WRAL Investigates

Former employees say short-staffed NC psych hospital rife with violence, abuse

More than a dozen former employees say understaffing at Brynn Marr Hospital contributes to what they describe as a dangerous place for patients and employees. Hospital officials say allegations of violence, sexual assaults, overmedication and lack of mental health therapy are unfounded.
Posted 2024-05-06T21:07:50+00:00 - Updated 2024-05-08T16:21:02+00:00
Claims of assault and over-medicating kids in crisis at NC facility

EDITOR’S NOTE: This article mentions self-harm, suicide, sexual assault, violence and psychiatric hospitalization. If you need mental health support, call or text 988 or consult this resources page or our county-by-county mental health resource guide.

In June last year, 11-year-old Henry picked up a sharp object and threatened to harm himself and his mother.

It had been a rough year for Henry, who has autism spectrum disorder and has been diagnosed with a host of other developmental, mental and physical health conditions. His mother, Nicole, said her son had been bullied by kids near their home in northeastern North Carolina, and he had been hospitalized a few months earlier due to suicidal thoughts.

Henry and Nicole are pseudonyms. North Carolina Health News knows the identities of the mother and son and reviewed copies of the child’s medical records with permission. Nicole spoke on the condition of anonymity due to fears of negative stigma attached to psychiatric hospitalization.

The day Henry found himself in crisis, he said he didn’t feel like himself and asked for help, Nicole recalled. But Henry’s request for help only led to more trauma.

Nicole took him to a UNC Health emergency room in Chapel Hill, where Henry was placed under an involuntary commitment, a legal tool used to mandate mental health treatment when a patient is considered a danger to themselves or others. Under that order, a sheriff’s deputy drove Henry to the first available psychiatric bed at Brynn Marr Hospital in Jacksonville.

Instead of receiving intensive, specialized mental health care at Brynn Marr, Henry experienced dangerous conditions and little in the way of treatment, his mother alleged in complaints to the state Department of Health and Human Services and the North Carolina Medical Board.

In her complaints, Nicole claims Henry was sexually harassed and attacked by other patients. He left the facility with an untreated concussion and received treatment for it at a specialized concussion clinic, according to the child’s medical records.

Nicole isn’t the only one to complain about the treatment provided by the privately owned psychiatric facility on the North Carolina coast.

In interviews with NC Health News, more than a dozen former Brynn Marr Hospital employees described a chaotic, violent facility — for patients and staff. The former employees depicted a soul-crushing, understaffed work environment that caused at least one former staff member to have suicidal thoughts. Another says she has nightmares about her time working at the hospital. Every former employee interviewed by NC Health News said they wouldn’t recommend Brynn Marr to someone in need of mental health care. One questioned whether the hospital should be operational at all.

NC Health News also obtained more than 200 pages of records from the state Department of Health and Human Services, in which regulators detailed violent incidents between patients. The records, which were heavily redacted and anonymized by the state, correspond with the experiences former employees described to NC Health News. The records include an interview with a doctor at Brynn Marr who said that staff members are “afraid to go on the unit.”

Jordan Wenzel, a former mental health technician at Brynn Marr, said the hospital over-relied on medication. “I feel like that’s Brynn Marr’s goal: ‘Let’s see how much medication we can get pumped through these kids instead of being proactive and developing a treatment plan,’” Wenzel told NC Health News.

Most of the former employees — including former mental health technicians, nurses and administrative staff — spoke to NC Health News on the condition of anonymity for fear of retaliation or potential negative impact on their careers. NC Health News verified their employment by reviewing documents such as copies of tax forms, pay stubs and Brynn Marr identification badges.

The former employees’ allegations — which a hospital executive says are either unfounded or false — follow probes by regulators into practices by the hospital and its parent company. Meanwhile, the hospital says it’s working to solve recruiting and retention issues.

Problematic past

In 2023, federal and state health regulators cited Brynn Marr for failing to provide a safe and therapeutic environment. Regulators made surprise visits to the hospital after NC Health News and the News & Observer co-published the story of an 11-year-old patient sent to Brynn Marr against her parents’ wishes. While there, she was sexually assaulted, her parents’ alleged in a complaint to the state health department.

Regulators put the hospital under “immediate jeopardy” after finding several deficiencies, including conditions that allowed an adolescent patient to escape. Immediate jeopardy is the most severe citation a hospital can receive, indicating serious harm or death has or is likely to occur to one or more patients, requiring immediate action.

The hospital had to make changes by June 2, 2023, to get back into compliance or risk losing the ability to bill federally funded programs such as Medicaid. According to the state Department of Health and Human Services, the hospital took the necessary corrective actions before the deadline. The department isn’t currently investigating the hospital; state regulators can only act once they get the green light from federal regulatory agencies, which have the ultimate authority over hospitals.

The state documents obtained by NC Health News detail staffing issues and employees who were scared of the people they were trying to serve.

In one state document, a doctor identified only as “MD #7” told regulators that staff members don’t try to de-escalate patients’ aggressive behaviors because they aren’t properly trained to handle violent patients. The facility has “lost lots of staff” and relies on medications for treatment, MD #7 told state inspectors.

Each of the 13 former Brynn Marr employees who spoke with NC Health News — who worked at the hospital between 2017 and 2023 — reiterated MD #7’s allegations. They added that constant staff turnover left patients with inexperienced caregivers and forced other employees to cover for those who had quit abruptly.

