LITTLE ROCK — A psychiatrist testifying for the U.S. Department of Justice told a federal judge Tuesday that the chief psychiatrist for the Conway Human Development Center lacks the specialized training needed to properly manage the center’s developmentally disabled residents.
Dr. Ed Mikkelsen of Wellesley Hills, Mass., was the last witness to testify for the federal government in an expected six-week trial in Little Rock over the government’s assertions that the state-run center isn’t properly caring for the residents, in violation of federal laws.
Although the federal government rested its case Friday and the state began presenting its case Monday, Mikkelsen was unavailable until this week because he underwent surgery when he was originally scheduled to testify.
Mikkelsen is one of several expert witnesses who evaluated the state-run center in Conway in 2008 and 2009 at the request of the Justice Department. The visits led the department to sue the state, claiming the center’s practices are outdated and the residents aren’t being treated in the least-restrictive environment, as federal law requires.
Mikkelsen, who served as an associate professor at Harvard Medical School, described his findings about the center’s psychiatric program, which is headed by Dr. Doug Callahan.
Mikkelsen said he found that many diagnoses at the center were “problematic” in that they often combined contradictory traits.
He noted that obsessive compulsive disorder was noted in 27 percent of the center’s psychiatric caseload- a “high” percentage.
He said that causes problems when medication is administered. If someone who is autistic is treated as though he has obsessive-compulsive disorder, or OCD, Mikkelsen said, the medicine used to treat the OCD has the potential to aggravate the autism.
Mikkelsen suggested that many of the people Callahan treats for OCD don’t actually have that disorder.
He also testified that the center chooses medications for residents based on three illegitimate reasons:
the psychiatrist believes the medication is harmful but the parents insist it be used,
to suppress the side effects of other medicines, rather than simply removing the offending medication, and
for sedation purposes only.
Mikkelsen also testified that according to Callahan’s resume, he doesn’t have any specialized training with developmentally disabled individuals, or any formal training in child psychiatry. Mikkelsen said he believes such training, or the equivalent supervision by someone with demonstrated expertise, is necessary.
“This is a very different subset of individuals and a very different practice from general psychiatry,” he told the judge, naming geriatric psychiatry and child psychiatry as two other subsets that differ greatly from general psychiatry and require expertise.
“How is Dr. Callahan supervised?” asked attorney Benjamin Tayloe Jr.
“My understanding is he is not - by anyone,” Mikkelsen replied.
The doctor said he believes the death of one resident was caused by the wrong medicine prescribed by Callahan, and afterward, Callahan prescribed the same regiment for another patient.
The trial resumes at 9 a.m. today before Chief U.S. District Judge Leon Holmes.
Arkansas, Pages 12 on 09/29/2010