CPEP: The Uncovered Story

CPEP—the Comprehensive Psychiatric Emergency Program run by St. Joseph’s Hospital—serves about 7,000 patients a year.  There are no published figures about its budget, but St. Joe’s budget is $402 million.  You can bet that CPEP is costing several of those millions.  Information about CPEP is not forthcoming.

            Why not?

            When I called CPEP and asked how many beds they have, I was told they couldn’t give out that information.

            Why not?

            Why don’t you give them a call yourself at (315) 448-6555 and see what you can find out?

            Meanwhile, here’s  another story that the Post-Standard isn’t reporting.

 Puttin’ in the Fix

             Dr. Ghaly would see his patients in the hospital in the morning; in the afternoon he would see his patients in the office, and then, a couple nights a week, he would go to work in CPEP.  The days’ after, when he would see me, he often would be frustrated and distressed:  CPEP wasn’t big enough or staffed well enough to care for all the patients who were coming there.

            It is practically impossible to get psychiatrist’s to cover CPEP; it’s not desirable duty.  Therefore, there is only one psychiatrist on the service at a time.  Patients come in by choice or are brought in by coercive police action and must be seen by a psychiatrist before they can leave.  The psychiatrist can treat and discharge, or admit to “the back.”

            The back of CPEP consists of a nursing station, a drug room, a couple showers and bathrooms, and a day room that has a couple tables, some chairs and a television.  It also has eight patient “rooms” too small to accommodate anything more than a single bed and a night stand.

            Patients are not treated in the back.  They only are held there until they can be transferred to a regular inpatient psychiatric unit.  The patients are medicated but receive no other kind of therapy, support or intervention.  And they are not supposed to remain in CPEP for more than three days.

            The problem is that there is nowhere for the CPEP staff to transfer patients to.  There aren’t enough beds available locally on inpatient psychiatry.  Syracuse has psychiatric units in the Veterans Administration Medical Center, SUNY Upstate Medical Center, Community General Hospital, and Hutchings Psychiatric Center.

Hutchings is the state hospital and there have been continual efforts to reduce its patient population or shut it down.  It was built in 1972 and has a dozen buildings but currently only three are being used for adult inpatient service.  It has 105 beds to serve five counties.  The number of beds at the other facilities is not publically reported, but is about forty beds each.

Hutchings is the only place that admits children and adolescents, and it has 30 beds for that use.  There used to be a private hospital, Benjamin Rush Center, whose owner had wisely read the future and created a large children’s’ unit in the 107-bed facility.  After the owner’s death, the hospital was sold to Four Winds, and then closed by the state for “numerous deficiencies.”  Speaking from experience, on its worst day Four Winds was better than Hutchings on its best day.  But when the state investigators come, are they going to hold a private facility to the same standard as a state facility?

There is bias against treating people for profit, no matter how well and how successfully they are treated.  Additionally, the argument is that the state hospital has to be kept open no matter how poorly it treats people (“We will work with the staff and try to engender improvements.”) because the need is so great.  The state can’t shut itself down; it has to have some place to put people.  Besides, Medicaid charges for Hutchings treatment are less than Medicaid charges for private treatment.  In the end, it is never about the quality of care; it is always about the money.

The end result of the shortage of inpatient psychiatric beds is that patients back up in CPEP and general hospital emergency rooms.  The director of Upstate Medical Center’s children’s emergency room attended a public hearing and made it very clear that he didn’t want children with mental problems in “his” emergency room.  So what happens?  Nine-year-old Michael ends up sharing space at CPEP with Al the convicted killer. 

When there are no vacant beds in the county, CPEP staff have to start searching the state to find any bed, anywhere.  Patients are sent out-of-county, away from their family, friends and homes, in order to receive treatment.  In Central New York there is a gross failure of hospital administrators and government officials to plan and work effectively to meet the needs of patients with psychiatric diagnoses.

Mental illness is neither glamorous nor popular, and is treated behind locked doors, so it gets ignored.  St. Joseph’s cardiac care services are ranked number one in the state; Crouse Hospital has the best Neonatal Intensive Care Unit in a fifteen-county area; Upstate has the only Level I Trauma Center between Pennsylvania and Canada; Community General—well, it does the best it can.  But nobody wants to provide for patients who are mentally ill.

