Greystone Park Psychiatric Hospital. Photo by Mclib via Wikimedia Commons.

New Jersey's Office of the Public Defender has sued state officials over what it describes as crowded conditions and violent behavior by residents at the Greystone Park Psychiatric Hospital.

Filed on Monday in U.S. District Court for the District of New Jersey, the suit was brought on behalf of a class of current and former residents at Greystone Park by the Division of Mental Health Advocacy, which falls under Public Defender Joseph E. Krakora's purview.

It alleges that Greystone is witnessing an explosion in the occurrence of violent behavior by residents, and said an influx of patients transferred there due to the closing of other state institutions has led to overcrowding and made the circumstances unstable.

The volatile atmosphere has led many of Greystone's psychiatrists and medical staff to quit for fear of their safety, according to the suit, which accuses state officials of trying to cover up the mounting problems rather than search for solutions.

The suit claims residents are denied their due process rights under the 14th Amendment to a safe and humane physical and psychological environment, the right to be free from state-created danger and from the deliberate indifference to medical needs, and the right to be protected from patient-on-patient assaults.

The office also claims state laws governing involuntary commitment are being violated at Greystone.

The named defendants include Gov. Phil Murphy; Commissioner Shereef Elnahal of the state Department of Health; Commissioner Carole Johnson of the state Department of Human Services; Elizabeth Connolly, acting Human Services commissioner; Greystone Park Chief Executive Officer Tomika Carter; Greystone Park Medical Director Evaristo Akerele; Attorney General Gurbir Grewal; and Deputy Attorney General Swang Oo.

The Department of Health, for its part, has pointed to improvements at the facility, those it said are already carried out, as well as those that are planned.

Lead counsel for the plaintiffs is Carl Herman, director of the Division of Mental Health Advocacy, joined by Deputy Public Defender Nora Locke and Assistant Deputy Public Defenders Rihua Xu and Eric Sarraga. Also representing the plaintiffs are Andrew Wolf, David DiSabato and Lisa Bouckenooghe of the Wolf Law Firm in North Brunswick.

The state's Division of Mental Health Advocacy, which serves people committed to mental health facilities, has a statutory mission that includes bringing class actions and other litigation, according to Herman. In its previous incarnations, the division was under the umbrella of the state Treasury, and later operated under the Office of the Public Advocate before it was absorbed by the Public Defender's Office in 2010, he said.

The staff of the Division of Mental Health Advocacy, in regular visits to Greystone, found overcrowding, such as when a unit with 25 beds had 27 patients, according to Herman. Finding accurate data about staffing at Greystone has been a challenge, but the division is aware that many psychiatrists and physicians have recently left their jobs, he said.

Greystone has seen an influx of fragile, geriatic patients since Hagedorn Psychiatric Hospital in Glen Gardner closed in 2012, the suit said. And when the North Jersey Developmental Center and the Woodbridge Developmental Center closed in 2014, Greystone saw an influx of individuals with serious cognitive disabilities, according to the suit.

Greystone's adult psychiatric population, many of whom are young and prone to assault, now live alongside the elderly, former Hagedorn patients and the developmentally disabled residents, since the facility does not provide separate units, the suit alleges.

Apart from violence directed at other patients, nearly every doctor at Greystone has been assaulted, according to the suit, including Marek Belz, who allegedly was assaulted several times in the forensic unit, including one time when he was punched in the head. Belz resigned in 2016 after working at Greystone for five months, the suit said. Seung Lee, an evening on-call psychiatrist, was severely assaulted by two patients when responding to an on-call request, and was subsequently hospitalized. Another doctor, Ravi Baliga, was lifted off the ground, pushed against the wall, and thrown to the floor by a patient and robbed.

Greystone has also seen in influx of illegal drugs in recent years, the suit claims.

The suit also claimed that, due to the departures of many psychiatrists at Greystone, the remaining psychiatrists must “cover” civil commitment hearings for patients they have never evaluated. According to the suit, Akerele, the medical director, and Deputy Attorney General Oo “are systematically engaged in the practice of pressuring doctors to conceal material information from the civil commitment court, and punishing doctors who refuse to lie.”

In one alleged case, a psychiatrist testified in court about his lack of knowledge about a patient and lack of time to prepare. Oo informed Akerele of the testimony in the sealed hearing, prompting him to summon that psychiatrist into his office, yell at the psychiatrist, and instruct him never to provide such testimony in court again, the suit claims.

A spokeswoman for Elnahal, Donna Leusner, said the Department of Health does not comment on pending litigation. But Leusner cited multiple actions undertaken by the department to attract and retain doctors, including obtaining recent approval for raises in pay for psychiatrists, and the award of a contract to an agency that will bring on additional psychiatrists in the coming months. She added that psychiatrists are in short supply statewide and nationally.

Leusner also referenced a recent assessment of state psychiatric hospitals that was commissioned by the Department of Health, which outlines improvements already made, such as the hiring of 220 clinicians and other staff. In addition, she pointed out that the Department of Health has plans for $23 million in physical plant improvements at psychiatric facilities.

Murphy's office and the Attorney General's Office declined to comment on the suit.

The Department of Human Services did not respond to a request for comment about the suit.