LITTLE ROCK — Psychiatric terminology and names of medications used to treat psychiatric conditions were flung around a Little Rock federal courtroom on Wednesday as the testimony of a Massachusetts psychiatrist, testifying as an expert witness for the U.S. Department of Justice, continued into a second day.
It was the 16th day of a trial stemming from a lawsuit the Justice Department filed in early 2009 against the state over its operation of the Conway Human Development Center, which serves about 500 developmentally disabled children and adults.
The nonjury trial being heard by Chief U.S. District Judge Leon Holmes is expected to last about three more weeks, with most of the remaining testimony coming from witnesses for the state.
In the lawsuit, the Justice Department contends that experts it sent into the facility before the suit was filed determined that the residents are subjected to outdated methods of care and aren’t being treated or educated in the least-restrictive environment possible, as federal law mandates.
The department wants Holmes to order the state to comply, but some parents and guardians say they fear the effect will be closure of the center, which is the only home some residents have known for years, even decades, and is the only facility that some parents and guardians trust to adequately address their loved ones’ complex mental, emotional and physical needs.
Dr. Ed Mikkelsen of Wellesley Hills, Mass., was cross-examined Wednesday by attorney Thomas B. York of Pennsylvania, who is helping defend Arkansas against the federal government’s allegations.
York scrutinized Mikkelsen’s testimony on Tuesday and Wednesday in which he criticized the center’s chief psychiatrist, Dr. Doug Callahan.
Mikkelsen said Callahan has too many patients and duties to devote proper time to each, that his diagnoses often don’t make sense and that his decisions about types and doses of medications to administer are often generic and off the mark, if not downright dangerous.
York discussed some of the fine points of Mikkelsen’s analysis of Callahan’s practices. He quizzed the Massachusetts doctor about his knowledge of practices prescribed in the Diagnostic and Statistical Manual of Mental Disorders, a standard resource, and about how his assessment of care at the Conway center compared with that provided to the developmentally disabled in Massachusetts.
While Mikkelsen said the average Conway center resident dies at the age of 46 1 /2, which he considered younger than normal, he acknowledged that it’s hard to make a direct comparison to other centers across the country where the population falls in a different age range, the setting is much smaller or the facility has a separate infirmary for the most severely ill patients.
Asked about his criticism of Callahan’s written complaints about, and acquiescence to, parental desires for certain medications and dosages, Mikkelsen said he thinks doctors at the center need to be more proactive in overriding misguided interference.
“In Massachusetts,” he said, “we have gone to court and had parents removed as guardians because they weren’t acting in the best interests of their children. The point is, you cannot ethically do something that is wrong simply because the parent wants it. ... You have to be willing to go to court.”
The trial resumes at 9 a.m. today.
Arkansas, Pages 12 on 09/30/2010