So it ends up with Dr. Ghaly standing in front of me with bloodshot eyes and steam hissing from his ears.  I ask him what’s wrong and he replies, “Eh!  CPEP . . . !”  He saw thirty patients in the last twelve-hour shift.  That is about twenty minutes per person to interview a complete stranger, make a diagnosis, figure out a treatment, sell it to the patient, and then write the notes the state requires.  In these circumstances would you feel that your daughter or father had been treated properly?  (To be continued)


About annecwoodlen

I am a tenth generation American, descended from a family that has been working a farm that was deeded to us by William Penn. The country has changed around us but we have held true. I stand in my grandmother’s kitchen, look down the valley to her brother’s farm and see my great-great-great-great-great-grandmother Hannah standing on the porch. She is holding the baby, surrounded by four other children, and saying goodbye to her husband and oldest son who are going off to fight in the Revolutionary War. The war is twenty miles away and her husband will die fighting. We are not the Daughters of the American Revolution; we were its mothers. My father, Milton C. Woodlen, got his doctorate from Temple University in the 1940’s when—in his words—“a doctorate still meant something.” He became an education professor at West Chester State Teachers College, where my mother, Elizabeth Hope Copeland, had graduated. My mother raised four girls and one boy, of which I am the middle child. My parents are deceased and my siblings are estranged. My fiancé, Robert H. Dobrow, was a fighter pilot in the Marine Corps. In 1974, his plane crashed, his parachute did not open, and we buried him in a cemetery on Long Island. I could say a great deal about him, or nothing; there is no middle ground. I have loved other men; Bob was my soul mate. The single greatest determinate of who I am and what my life has been is that I inherited my father’s gene for bipolar disorder, type II. Associated with all bipolar disorders is executive dysfunction, a learning disability that interferes with the ability to sort and organize. Despite an I.Q. of 139, I failed twelve subjects and got expelled from high school and prep school. I attended Syracuse University and Onondaga Community College and got an associate’s degree after twenty-five years. I am nothing if not tenacious. Gifted with intelligence, constrained by disability, and compromised by depression, my employment was limited to entry level jobs. Being female in the 1960’s meant that I did office work—billing at the university library, calling out telegrams at Western Union, and filing papers at a law firm. During one decade, I worked at about a hundred different places as a temporary secretary. I worked for hospitals, banks, manufacturers and others, including the county government. I quit the District Attorney’s Office to manage a gas station; it was more honest work. After Bob’s death, I started taking antidepressants. Following doctor’s orders, I took them every day for twenty-six years. During that time, I attempted%2
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9 Responses to CPEP: The Uncovered Story

  1. fernanda says:

    well i was admitted to cpep 3 times the staff are very nasty and mean i think they hate hispanics or they hate themselfs

    • annecwoodlen says:

      Your observation that maybe they hate themselves is very insightful. How could you go home at night and like yourself, knowing how meanly you’ve treated people all day?

  2. linda says:

    Thank you for all of your help. I’m sorry for typos… I also wanted to add to the above comments I made. As my son was tied up and sedated, his head was hanging off the bed. He had no support for his head. Then he yelled out several times that he didn’t feel well and no one came and checked on him. After they finally released him from restraints they realized that his blood pressure was so high they said we have to give you potassium. He said he didn’t want it but the Dr. Said” you will seem normal if you say yes”.
    I have started filling out forms and have placed calls. Tomorrow I’m going back to the hospital to demand to speak to the director of CPEP.
    Thanks for giving my son hope

  3. linda says:

    I had the unfortunate experience of witnessing my son being forced to go to cpep by police. He was cuffed like a criminal except that he had no rights. while he was being held in a waiting are the police kept cuffs on even while the nurses were taking his blood pressure and treating him like an object. The cops never took the cuffs off! My son then complained about the blood pressure cuff being too. Tight and please remove it. He was ignored, his hamds cuffed, he was frightened and helpless. I asked to go in and sit with him. I thought he was going to be cared for. The ytold me I couldn’t see him- he was on his own without witnesses. I was devastated.. I began yelling to him the bill of rights. I told him he has the right to ask questions.the male nurse ripped the cuff off him. He demanded to know his name..another less compassionate nurse came in and told my son”that doesn’t work in here”, “he doesn’t have to tell you his name” I assured him that he has every right to know who was treating him. Not once did anyone tell him they were there to help him or that they were going to care for him

