Pilkington v. Bevilacqua

• Decision Date: 30 September 1977
• Docket Number: Civ. A. No. 77-0190.
• Citation: 439 F. Supp. 465
• Court: U.S. District Court — District of Rhode Island
• Parties: Robert PILKINGTON, Individually and on behalf of all others similarly situated v. Joseph J. BEVILACQUA, Individually and in his capacity as Director of Department of Mental Health, Retardation & Hospitals, et al.

439 F. Supp. 465

Robert PILKINGTON, Individually and on behalf of all others similarly situated v. Joseph J. BEVILACQUA, Individually and in his capacity as Director of Department of Mental Health, Retardation & Hospitals, et al.

Civ. A. No. 77-0190.

United States District Court, D. Rhode Island.

September 30, 1977.

COPYRIGHT MATERIAL OMITTED

John M. Roney, Lynette Labinger, Providence, R. I., for plaintiff.

Forrest Avila, Sp. Asst. Atty. Gen.—R. I., Providence, R. I., for defendants.

OPINION

PETTINE, Chief Judge.

In this civil action for injunctive and declaratory relief and for damages, the plaintiff claims his summary discharge from state employment is violative of the First and Fourteenth Amendments to the United States Constitution, 42 U.S.C. § 1983 and state law. Jurisdiction is conferred pursuant to 28 U.S.C. §§ 1331, 1343, 2201, 2202 and its powers of pendent jurisdiction.

Findings of Fact

Plaintiff Robert Pilkington was dismissed by the defendants in this case on April 1, 1977 from his employment with the Rhode Island Department of Mental Health where he had been an administrator in an inpatient mental health unit for the prior three months. The dismissal occurred without prior warning in a meeting with defendants Reidy, Angelini and Hickey who, as his superiors, stated that they were dissatisfied with his work. Yet the defendants had little direct knowledge of Pilkington's work and never consulted with the chief medical officer of the unit regarding the plaintiff's performance. On the previous day these three had met privately and reviewed various criticisms the plaintiff had leveled against these men's current policies. The evidentiary question facing this Court is: to what extent did Mr. Pilkington's expression of criticism cause the defendants to fire him and to what extent did they have independent grounds related to his job performance for their decision?

It is necessary to review in detail conditions leading up to the April 1 firing to understand the First Amendment interests at stake. In or about October, 1976, the plaintiff applied for the position of unit program manager for the Northern Rhode Island (NRI) Unit of the Institute of Mental Health (IMH), a state hospital administered by the Rhode Island Department of Mental Health, Retardation and Hospitals (MHRH). The defendants are MHRH and certain officials of MHRH and IMH. This position was created as a result of the complete restructuring of the IMH, in its effort to obtain accreditation by conforming with certain standards required by the State of Rhode Island and the United States. As part of a program referred to as "unitization"¹ nine physically distinct and separately staffed units or departments were formed with a managerial position for each, termed "Unit Program Manager". As a result of his application and subsequent screening, the plaintiff was hired and assumed his duties on or about January 3, 1977. He was asked for and gave a commitment of two years of service, having previously been advised that his employment was conditioned upon his taking and passing a civil service examination when given. Mr. Pilkington's job was, in effect, to organize a new mental hospital and to do so immediately.

Under unitization, each unit was a minihospital with its own administrator (program manager) and its own professional (physicians, clinical psychologists, social workers, and activity and occupational therapists) and non-professional (attendant) staff, which, in toto, numbered 110 persons. Soon after beginning work, Mr. Pilkington organized the staff into a "Unit Council" to create a democratic atmosphere, to facilitate staff participation in the decision-making process and to help the staff cope with the difficult transitional period during unitization. Though the unitization goals had been announced for several years, the plan was implemented abruptly and obviously without complete preparation. Patients who were familiar with fellow patients were transferred; surroundings and old routines were uprooted. This caused patients to react negatively and become highly agitated. The staff, in turn, in its attempt to cope with the emotional problems, resorted to medication to subdue or tranquilize the patients.

