Insight Investigates

Behind the scenes of a State behavioral healthcare facility

By Mackenzie Connor, Staff Writer

Dimly-lit, white-washed rooms harboring psychopaths, tortuous shock treatments, bloody operating tables, and patients barbarically forced into restraints. Of course most of you have watched the gruesome, and sometimes horrific Netflix channels “based on real encounters” at insane asylums.

“Those shows aren’t far-fetched at all.” Jennifer Needham, who works at a state department of behavioral health care and developmental disabilities facility, said. To put it simply: this is as close as you’d get to a real insane asylum. “Of course, the media exaggerates it. The legitimate facilities are just the inspiration for these shows,”  Needham said.

There are actually a few different parts to where Needham works;  it’s not just one huge scary building. “There’s a normal hospital section, where I usually work as a respiratory therapist; there’s a forensics ward built next to it as well as a high-maximum security building,” Needham said. Society typically has the wrong idea about these kind of facilities; every patient admitted doesn’t necessarily have a rare mental disorder like you see in the shows, only some of them.

  There is a wide variety of  people that occupy the Medical Center of Rhode Island Behavioral Facility. “Some patients who stay here permanently are brain dead and their insurance has run out, so they come here,” Needham said. When someone is in a serious accident that medically results in no brain activity, their families have the choice to either rely on a ventilator to keep the victim alive, or stop life support. “For the patients who have been on ventilators for many years, or have long term illnesses, they eventually exhaust their insurance and can no longer afford hospital care, so we treat them in our medical center,” Needham said.

But, on the other side of this large facility, there are more unusual conditions. A few patients that have been there for a while, were diagnosed with a rare illness called pica. This disorder involves the constant, abnormal craving, as well as the consumption of substances such as jewelry, chalk, pencils, utensils, etc. “I’m not even allowed to wear my wedding ring when I treat these people,” Needham admits. “They would end up consuming it somehow,” Needham said.

“This irregularity often stems from past abuse, vitamin deficiency, or schizophrenia. As a respiratory therapist, there will be times when I’m called for an emergency on a pica patient who swallowed an abnormal object. As I’m trying to help them avoid choking, the patient will snatch my hair band or necklace for dessert,” Needham said. “One pica patient had a severely broken arm, after surgery was performed and a brace was carefully placed supporting the site of injury, the woman began eating the pins holding the brace in position,” Needham said.

Besides pica, the Medical Center of Rhode Island Behavioral Facility is home to patients with many other disorders, such as apotemnophilia. People diagnosed with this affliction possess an overwhelming desire to self-amputate. “After these people either rip, bite, chew, or cut off their appendages, they seem much happier,” Needham said. “This condition is common in patients with damage to the right parietal lobe of the brain. Other forms of self-mutilation are seen in patients with emotional crisis, impulsivity, psychosis, as well as mood and personality disorders,” Needham said.

Among the other conditions patients at this facility have, there is one known as munchausen, which occurs when a caregiver purposely makes his or her child sick. “We will get parents who feed their kids bleach, Comet, and other poisonous substances to intentionally harm them. This disorder stems from a craving for  attention, past abuse, or brain injuries,” Needham said. “Sometimes the condition is extremely severe and a parent will make their child so ill that they end up dying.”

Beyond the normal hospital and medical center, there is a forensics ward, and a high-maximum security unit. These areas are home to cannibals, psychotic people, and murderers.  “Some of these criminals and medical patients have been in here for decades. One man suffocated his older brother to death with a pillow when he was 8. He is now in his fifties,” Needham said. “There are also a few patients in here with a condition known as Capgras Syndrome: a delusional disorder where one is fully convinced that a family member, sibling, or friend has been permanently replaced by an identical imposter, and they usually end up murdering the ‘imposter,”’  Needham said.

  “Other than the few disorders mentioned, we have people with anxiety, delusional states, hallucinations, emotional problems, panic attacks, personality disorders, paranoia, PTSD, psychotic illnesses, schizophrenia, traumatic brain injury, and bipolar issues,” Needham said. “For the average person it seems near impossible to grasp the fact that I work with these types of people three days a week; but for me they’re just the day-to-day patients who come in and out of  this building. Of course it’s scary, and I still get nervous sometimes, but you learn to deal with it,” Needham admitted.

“These people can’t help it; they have mental issues and there’s nothing in the patient’s power they can do to help themselves; that’s why it’s up to us,” Needham said. “The Medical Center of Rhode Island Behavioral Facility is fully equipped with highly-trained security. The staff is taught how to react to certain situations, and even the doctors have to go through security measures,” Needham said. “Overall this program is phenomenal, and we do the best we can to ensure the health of our patients.”