For the first time on Tuesday, S.C. Department of Mental Health leaders were publicly asked why a longtime patient died in January from suffocation after the agency’s employees piled on top of him.
For two hours, a House panel tasked with conducting a routine review of the agency dove into Mental Health’s failed handling of 35-year-old Georgetown native William Avant. Members of that panel, a House Oversight subcommittee, said their probe into Avant’s death likely will continue.
Lawmakers said they could subpoena records from the agency, which has refused to answer questions about Avant’s Jan. 22 death at the Bryan Psychiatric Hospital in Columbia, citing confidentiality laws.
One lawmaker, state Rep. Micah Caskey, R-Lexington, hinted the group could review video of Avant’s death at its next hearing. Details of Avant’s death — based upon that video — were first reported by The State newspaper.
Mental Health Interim Director Mark Binkley acknowledged to lawmakers Tuesday that he has never seen that video.
“Bottom line, we will get all the answers that we seek, whether now or eventually,” said state Rep. Bill Taylor, an Aiken Republican on the Oversight panel.
The hearing, which began with a moment of silence for Avant, was held nine days after The State revealed that Avant died in January after staffers attempting to restrain him failed to follow their training. That training expressly prohibits pinning a patient face down or lying across the patient’s back. Mental Health employees did both in Avant’s case.
The agency’s training also requires staffers who are physically restraining a patient to check the patient’s breathing. No one checked Avant’s breathing, and when they got off him four minutes later, he was dead.
Records from an investigation by state health regulators, reviewed by The State, showed three of the 13 Mental Health employees involved had not completed their mandatory training on how to interact with — and, if necessary, physically restrain — psychiatric patients.
Avant’s death had not come up in the previous nine hearings into Mental Health. The panel’s chairman, Anderson Republican Jay West, said the committee in February requested the agency provide it with any information related to any cases of abuse or neglect, but that Mental Health never responded.
Mental Health leader lacked answers
At the start of Tuesday’s hearing, Binkley told lawmakers that patient confidentiality laws prohibit him from speaking about Avant’s death or even confirming that Avant was a patient at Bryan.
That meant lawmakers spent the hearing attempting to ask questions about Avant’s case without directly referencing it.
For example, rather than asking whether any employees involved in Avant’s death were fired, Caskey asked whether Mental Health has fired or suspended any employees in 2019 for failing to follow the department’s training on physically restraining patients.
Binkley said he believed so, but he did not know for sure because he didn’t make those decisions.
At times, lawmakers were frustrated at Mental Health’s limited supply of answers.
“We’re continuing a façade of not talking about an incident that provoked such reaction across the state,” Caskey said.
However, agency officials confirmed Tuesday that Mental Health revised its training materials in June 2018 to emphasize that patients are not to be restrained face down, that employees should never lie on top of their backs or chests to restrain them, and that employees should always check the breathing of patients who are being restrained. Those policies had been in place for years, agency leaders testified.
Mental Health leaders did not explain why three of the staffers involved in Avant’s death had not completed their mandatory annual training.
Sandy Hyre, Mental Health’s Director of Evaluation, Training and Research, said it is up to employee supervisors — not the agency’s training division — to make sure their employees have completed their training.
Mental Health has drafted and conducted its own training since at least 1981, but agency leaders have been in months-long discussions about replacing that training with commercial materials that other states use, Binkley said.