February 29, 2024
Source: WXYZ
Photo Source: Unsplash,
“I’ll never forget it. I’ll never get over it.” That’s how Bri Jackson describes her stay inside a local psychiatric hospital – a stay Bri says never should have happened. “If you would have told me that something like that would happen, I would find it so hard to believe in the United States of America,” said another patient, who asked for anonymity, about their stay in the same psych ward. These patients and others are alleging they were locked up and held against their will in Pontiac General Hospital’s psychiatric unit, or coerced into staying for treatment for illnesses they say they do not have.
During the pandemic, 7 Investigator Heather Catallo started investigating these allegations. She spent hundreds of hours during the last two years talking with patients, former employees, and mental health experts, and reviewing hundreds of documents.
“I’ll never forget it. I’ll never get over it.” That’s how Bri Jackson describes her stay inside a local psychiatric hospital – a stay Bri says never should have happened.
“If you would have told me that something like that would happen, I would find it so hard to believe in the United States of America,” said another patient, who asked for anonymity, about their stay in the same psych ward.
These patients and others are alleging they were locked up and held against their will in Pontiac General Hospital’s psychiatric unit, or coerced into staying for treatment for illnesses they say they do not have.
Very few people have been willing to talk publicly about what’s going on behind the closed doors of a locked psychiatric ward. But now patients, parents, and employees are coming forward to talk to us about what they say are their experiences with the psychiatric treatment at some local hospitals and with psychiatrist Dr. Nagy Kheir.
After the 7 Investigators started asking questions in the probate courts about Dr. Kheir last spring, he suddenly resigned from one of the hospitals where he was in charge. But he’s still working for at least two other hospitals where patients say he has all the power over them.
They describe a system that uses the courts or the threat of the courts to keep patients locked up longer than necessary. Also, the 7 Investigators have discovered a crucial court form that can rob you of your freedom, that’s being signed long before a doctor ever examines you .But before we explore all of that, it’s important to understand how you end up in a psychiatric hospital in the first place. According to therapists, patients in crisis usually first go to the closest emergency room, either by choice or because a police officer, family member or doctor thinks they’re a danger to themselves or others.
Once you’re at the hospital emergency room, you’re placed in the psych holding area. When a bed at a psychiatric hospital opens up, you’re transferred. Then according to state law, you’re supposed to see a psychiatrist within 24 hours.
Against her will
“I’ve never been treated so poorly, like I wasn’t a human being,” said Bri Jackson.
Bri says after she lost her job and her health insurance in 2022, she ran out of her antidepressant medication. When she qualified for Medicaid, she went to a family doctor to try to get her medication refilled.
“Were you suicidal,” asked 7 Investigator Heather Catallo.
“No! No. Not at all,” said Bri. “I cannot stress this enough -- I went there to get medication!”
When Bri filled out her doctor’s assessment form, she answered yes to the questions about feeling hopeless and depressed. The 38-year-old from Oak Park says she just wanted her antidepressants so she could stop feeling so sad.
“He [the doctor] suggested that I go to Ascension Providence ER to see a psychiatrist,” said Bri. “He did say you may be able to do a one-day inpatient.”
Thinking a psychiatrist could refill her antidepressants and provide therapy, Bri drove herself to the emergency room. But that’s when she says everything fell apart.
“I was crying cause I was locked in a ward, and I didn’t know what was going to happen,” said Bri.
Bri says she never saw a psychiatrist -- and that’s not all.
“Can I make a phone call? Can I go call my mom? Can I go call my brother? Can I leave this area? And the answer was no,” said Bri.
Bri later found out a social worker at Ascension filled out a petition for the court, stating Bri reported suicidal ideation. Again, Bri denies being suicidal.
Bri says she later learned that a doctor signed a clinical certificate. Both the petition and the certificate are court documents used to hospitalize someone against their will, and doctors and psychiatrists fill them out under the penalty of perjury. The clinical certificate also labels Bri with a diagnosis of psychosis, even though psychosis is not mentioned anywhere else in her medical records.
