emphasize that involuntary commitment includes a legal process that generally involves many parties, such as a patient's attorney, family members, the court system, case managers, law enforcement, and outside referring clinicians.
We understand the tremendous responsibility that comes with supporting patients admitted involuntarily to our hospitals. These are serious decisions, and our clinicians fiercely advocate for our patients’ best interests.
Inaccurate portrayals of Acadia hospitals in the media perpetuate harmful beliefs about behavioral healthcare
Inaccurate and incomplete reporting about behavioral healthcare may unfortunately reinforce the fear and misconceptions some may have about seeking treatment. These reports may even perpetuate the myth that psychiatric care is ineffective or even harmful.
As part of our commitment to deliver technology-driven quality care, Acadia continues to invest millions of dollars annually into our hospitals. We also partner with many of the most highly respected, well-established health systems throughout the country to expand access to life-saving behavioral health care in local communities. Additionally, it is important to acknowledge the dedication of our 23,500 Acadia employees who come to work every day living our purpose to Lead Care with Light in support of patients, families and communities seeking hope for brighter futures.
Acadia remains focused on addressing our country’s mental health crisis
Our country is facing a severe mental health crisis. According to Mental Health America, over half of adults with a mental illness receive no treatment. Given our nation’s record level of suicide rates, it is critical to ensure patients needing behavioral healthcare can receive proper treatment.
Acadia is committed to improving access to care and making the system easier to navigate for patients. We remain focused on providing the supportive, collaborative and compassionate care that is so desperately needed.
