Health-care advocates question budget cuts after patient strangled

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Coroner Greg Shore said he is awaiting the complete records of the 36-year-old's hospitalizations and had no details of his diagnosis. Officials haven't released the suspect's name or any other information about him.

As the investigation into the death of 42-year-old Paul Joseph Radler of Simpsonville continued, mental health advocates questioned whether state budget cuts and the shutdown this year of the State Hospital in Columbia may have contributed to the tragedy.

"I think they try to do a good job at Patrick Harris," said John Brady, whose son is a long-term patient there. "What they are not able to do, I don't think is their fault. It's our fault. We are not adequately funding the Department of Mental Health."

But a spokesman for the state Department of Mental Health said staffing levels at Harris are higher than they were two years ago, and that the more than $50 million in budget cuts and 900 staff positions the agency has lost since 2001 weren't factors in the death.

Most of the staff cuts were administrative positions in the state office and at hospitals in Columbia, and employees at the hospital that was closed, said John Hutto, spokesman for the department.

Hutto called the death "a very unfortunate incident" but not linked to staffing or facilities. He wouldn't release details about security measures at the time of the death, saying those issues are part of the investigation. "We've had budget cuts, but the budget cuts have had no effect on patient care at Harris hospital," Hutto said. "Patient safety and staff safety are foremost at Harris hospital, at Bryan hospital (in Columbia), at all of our mental health centers."

Dave Almeida, executive director of the state's office of the National Alliance for the Mentally Ill, said he didn't know details of the case but that Patrick B. Harris isn't an "appropriate" place for long-term psychiatric patients.

"If the agency is saying that their staffing levels are higher than they were before, then I'm concerned that there's a larger problem," he said. "I see no way that you can diminish the impact of budget cuts at the Department of Mental Health when something like this happens. It just can't be a coincidence."

Hutto said state mental health officials could recall no other homicide that has occurred at a state mental hospital.

Shore said hospital staff entered Radler's room at 6:20 p.m. Friday and found him and the suspect in the bathroom. Radler wasn't breathing, and the suspect told mental health security officials "that he had choked Mr. Radler," the coroner said.

Shore said he didn't know the motive.

Radler had no brain activity when he arrived at Anderson Area Medical Center. He was taken off life support on Sunday and his organs were donated. Radler's father told the coroner that his family, who lived in Wisconsin, hadn't been in contact with him for 20 years. Radler had been a ward of the state since he was 18, Shore said.

Kathryn Richardson, spokeswoman for the State Law Enforcement Division, said SLED is assisting the Department of Mental Health with an investigation into the death, but she wouldn't release any details.

The suspect has been moved to a private facility in Columbia that the state uses as a prison for mentally ill offenders, Shore said. He wouldn't release the suspect's name but said charges are pending. An autopsy planned for Monday had to be delayed until today because of a scheduling conflict with a pathologist, he said.

State Sen. Ralph Anderson, D-Greenville, said elected officials aren't paying enough attention to mental health issues.

He cited the failure two years ago of a bill he introduced that would have created a user tax on tobacco and alcohol. The measure would have raised more than $200 million for health care, including mental health, he said — money that would have been matched at least 2-to-1 by the federal government.

"I think it's a sin, really, that we create the atmosphere in these different programs that's conducive to allowing things like that to happen," he said.

Will Folks, a spokesman for Gov. Mark Sanford, laid blame for problems at the mental health department on the Legislature, which shot down the governor's plan for consolidating and streamlining all the state's health agencies under a cabinet position that answers to the governor.

"Where there's splintered accountability in government there's often no accountability in government," he said. "Until we consolidate the executive functions, we're going to continue to see situations where there's not as much accountability as there ought to be."

Calls to the office of George Gintoli, director of the state Department of Mental Health, were referred to his spokesman.

Hutto, the mental health department spokesman, said the hospital has a 1-to-4 ratio of staff to patients during the day and 1-to-6 at night. In 2002, Harris had 200 staff members involved in direct care, such as doctors, nurses, social workers and psychologists. This month, the hospital has 217, he said.

A spokeswoman for the Joint Commission on Accreditation of Healthcare Organizations said there are no national standards for staff-patient ratio in psychiatric hospitals.

The 22-year-old Harris hospital has beds for 132 patients and had 123 patients on Monday, including 41 long-term patients, Hutto said.

The department is working on arrangements to allow the Greenville Hospital System, which often is overloaded with psychiatric patients, to send patients there, along with a psychiatrist from GHS, he said.