Bri says the Ascension Emergency Medicine doctor who signed that clinical certificate never examined her and his name does not appear anywhere in her medical records that we reviewed from that Ascension Providence hospital stay.
“And I’m like – I didn’t see this doctor. I don’t have psychosis – what is this? And I’m starting to get a little bit frazzled. I’m reading them the law – that I have to see a
psychiatrist. I’m here voluntarily and they’re like that petition says no you aren’t,” said Bri.
Bri has a law degree and knows her rights.
“They didn’t believe me,” said Bri.
Despite multiple requests for interviews, officials from Ascension refused to talk to the 7 Investigators about why Bri was held, and about why a doctor who allegedly never saw her signed the commitment petition. The doctor did not return our calls either.
After three days in the Providence ER, Bri says she was then transferred involuntarily to Pontiac General Hospital’s psychiatric unit. At first, she says she hoped they would realize a mistake had been made and let her go home.
“I get the paperwork that I’m to sign in voluntarily. If I don’t do it, they can then take these petitions and court orders (clinical certificates) that they have yet to file up until this point.
Everyone’s using it to keep me there, but it hasn’t been filed in any court. They can take those, file them and then I would have to stay there until the hearing which could be up to 30 days,” said Bri.
So Bri signed herself in, believing she could leave in just a day. Instead, she says she was held for another nine days. And she says she quickly learned that inside the psych ward, you need to lie.
“I found out talking with the other girls, do what I can to get out of here meant I wasn’t going to see the psychiatrist to be wholly treated. I was going to tell him what he wanted to hear. So that’s what I did,” said Bri. “I felt in no way I was getting therapy or treatment. I was [only] getting medication. The same medication I had already been on. Why do I need to be here?”
While Bri was at Pontiac General, her records indicate she was under the care of the hospital’s chief psychiatrist at the time, Dr. Nagy Kheir. Dr. Kheir ran the entire psychiatry program at Pontiac General Hospital for seven years. From 2019 until last April, Kheir had also been in charge of Pontiac General’s psychiatry residents.
“There is no having a conversation with Dr. Kheir. Somebody told me you say yes, no or OK to him. Otherwise, you could be put there longer,” said Bri. “You say nothing to him if you want to go home.”
Bri says most days she saw a different psychiatrist, who, according to her records, consistently diagnosed her with depression. But on the day she was approved for discharge – medical records show she was suddenly diagnosed with Bipolar disorder, and then Dr. Kheir signed off in her chart.
“He never mentioned it. It was news to me when I get out and I read my discharge papers,” said Bri. “I mean when you look at these things altogether, that's why I think it's about money because to get me there, you can't just say I'm depressed. You can’t just say I’m sad.”
Bri is not the only patient who alleges they had problems with the system.
Evaluations in Question
“I don’t want her to go back there,” said Lakeshia through tears. “She’s now traumatized from what has happened to her at Pontiac General Hospital.”
Lakeshia says she became her daughter’s legal guardian after the 23-year-old was diagnosed with Bipolar disorder. In January of 2022, Lakeshia says she had to take her daughter to Detroit Receiving Hospital during a depressive episode. She then got transferred to Pontiac General Hospital.
“My daughter was there for nearly a week without Pontiac General making contact with me, without even so much as a phone call,” said Lakeshia.
Lakeshia says when her daughter was able to call, she got terrible news.
“She was crying, crying. I’m like ‘what’s wrong?’ She said, ‘They just jumped on me,’” said Lakeshia. “I said, ‘who jumped on you?’ And she says, ‘an employee.’”
Lakeshia says she raced to the hospital and called 911 on the way.
But when she arrived, she says hospital staff would not let her see her daughter and she says they would not let the sheriff’s deputy see her either.
“They said, ‘well she’s sleeping because we had to give her an injection.’ Why would you give her an injection if she’s been jumped on?” said Lakeshia.
Lakeshia alleges her daughter had the most trouble with Dr. Kheir.
“Dr. Kheir put in a request for the courts saying she was refusing her medications, she was hostile. So they put in a request for her to stay there longer,” said Lakeshia.