Exacerbating this difficult situation was a general confusion caused by inadequate office space for the staff; on-going painting during the move; shortage of furniture; lack of physical necessities including beds, clothing, shoes, linen, and towels; lost, misplaced and outdated medical records; lack of a centrally controlled service for supplies; and an increase in overtime from $40,000 per two-week period to $80,000 per pay period. In general, it is conceded by the defendants, a chaotic condition prevailed.

It was in this atmosphere of confusion and pressure that the IMH, scheduled to be inspected for accreditation, launched a crash program to shape its house in a manner which seemed most likely to satisfy the examiners. The officials, feeling that documentation and correction of records was of prime importance for accreditation, set a target date to accomplish this task; but it became an unduly burdensome job because it entailed correcting past deficiencies while at the same time fulfilling current documentation requirements without a sufficient staff or the use of overtime. The plaintiff contended, and the Court so finds, that it was impossible to do all this and in fact provide the patient care and therapeutic environment mandated by the various health laws.

The plaintiff's reaction to the officials' insistence on administrative priorities is actually the core of the present controversy: he voiced opposition, stating that the administrative demands should not be at the expense of staff morale and patient care. The end result was the claimed exercise of First Amendment rights by the plaintiff culminating in his being fired and this law suit. For example, the plaintiff and the Unit Council made their feelings known and either criticized or voiced objections in the following ways: they contended that the inordinate effort being consumed in paperwork left insufficient time to care properly for and treat patients; they opposed further admissions in their unit, stating they would accept patients only under protest and under certain conditions; on or about March 9, when needed supplies were not forthcoming, the plaintiff threatened to notify the press and lead his unit in a walkout; they opposed staff reductions; they disfavored vocally the dispensation of medicine by personnel not licensed to do so; when ordered to prepare 50 treatment-care plans per week, the plaintiff and the council argued they had determined that at most 30 plans could be done per week if they were to comply with the mental health laws. Moreover, during a meeting of the Governor's Council on Mental Health, the plaintiff disagreed with defendants Reidy and Angelini over the issue of staff quality and invited and encouraged outside groups to tour his unit. On an occasion when an attendant threatened to call her congressman and Dr. Bevilacqua to protest conditions at the IMH, the plaintiff refused to attempt to stop her. And at a hearing concerning whether or not a patient should be certified for retention at the IMH, the plaintiff testified on behalf of the patient contrary to IMH's position and stated that he believed the patient was not a danger to himself or others and should not be held at the hospital against his will. Hindsight demonstrates that Pilkington's general position was correct that unitization and the meeting of certain standards could not be accomplished as quickly as defendants wished.

In hearing this testimony, it was inescapable for this Court reasonably to infer that the defendants considered this conduct cantankerous and resistive of their demand that an all-out drive be made to accomplish those things they deemed indispensible to accreditation. As to the dispensation of medicine by unauthorized personnel, the plaintiff was told to drop the issue because it was very touchy and complex. The response to the 30 treatment-care plans instead of 50 was, "Forget the god damn Mental Health Law; I want 50 a week—do them." The reaction to the plaintiff's invitation to the public to tour the unit was a directive not to be so open—make the groups, "fight for their information." And as to the protest against further admissions, the plaintiff was told never again to accept a decision of the administration under protest.

On the other hand, the plaintiff's conduct had a positive effect on the personnel and patients. Mark Muradian, the clinical psychologist in the NRI, testified that from a condition of total chaos which did not "carry on even a minimal patient care", the plaintiff's leadership, advocacy and concern for patients heightened morale and improved the therapeutic environment.

This witness stated that the plaintiff was fired because he openly criticized the existing conditions; he further stated that firing the plaintiff so "shocked" him, he, the witness, is presently "less willing" to express his own views. In like manner, Linda Poole, a clinical social worker, testified that the central administration didn't seem to be concerned with how much time was being spent with the patients. Instead, the interest was in, "how many treatment plans are completed", how many reports completed; the administration was "only interested in numbers, not concerned about quality". She believed the plaintiff was fired because he was so outspoken and that once he was fired, "all became concerned and feared anyone who had worked with him would be next."

One staff member termed the therapeutic milieu under the plaintiff the best she had seen in 9 years at IMH. One disinterested physician who did not work for IMH but who saw patients at NRI testified that treatment at NRI was good and that the unit was cleaner and more efficiently operated than other units he v...