Sexual Assault in Psychiatric Facilities Part 2: How to Recognize Sexual Abuse in Mental Health Facilities

Sexual assault in psychiatric facilities is one of the most prevalent, yet least-discussed forms of sexual assault. How can we recognize when such assaults are happening? What can we do to raise awareness of the danger?

In our previous blog post, we highlighted the issue of sexual assault in psychiatric facilities. Despite its frequency, it is regularly left out of public discussions on sexual assault and abuse. Recognizing when it occurs is the first step in raising awareness of the issue as a whole.

In Part 2 of this blog installment, we will review ways to recognize when sexual assault may be happening in a psychiatric facility, and will suggest ways that we can begin to increase public awareness of these heinous assaults. Read on to learn more about what can be done.

Psychiatric Ward Assaults

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How Can We Recognize Sexual Abuse in Psychiatric Patients?

Sexual assault survivors in general may have hesitations and reservations in speaking up about incidents, often due to fear of retaliation, shame, embarrassment, or confusion.

On top of these commonly experienced reservations, mental health patients in particular may face additional difficulties in reporting sexual assault or discussing it. For instance, the patient may have a heightened fear that they will not be believed if they report an incident. Also, psychiatric patients may not always be in a position to communicate what is happening with them or in their environment.

For these reasons, it is all the more important for family members and loved ones of mental health patients to be especially vigilant for signs of sexual abuse. Signs can be both physical, and emotional/behavioral. Likewise, staff conduct can also indicate signs of abuse. Indicators set forth by the Centers for Medicare & Medicaid Services (CMS) can provide much guidance on these signs.

Immediate Jeopardy Indicators

The CMS State Operations Manual defines Immediate Jeopardy (IJ) as “a situation in which the provider’s noncompliance with one or more requirements of participation has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident.” Once a hospital or healthcare organization gets an IJ rating, it’s given a time frame to fix the deficiency. If not, CMS will terminate the facility’s Medicare and Medicaid funding.

‍According to the CMS Manual, signs of sexual abuse in a psychiatric facility may include:

Physical Signs of Abuse

• Marks on the body
• Unexplained head and/or bodily trauma,
• Facial injuries or fractures
• Bruises around the breast or genital area; or unexplained bruising

Other physical signs of sexual abuse may include the presence of sexually transmitted disease, frequent urination, and torn or damaged clothing.

Emotional/Behavioral Signs of Abuse

• Fear of a certain person or specific place in the facility
• Fear of being left alone or of being in the dark
• Disturbed sleep or nightmares
• Extreme changes in behavior, including aggressive or disruptive behavior
• Withdrawal, isolating one’s self, feelings of guilt and shame, depression, crying, talk or attempts of suicide, or running away

Not all instances of sexual assault leave physical indicators of the abuse. In many cases, emotional and behavioral changes can be strong signs that sexual assault is occurring. The key is being able to recognize changes in the patient’s normal behavior. This requires an understanding of their patterns of behavior. Frequent, regular visits and/or consistent communication with caretakers can help in this regard.

Staff/Facility Misconduct

The behavior and conduct of the staff at a mental health facility can also provide signs and indicators that sexual assault may be occurring. Such signs associated with staff include:

• Threatening, intimidating, humiliating, or demeaning a resident
• Taking, sharing, or posting of sexually explicit photographs of residents
• Failure to investigate allegations of abuse or neglect
• Failure to implement policies to prevent abuse
• Confinement of a patient in a room or other area by a blockade, device, or threat

Other signs of potential sexual abuse by staff include: using derogatory sexual terms, exhibiting an aggressive demeanor, and seeing or treating others as sexual objects.

If you recognize any of these physical, emotional/behavioral, or administrative signs of sexual abuse, contact authorities promptly and file a report. You should also contact a sexual assault lawyer, as further legal action may be needed to pursue the proper remedy (such as an investigation into the facility as a whole).

As individuals, professionals, and as a community, we can take steps to educate others about these injustices and prompt the necessary action for reform.