The 7 Investigators obtained the clinical certificate that Kheir signed for the probate court to order the 23-year-old to stay at Pontiac General for up to 60 days.
“Dr. Kheir, prior to his so-called evaluation, never contacted me to get history,” said Lakeshia. “How can you put a diagnosis on someone you have not spent time with?”
Another patient says the same thing happened to them.
“He’s the worst person ever. He’s so bad. He doesn’t even know the extent that my children suffered not having me home,” said a patient from Oakland County who did not want us to show you their face or use their name.
But they describe the same things we heard from other patients. They allege they were held against their will for 2 1/2 weeks at Pontiac General and given a diagnosis by Dr. Kheir they say they’d never received before.
“I said something like, ‘I don’t belong here doctor,’” said the patient. “And he said, ‘no you have bipolar in like first degree,’ or something like that. I said, ‘what do you mean I have that?’ and he goes, ‘no, that’s what you have and you’re staying here with us.’ (He) basically walked out of the room. And that was his evaluation – less than five minutes.”
The patient says they landed in the psych ward after getting picked up by police after acting out of control because they were using a marijuana product.
“Prior to that incident have you ever been diagnosed with a mental illness?” asked 7 Investigator Heather Catallo.
“Never in my life – never! I’ve never even seen a psychiatrist, ever,” the patient said.
The patient says they refused the medication Dr. Kheir wanted to give them.
“They held me down and gave me a shot in the arm,” said the patient.
Dr. Kheir was not just dictating the fate of psychiatric patients at Pontiac General for seven years, he also works at StoneCrest Center in Detroit and Harbor Oaks in New Baltimore.
Clinical Certificates: A Deeper Look
Sources inside both Pontiac General and StoneCrest Center tell the 7 Investigators that Dr. Kheir pre-signs the documents that are used in the civil commitment process. These photographs show the pre-signed blank forms ready for use inside Pontiac General Hospital.
The 7 Investigators obtained copies of the blank clinical certificates from both hospitals that already have Dr. Kheir’s signature on them.
"The Michigan Psychiatric Society is very disappointed to hear of this unethical and unprofessional and possibly illegal activity being done... The benchmark for this level of human rights suspension therefore must be very high and not for convenience of the provider doing the evaluation."
The blank StoneCrest forms also have a pre-filled examination time of 15 minutes typed in as well.
We showed the pre-signed forms to clinical social worker Marianne Huff. Huff is the president of the Mental Health Association in Michigan.
“Wow… I think that's really problematic,” said Huff. “Very unethical. Very, very unethical.
We are talking about people having their civil rights taken away, basically being held against their will without due process.”
Huff says with a pre-signed form, there's no way to know who really assessed the patient and whether the assessment was accurate and fair.
"I declare under the penalties of perjury that this document has been examined by me and that its contents are true to the best of my information, knowledge, and belief."
“If he's got his name on there and he signed it, that means he, as a psychiatrist, conducted an assessment and is putting forth a certain recommendation. Otherwise, the question becomes, if he's not doing it, who is?” said Huff.
“I wouldn't do that with my license,” said Bethany Atwell, a licensed clinical therapist and a Clinical Certified Trauma Professional.
Atwell often has to hospitalize patients. She, too, was surprised that a psychiatrist would pre-sign a blank form that’s used for the courts.
“It kind of feels like a violation of the patient's rights,” said Atwell.
Who is Diagnosing patients?
Sources inside the hospital tell the 7 Investigators the psychiatric medical residents still in training were the ones filling out the pre-signed forms. Sources say that’s not allowed because they’re not board-certified psychiatrists yet.
Former and current employees also say Kheir spent so little time at the hospital, there’s no way he can be doing all the evaluations he supposedly signs off on.
On several different days starting in early 2022, the 7 Investigators kept track of when Dr. Kheir left Pontiac General. Sources inside the hospital say the former chief psychiatrist only stayed at work a couple of hours.
