During the early morning hours of Aug. 8, 1989, two detectives were summoned to the grounds of Forest Haven, Washington, D.C.'s institution for the mentally retarded "to investigate the report of a dead body." At the scene, they discovered the "body of a B/M (black male) . . . lying on his right side in his bed in a fetal position . . . ." Their report further related: "He was wearing a hospital gown and white socks with red stripes. . . . There was what appeared to be dried blood on his mouth."
The body was identified as that of Arthur Harris, a severely retarded young man known to his family and friend as Arkie, who had spent more than 17 years institutionalized at Forest Haven.
Not long before his death, Arkie's family had celebrated his 22nd birthday at Forest Haven, 300 acres of wooded, campus-like grounds located outside Washington in suburban Laurel, Md. In one of the 22 cottages, many with pleasant-sounding names like Athelia, Dogwood and Camelia, they ate ice cream and cake and snapped photographs. But when it came time for them to go home, Arkie's older sister, Brenda, did not want to leave. For reasons she could never explain, she was filled with fear and despair as she said goodby to her brother. "We said we got to go, but she just stood there," recalls their mother, Gloria Mae Harris. "So I waited about a half an hour for her, and I went back in the ward and she's laying in the crib with him. She said, 'Mom, I don't want to let Arkie go.' I said, 'Honey, he's OK, nobody's going to hurt him here.' So she looked back and she busted out crying and she went right back and held him again. That's when I said 'Brenda, come on,' 'cause I was trying to be strong for her. But she kept crying and soon we both ended up crying, and I went back there and I said, 'He's fine.' She looked at him and said, 'I love you Arkie.' And he just took his hand to her face. She said, 'I feel better now.' "
But Arthur Harris would soon become one of at least 10 Forest Haven residents who, during a two-year period, died of complications related to aspiration pneumonia, an infection that can be caused by entry of food into the lungs when patients are fed while they are lying down instead of sitting up.
Those deaths, says John Dunne, the assistant attorney general for civil rights during the Bush Administration, constitute the deadliest known example of institutional abuse in recent American history. "Based on our various investigations around the country" says Dunne, "there was no other institution of any kind in America where so many people died from abuse and neglect over such a short period of time."
The ultimate death toll at Forest Haven may never be known. The problem dates back at least 20 years, according to city records and interviews, when the population of the facility averaged more than 1,300. Yet the Justice Department and city only began to monitor deaths there between May, 1989, and March, 1991, while the institution was in the process of closing and roughly 200 residents remained. "There is nothing to indicate that there was a dissimilar rate prior to that," says Joseph Tulman, a law professor at the District of Columbia School of Law who worked on behalf of Forest Haven residents. "What we discovered in 1991 was only the tip of the iceberg."
Social problems such as homelessness, street crime and drugs generate headlines, but less public attention has been focused on the often life-threatening conditions facing people living in prisons, mental hospitals, institutions for the mentally retarded and public nursing homes. Especially threatened are those left behind at institutions such as Forest Haven, forgotten as communities debate whether to maintain such facilities or to close them.
Mary Bray, an occupational therapist who has investigated conditions at facilities for the mentally retarded as an expert for the Justice Department and advocacy groups, says that Forest Haven is hardly unique and residents all across the country are still in danger of dying of aspiration pneumonia.
"Over 200,000 people in institutions who are immobile and rely on others for eating are at risk. Others such as the mentally retarded, high-risk infants, children and adults with developmental disabilities are also at risk," says Bray. "Part of the problem is that the parents and relatives of a good number of these people have long since forgotten them. So there is no one to make sure they are not neglected or abused."
The Justice Department and private advocacy groups have sued state governments in Pennsylvania, Connecticut, Oregon, Tennessee, Oaklahoma and many other states for violating the constitutional rights of mentally retarded residents of state-run institutions. In a number of cases, lawsuits have charged that residents had died unnecessarily from aspiration pneumonia.