How Widespread Are Sexual Assaults in Mental Health Facilities?

Sexual assaults in mental health facilities, prisons and jails, long-term care facilities, and other similar institutions can often be ongoing issues, not just single isolated incidents. For instance, at the Federal Correctional Institution (FCI) in Dublin, an entire culture of sexual assault and rape was fostered at the facility, to the point where the facility was dubbed the “Rape Club.”

Such conditions can exist in psychiatric facilities as well. If there is an incident of sexual assault on site, it is very probable that other incidents may have happened besides that one. This is known as “institutional abuse” — meaning that the sexual abuse may be systematic and built into the faulty policies and practices of the facility itself.

Thus, it’s important to report any suspicious behavior or conditions, both in terms of the patient’s demeanor as well as the staff’s conduct.Be cautious about placing a loved one in a psychiatric facility, nursing home, or long-term care facility, or other similar institution if:

• The facility has a history of being investigated for patient abuse
• The institution has received an Immediate Jeopardy Violation or warning

Consider these locations of Universal Health Services hospitals in California, which have been subject to formal investigations:

• Fremont Hospital (Fremont, CA): Investigated by the state in 2016 and 2018; one patient was sexually assaulted in 2018. The facility received an Immediate Jeopardy violation in 2016.
• Del Amo Behavioral Health System (Torrance, CA): Investigated by the state in 2009, 2014, 2017, 2018, and 2019. These were linked to instances of wrongful death, sexual assault, and the escape of a suicidal patient. The facility received an Immediate Jeopardy violation in 2014 due to a wrongful death.
• Canyon Ridge Hospital (Chino, CA): The state investigated this facility four times in 2011, 2012 (twice), and 2015. Two instances of sexual assault were reported in 2011 and 2012. The facility was found to be at fault for not monitoring the patient. The facility received an Immediate Jeopardy violation in 2012 due to physical assault.

Again, if you learn of any abusive behavior, or suspect that a mental health facility is violating the rights of patients, contact a lawyer for advice. Filing a claim against such an institution can be complex, especially if a potential Immediate Jeopardy violation may be involved.

What Can We Do About Sexual Assaults in Psychiatric Facilities?

There are many actions we can take in order to combat sexual abuse in psychiatric facilities. As individuals, professionals, and as a community, we can take steps to educate others about these injustices and prompt the necessary action for reform.

Our Goals as Individuals

As individuals, it is within our power to:

• Listen to and believe every survivor of sexual assault
• Report instances of abuse, whether it be to the police, CPS, medical boards, human services, or other entities
• Share resources for sexual assault survivors

Our Goals as Legal Professionals

At the Pride Law Firm, it is our aim to:

• Reform public policy on sexual assault
• Create stronger laws and regulations that will hold facilities accountable to reporting, investigating, and preventing abuse
• Legally require facilities to publicly report instances of sexual assault
• Increase staff to patient ratios at mental health facilities
• Incentivize the hiring of qualified individuals

Our Goals as a Community

As a community, we should:

• Create a mental health plan and policy that focuses on healing that is inclusive of all survivors, including Men, Children, Queer, Nonbinary, and Trans patient experiences
• Promote healing and self-care where possible
• Educate others on the issue of sexual assault in psychiatric facilities

By educating ourselves and others, standing up, and taking action, we can begin to break down the barriers to reporting and investigating associated with mental health facilities. Pursuing legal action for injustices and reforming the law can help prevent future incidents from occurring.

Contact a Sexual Assault Lawyer for Guidance

Sexual assaults in psychiatric facilities have been allowed to persist because they often happen in the dark, away from the attention needed to bring about change. At the Pride Law Firm, we are passionate about making community-wide changes that improve the safety and security of patients in such facilities.If you or a loved one have been affected by sexual abuse in a mental health facility, contact us at 619-516-8166. All consultations are completely private and held in the strictest of privacy. Together we can create ways to bring justice to your family and the greater community as well.