On the 26 days we tracked him, he left anywhere from 10:48 a.m. to 1:33 p.m. Some days he drove to StoneCrest Center in Detroit. Some days we found his car at home by 3 p.m.
“Is that enough time to see all the patients there?” asked Catallo.
“Absolutely not. There's no way,” said a former Pontiac General Hospital employee who asked that we not identify her because she still works in the industry. “How do you justify that many patients and you certainly can't spend more than – I can personally say, I've never seen him spend more than five minutes is pushing it.”
The former employee says she witnessed several patients whose rights were violated.
“I think that’s a travesty,” said the employee. “It’s the epitome of evil. It’s the epitome of greed.”
On Feb. 1, 2022 Dr. Kheir walked out of Pontiac General’s doors and got in his vehicle at 10:48 a.m. Yet a clinical certificate obtained by the 7 Investigators for a StoneCrest patient in Detroit shows Kheir examined the patient just 12 minutes later at 11 a.m.
The drive from Pontiac General Hospital to StoneCrest Center takes at least 37 minutes without traffic. So how could he be examining a patient at the same time that he was driving?
“The way he treats patients… to use scare tactics to get them to take psychotic medications or he will report you and make you stay even longer. Because as I've witnessed him say before, the court is always going to side with me,” said the former employee.
“The judge sided with him because he’s a professional doctor, and they took his word for it, which is why I tried to say something. But I was not allowed to say anything [during the court hearing],” said Lakeshia.
For the patient from Oakland County, a county social worker even recommended that they be released from the hospital but according to court records, the judge sided with the hospital and the patient had to stay at Pontiac General Hospital longer.
“Do you feel the doctor used the courts against you?” asked Catallo.
“Yes, he used them to make me stay there, to bill my insurance more money. If it was up to him, like he told me to stay there for 31 days,” said the patient.
“Patients don’t need to be in there that long if there can be another plan of care found for them outside a psychiatric hospital,” said Atwell.
“If a patient came in and they were resistant to treatment, we would take them to court. And in some cases, the patient did need to stay, but in other cases, we would get people that needed to go to rehab,” said Katrina Davis, the former court liaison for Pontiac General Hospital.
Davis used to file those clinical certificates with the court. She told the 7 Investigators there was a lot of pressure to keep patients in the hospital.
“If we had 10 discharges, they’d want 10 admits coming in,” said Davis.
So let’s look at how much Pontiac General is getting for all of those in-patient stays.
Dr. Kheir was the chief psychiatrist there from 2016 through April 2023.
Medicaid pays for patients through the Oakland and Wayne County community health networks.
In Wayne County, the hospital’s contract calls for at least $880 a day for in-patient care.
In Oakland County, according to the contract, the hospital can bill for at least $950 a day.
That means Bri Jackson’s stay racked up at least $7,600 in Medicaid fees for the hospital.
Since 2017, the Oakland Community Health Network has paid Pontiac General $24,261,583.22 in Medicaid mental health payments.
$6,712,193.22 of that was for Bipolar diagnoses, and $14,023,171.10 was for Psychosis diagnoses – two common labels court records show patients are given on those clinical certificates that are used to hold them.
Complaints Against Dr. Kheir
The 7 Investigators uncovered 10 state complaints filed against Dr. Kheir with Michigan’s Department of Licensing and Regulatory Affairs (LARA) that date back to 2013.
In one complaint, the patient alleged that while she was at StoneCrest Center, Kheir forced her to take psychiatric medications by threatening to say she was “psychotic.”
For a 2016 complaint, the patient alleged, “the doctor met with me for less than five minutes and to meet the quota of a full house on his hospital unit, he petitioned me… to be
admitted.”
According to a 2019 complaint, the patient told LARA that Dr. Kheir “without asking any questions decided I would stay for seven days…” The patient told state investigators ,“he does not treat patients, but abuses the system to his own financial benefit...” calling Kheir, “not just an abuser but a danger to our society.”
The complaints all echo a similar theme: Patients held against their will, patients diagnosed with illnesses they say they don’t have, and lack of communication with the relatives of the patients.