    I was left in a waiting area with no explanation of what was happeningto my son. My son was yelling out for me. Then I didn’t hear him. They took. Him in another area for the continual torture .I was lleft clueless and panicky and helpless and hopeless in a waiting room…little did I know what horrific measures wee being used on my son!!!!! I think I would’ve been arrested for beating up anyone that hurt my child. I was then informed by a nurse that I could. Speak to my son on the phone. I will never be able to forget the horror in my son’s voice- he was drugged up by these people. How dare they shackle my son’s feet an then ask him why he was causing a scene in waiting room? Then they team of torturers simutaneously jumped on him held his head and shoulders and body down and the nurse yeilding a needle said”how dare you cause all those problems in waiting area” and then while they were holding him she came with needle toward his arm and he screamd out”NO!!!!!!!!!!!!!!!!! His voice was not heard. They had him tied up hands and feet and wrapped a resstraining sheet around him, I’m crying as I write this. I was around the corner and I couldn’t save my son. I’m having so much anxiety I haven’t eaten in three days. My son is showing signs of ptsd he is upset depressed angry , feels like all his trust and rights were taken from him.

    How can this happen? This is so damaging to the health of so many people. Why is this place allowed to do this? I want to press charges against the. Police and against the people that hurt my son. Hurt his. Soul. How does he recover from this??? How can we fight back?

    • annecwoodlen says:


      File complaints with:

      1. NYS Commission on Quality of Care and Advocacy for Persons with Disabilities Quality of Care and Advocacy for Persons with Disabilities Commission on Quality of Care and Advocacy for Persons with Disabilities
      How To Submit A Complaint
      Abuse and/or Treatment (Online)
      The Commission is authorized to investigate allegations of poor care or treatment involving New York State mental hygiene programs operated or licensed by the Office of Mental Health (OMH), the Office for People with Developmental Disabilities (OPwDD), or the Office of Alcoholism and Substance Abuse Services (OASAS). If you suspect poor care is being given to you or someone you know, you can file a complaint by:
      Using the link above, calling 1-800-624-4143 or writing a letter addressed to:
      Division of Quality Assurance and Investigations
      NYS Commission on Quality of Care and Advocacy for Persons with Disabilities
      401 State Street, Schenectady, New York 12305-2397
      2. Demand an interview with the director of the CPEP.
      3. Contact your local legal aid office and ask to speak to the PAIMI attorney (Protection and Advocacy for Individuals with Mental Illness).
      4. File a complaint with the NYS Office of Mental Health
      Customer Relations toll free at
      What does Customer Relations do with a complaint?
      Generally, complaints are referred to field staff or to consultants for investigation. We attempt to complete all investigations within 30 days.
      5. File a complaint with the director of the hospital.
      6. Find out what doctor was in charge and file a complaint against his license by going to the NYS Dept. of Health, Office of Professional Medical Conduct (OPMC).
      7. Go to the newspapers and television stations; if they won’t do a story then write a letter to the editor.
      8. Report it to your county and state legislators.
      9. Tell everybody you know.

  4. deanna germain says:

    i was escorted out of CPEP by SECURITY! They chasnged my meds and wwere going to discharge me!!! no appt for folow-up giaranteed -not until i threw a screaming fit did they chasnge my meds 3 times to kinda the right ones.And i was escorted to the waitmnng room!!!!!! INSANE!! they shouyld be sued!!!

    • annecwoodlen says:

      I agree–they should be sued. If you initiate a case, I will support you. What psychiatrist were you seen by? Throwing a screaming fit either will be effective or will get you drugged into submission. And CPEP’s mission does not include getting you a follow-up appointment. A medical Emergency Room also does not guarantee you a follow-up. You can only hold CPEP responsible for failure to do what it’s supposed to be doing, not for failure to do everything you want them to do.

  5. Would like to talk with you about the closing of the CPEP for Westchester County that is being discussed by Summer 2011. Michael Cappiello, CSEA.

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