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Abuse of the helpless and "chilling" humiliations, including violence and cruelty, which emotionally and physically harmed autistic residents at the Eitanim psychiatric hospital continued "for years," a situation that staffers were quite aware of, according to an investigative report on the hospital. The report is one of the most damning in the history of Israel's mental health system, and this is the first time its details have been published.

The report sharply criticizes the government hospital's director, Dr. Yaakov Margolin, who did not promptly investigate complaints received in February 2003. The report also said he did not intervene in the autisitc department's operations prior to the lodging of the complaints.

The department's director, Dr. Daniel Meir, also came under fire for saying that he agreed to demands made by its head nurse and other personnel "not to enter the department, because his presence interrupts therapeutic activities," and that he "refrained from using his authority as a doctor and director."

Published by a committee headed by a psychiatrist, Dr. Eli Danilovitz, the report determined that "if the events had been investigated with due seriousness in real time, perhaps at least some of the events and their outcomes could have been avoided."

As a result of the report, in an unusual step, the Health Ministry asked Dr. Margolin on Sunday to respond to several questions, including: why the department was neglected for years and conditions were so poor as to be "unsuitable for a modern facility;" why hospital management did not repond to continual requests by the department's director for additional personnel and professional support and to requests by staff members improve conditions; and why hospital supervision was so lax that enabled abuse to take place over such a long time while being a widely known fact among staffers.

The report accuses the department's head nurse who, together with a member of the department's support staff, is said to have committed violent and "irregular" acts against patients, and caused "unnecessary suffering and humiliation to patients."

The committee found that the head nurse allegedly had committed "unauthorized and unpermitted acts." In one case whereby Meir had determined that a patient's medical condition was causing him to lose his balance and to fall, the nurse determined that "he had no medical problem," and his falls were an attempt to manipulate the staff. Therefore, the nurse instructed staff members to force the patient to walk. Staffers complied, by among other means, kicking him when he fell.

The committee found that those in charge of the department "misappropriated the faith of the public by harming the helpless."

The panel found that a subculture with its own language and unwritten rules existed in the department, and that the head nurse was commonly referred to as "department head."

The committee was established following revelations of abuse at the hospital, located near Jerusalem, earlier this week following complaints lodged by staffers and medical students who had rotations at the department. As a result of the complaints, Health Minister Dan Naveh ordered the department closed and its 19 patients transfered to other facilities.

In the meantime, new staff members were expected to operate the department, although the order has yet to be implemented and most veteran staff members reportedly are still working there.