“Essentially from day one to day 14, it was a complete and total loss of freedom,” said attorney Andrew Bossory.
Bossory filed a complaint with LARA for his client who says Dr. Kheir held her against her will for two weeks inside the StoneCrest Center psychiatric ward back in 2015.
Bossory says his client was upset about the death of her dog and accidentally took one anti-anxiety pill and then had a glass of wine. After she passed out, doctors thought she was trying to kill herself – which she denied.
“So from the get-go, qualifying this as a risk of harm to self-type of incident was a stretch,” said Bossory.
“Why do you think they kept her so long?” asked Catallo.
“They were able to bill insurance for it,” said Bossory.
Bossory says his client suffered so much trauma while locked up in the psych ward, nine years later, she’s still in counseling.
“It can cause long-standing, long-lasting, severe mental harm,” said Bossory.
In all but one of the state complaints, the three-person panel of psychiatrists voted not to pursue penalties or do a deeper investigation into Dr. Kheir.
“If we have complaints alleging identical issues and the [investigative] process hasn't even started, there may need to be some follow up,” said Bossory.
In 2021, a state administrative law judge ruled that Dr. Kheir did violate the Public Health Code after he failed to communicate with a Pontiac General patient’s family.
That family complained to the state, alleging, “Dr. Kheir failed to spend appropriate time as required by law with his patient for initial evaluation… we are under the impression [the] Dr. spent less than 10 minutes.”
Kheir says he did call that family.
But the Michigan Board of Medicine Disciplinary Subcommittee later put Kheir’s medical license on probation for six months because of that incident.
The 7 Investigators asked the state licensing division to explain to us why so many similar complaints have not been pursued by state investigators, but they refused several times to talk to us on camera. They also refused to discuss their complaint investigation process.
The Doctor Speaks
Dr. Kheir eventually did talk to us on camera. After several requests for an interview that were ignored, the 7 Investigators caught up with Dr. Kheir at his new clinic in Warren.
“We’ve been trying to reach you. We’d like to talk to you about why you’re pre-signing these clinical certificates,” asked Catallo.
“What?” said Dr. Kheir.
“You’re pre-signing clinical certificates,” said Catallo.
“Yes,” said Dr. Kheir.
“Before patients are examined,” said Catallo.
“Yes,” said Kheir.
“Doesn’t that violate their rights,” asked Catallo.
“Not uh, we examine them, but I sign it to be ready for the time factor,” said Dr. Kheir.
During an hour-long exchange, Dr. Kheir told us that he did not think pre-signing a blank court form that’s used as part of the civil commitment process is unethical.
“What do you say to these people who say what you’re doing is totally unethical?” asked Catallo.
“I’m not aware of what they’re saying,” said Kheir.
“Multiple experts are telling me this is not appropriate. Not ethical,” said Catallo.
“I don’t know. I will ask about that. But I think we are doing it, we are doing it in different hospitals without any problem, but if it’s not, if it’s a problem I can not sign it. But the issue is to be ready for time factor, saving time, not faking anything, or not seeing the patient – no,” said Kheir.
The 7 Investigators checked with sources at several area hospitals who all told us no one else they know pre-signs these important forms that are supposed to be filled out at the time the patient is evaluated by the psychiatrist.
“But how do you explain the time you weren’t actually there? When it says the time on the [clinical certificate] and you examined the patient, you’re saying it under oath – that you examined the patient at that time – you weren’t physically at StoneCrest – how could you have done it then?” asked Catallo.
“Yes. I can see the patient at 9:00 but I can write my note at 8:00 at my home,” said Dr. Kheir.
Dr. Kheir also told the 7 Investigators he sees 40-50 patients a day.
“We have multiple patients that say they’ve been diagnosed with things that you say they have – that they say they don’t have. Are you changing or increasing diagnoses to make them worse in order to justify the long stays in the hospital?” asked Catallo.
“Of course not. No. I am the most, in my opinion, conservative physician,” said Dr. Kheir.
“Are you holding patients against their will?” asked Catallo.
