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Hartford - Connecticut's mental health commissioner says she's satisfied with her agency's process for determining whether mentally ill young adults are healthy enough to leave state respite programs in the wake of the brutal Christmastime slaying of a Deep River mother.
Pat Rehmer, who cannot discuss individual cases, said the Department of Mental Health and Addiction Services' clinical staff members carefully evaluate patients before they leave for outings, such as home visits.
"If there are serious concerns, then I think we would make a very careful clinical decision about whether that person should be allowed to go or not," Rehmer said in an interview with The Associated Press. "We feel quite comfortable saying to a young adult - and young adults don't always like this - 'This isn't going to work for you. We want you to stay here today."'
Rehmer's comments follow the Dec. 26 death of 45-year-old Margaret Rohner, who was brutally killed by her emotionally troubled 23-year-old son, Robert O. Rankin, known as Bobby. According to family and friends, Bobby was a client at the department's River Valley Services, a voluntary residential respite program located in Middletown.
Days before Rohner's death, he was released to his father, Rohner's former husband, despite concerns raised by Rohner to DMHAS staff that her son wasn't taking his psychiatric medications because they made him feel sleepy.
Despite earlier reservations, however, Rohner agreed to let Bobby come to her home to open Christmas presents and spend the night. He later confessed to police that he had killed his mother.
Since her death, Bobby's father, Robert Rankin, told the AP that he didn't believe River Valley Services staff should have allowed his son to leave the respite program for the holidays.
Some of Rohner's friends agree.
"I can tell you, without a doubt, that Margaret feared her son, especially when he was off his meds," said Sandy Bannon of Killingworth, a close friend of Rohner's for 27 years.
"He was most definitely a danger to himself and a select few others."
Due to patient confidentiality rules, Rehmer couldn't confirm whether Bobby was a client. However, she and agency spokeswoman Mary Mason said whenever any critical incident occurs involving a client, a peer review is conducted to determine if something went wrong and if any changes should be made. Peer reviews cannot be released to the public.
"I think it's important to recognize that any kind of incident where there is any death or serious situation, the staff is invested in rethinking and looking at what has occurred. And we take that very seriously," she said.
Rehmer said she is satisfied with the agency's current policies for determining whether a client is OK to leave a respite program.
"We do have clients that unfortunately end up in situations like this. We have clients that commit suicide, and we have clients that sometimes hurt other people," she said. However, she notes, the agency treats about 110,000 people and such incidences are rare though devastating to staff.
Rehmer said if clients protest and staff believe they may be a serious risk to themselves or others, DMHAS can have them hospitalized, even though the respite program is voluntary.
Last month, Robert Rankin told the AP that staff at River Valley Services didn't relay any concerns to him about Bobby when he came to pick him up for the holidays, such as whether he should have contact with his mother.
Bannon recalled Rohner telling her about a therapy session she had attended with Bobby, possibly last summer, where he talked about wanting his mother dead.
"That's got to be in the notes somewhere," Bannon said.
Bannon said Bobby could be very charming and might have convinced staff he was fine to leave with his father that day.
Another longtime friend, Ali Thompkins of Washington Depot, recalled going with Rohner to visit Bobby last spring at River Valley Services. She said he was "sweet as pie" with a young female staffer, a marked difference to how he treated his mother.
Rehmer said the vetting process for determining whether a client is ready to go home for a visit is individualized and depends on each client's status, level of care and level of supervision, among other considerations.
Rohner's friends told the AP that she had voiced concerns with DMHAS officials about Bobby not taking his psychiatric medications. Robert Rankin said his son, who is being held at Garner Correctional Institution and has yet to enter a plea, has been diagnosed with a form of schizophrenia.
"When he would go off his meds, he would become very scary to her," Bannon said. "And most of his anger and most of his outbursts were all directed at her. So she was in fear and made it quite clear to them, on numerous occasions, calling up there, that something bad was about to happen."
Patricia Unan, a close friend, said Rohner told her Dec. 19 that she had pleaded with someone at River Valley Services to hospitalize Bobby and force him to take his medications because she recognized he was heading for a mental breakdown.
"She said they told her they wanted to wait until after the holiday to address the situation," Unan said in an email. Bannon said Rohner told her the same thing.
Bobby's attorney, Dennis P. McMahon, has said his client has serious psychological problems.
"He's struggling with this now," McMahon said in January. "I don't think he understands what is happening."