“No. I cannot do that,” said Dr. Kheir. “Do you believe I get more money for 10 days? No, this patient who left at 12 days, same day, I will have another new patient, so that day and the gaps are the same, patient after patient. These hospitals are full every day.”
Dr. Kheir gave us a tour of his newest venture, an outpatient psychiatric center called Kare Clinic in Warren. He says he considers himself a very conservative doctor when it comes to hospitalizing patients.
“A lot of patients say they were basically coerced into signing in voluntarily, because they were threatened that you would take them to court and make them stay longer if they didn’t sign in voluntarily,” said Catallo.
“Maybe there’s a misunderstanding by them. You have to explain the procedure,” said Dr. Kheir. “I’m not eager to keep patients, I’m not this guy at all. I’m not denying it, I’m not trying to pretend I’m the nicest one here.”
“Are you examining every patient yourself?” asked Catallo.
“Every single patient!!! I’m not fabricating or doing any kind of wrong records, and accusing the patient if something is not existing and let him go to court, no,” said Dr. Kheir.
But some patients say they never should have been held in the first place.
“There’s people that really need help, but I am not one of them,” said the patient from Oakland County.
“It's time I'll never get back. It's time stolen away from me. I had no due process. I had civil rights that were violated. And it's just changed me for the worse,” said Bri Jackson.
Kheir later released a statement to 7 Action News through his attorney. The statement reads:
“During my 18 years practicing psychiatry, it has been my mission to comply with the standards of my profession, to treat patients with dignity and respect, and to uphold the confidential nature of the physician-patient relationship. Patient confidentiality and other protections afforded to patients under Michigan and federal law prohibit me from addressing any specific instances of patient care in this forum.”
The Investigation Continues
Despite several attempts to talk to Pontiac General Hospital, no one from that hospital has returned our calls or emails.
That’s the same situation with StoneCrest Center. Even though the 7 Investigators called and emailed several times to ask about their pre-signed clinical certificates, no one has called us back.
If you’ve encountered a situation like this at a local hospital – please let us know HERE.
The 7 Investigators asked the Michigan Psychiatric Society about the use of pre-signed clinical certificates. The MPS issued this statement:
“The Michigan Psychiatric Society is very disappointed to hear of this unethical and unprofessional and possibly illegal activity being done... Involuntary psychiatric treatment is a process that is a tool that needs to be reserved to a small subset of people that have severe mental health issues or substance use disorder issues that impair their judgement as a result of the illness’s direct effect on the brain so much that it leaves them vulnerable to self-harm, successful suicide, or harm to others including homicide. The benchmark for this level of human rights suspension therefore must be very high and not for convenience of the provider doing the evaluation. This is why we need to maintain the highest level of educated providers possible to be able to discern if this is a mental illness or substance use disorder as the root cause versus a medical issue that does not fall in this category of interventions. Additionally, someone trained in the ethical balance between treating a person involuntarily and suspending their individual right to self-determination versus the risk of not treating them and the possible irreversible consequences.Medical illness can masquerade as mental health issues and need to be diagnosed and treated as such. Treating people who do not agree with a medical or surgical intervention as “mentally ill” so the procedure can be completed at the providers wish is wrong. To take away an individual’s rights to self-determination cannot be based on religious, philosophical, education, place of origin, sexual orientation or racial differences that may not align with a treating provider’s “plan.”Cognitive problems that do impair the individual’s capacity to understand the nature of their illness, risks and benefits of treatment or no treatment and variations on the treatments offered can be addressed through the probate court guardianship and conservatorship process. Adjudicated by a judge, these are a different process than the involuntary psychiatric process which is also adjudicated by a probate court judge but preempted with human rights suspension (Habius corpus) 4th amendment rights pending the adjudication...The behavior that has been outlined of physicians signing the certification form without ever seeing the patient and examining them is therefore completely wrong and unethical. Likewise having a lesser trained individual with not much more than a lay knowledge of the difference between mental health/substance use disorder and a medical problem mimicking them is poor health care as well.”
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