Former employees of a psychiatric hospital in Jacksonville owned by Universal Health Services speak out about violence and lack of mental health treatment at the facility. PHOTO: JAMIE MUNDEN/WRAL NEWS
Former employees of a psychiatric hospital in Jacksonville owned by Universal Health Services speak out about violence and lack of mental health treatment at the facility. PHOTO: JAMIE MUNDEN/WRAL NEWS

The former staff members echoed allegations made in 2016 by scores of former employees of other hospitals owned by Brynn Marr’s parent company, Universal Health Services, a publicly traded company headquartered in Pennsylvania. The company operates hundreds of inpatient behavioral health facilities across the country, including two others in North Carolina: Holly Hill in Raleigh and Old Vineyard in Winston-Salem.

In 2020, UHS agreed to pay $117 million to resolve multiple allegations against several of its hospitals for knowingly filing false claims for payment for behavioral health services that weren’t necessary or weren’t appropriately provided, according to the U.S. Department of Justice. UHS entered the settlement agreement without admitting guilt.

In a case against a UHS-owned facility in Virginia, former patients made claims of sexual and physical abuse, as well as allegations of medical record falsification. In Illinois, a UHS-affiliated facility was ordered to pay $535 million in a negligence lawsuit following allegations of the sexual assault of a 13-year-old patient by another patient. The company’s lawyer called the verdict excessive and said the hospital plans to challenge it.

Additionally, Universal Health Services is under scrutiny from U.S. senators for alleged “exploitation, mistreatment and maltreatment, abuse and neglect and fatalities” at residential psychiatric facilities for young people. A spokesperson for the committee said the investigation is ongoing and declined to provide additional comment.

Former Brynn Marr staff members made similar allegations in citing their reasons for leaving, including frequent assaults and injuries from patients, little training or support from management, as well as heavy workloads and long hours. Many said their mental health deteriorated as a result of working at Brynn Marr.

NC Health News sent Brynn Marr Chief Executive Cynthia Waun a list of allegations made by former hospital employees interviewed for this article. Waun provided a five-page response.

“From BMH’s [Brynn Marr Hospital’s] own attempt to review the allegations you have received, we strongly believe they are unfounded and many are likely outright false,” Waun wrote.

“We do not think extrapolating conclusions about BMH based on the out-of-context statements of a handful of former employees is fair to the thousands of hard-working staff members and clinicians who work in the challenging behavioral health care environment, or to the thousands of patients who have received good care from BMH without incident.”

‘Punching bags’ for patients

The mental health technicians — who supervised patients, led group sessions and took them to outdoor time, to meals and to showers — recounted the most violent allegations. Aaron McDonald, a former technician, described himself and other technicians as “punching bags” for patients on the teenage boys’ unit.

Another technician recalled a time when a teenage male patient bit another technician in the back, tearing his shirt. Two employees, in separate interviews, brought up an incident in which a patient purportedly hit a technician in the face, breaking his eye socket and sending him to the hospital. One nurse recounted the time she saw a patient slam another nurse’s face into the wall, knocking out her two front teeth.

Brynn Marr’s CEO wrote that she didn’t find any incident report or workers’ compensation claim about a nurse losing her teeth.

In an interview with NC Health News, one former technician who worked on the teenage boys unit at Brynn Marr described being beaten by patients. Several former staff members described times when a violent incident broke out among multiple patients and they called for back-up and no one came to their aid because other staffers were too frightened to intervene.

The former staffers alleged these kinds of calls for help happened almost daily, sometimes multiple times a day.

“I had to pray before I go in there because I don't know if I'm going to make it out safe,” one former technician said.

Brynn Marr accepts male and female patients of all ages in its acute care units, typically for short-term psychiatric hospitalizations. The hospital also has a residential unit for teenage girls where the patients stay longer and take academic classes. The units for adults and children who are 12 years old or younger are co-ed, while adolescent units are gender-specific. Teenage patients tend to be the most aggressive, former staff members say.

Several former technicians described patients attacking each other or ganging up to victimize one patient. Four former staffers, in separate interviews, alleged that the most violent patients were typically those who had been at the hospital for several weeks, months or sometimes years. They added that the patients with the longest stays were often children involved in the foster care system.

Nicole worried for her son’s safety during his 11-day hospitalization, describing Henry as small for his age and fragile, due to Ehlers-Danlos syndrome, a condition that affects the skin and joints. She alleged in a complaint to the state that her son was attacked, was called sexualized names and asked to perform sex acts by other patients in Brynn Marr’s children's unit. Nicole said there were times when she could hear yelling and alarms in the background as she talked to her son on the phone.

“Every time I talked to him, he was crying, sobbing, begging to come home,” she said.

One day, Henry called his mom in tears saying that a patient who had been bullying him had pushed him down and punched him in the face multiple times before staff intervened. He told his mother that his jaw hurt and his ears were ringing. The nurse told Nicole that it was an unprovoked attack and that she would try to have the aggressor moved to a different unit, the mother claimed. However Henry told his mother that the patient was never moved.

When Nicole picked Henry up from the hospital, she said he had bruises on his face. Their family doctor determined that Henry had a concussion and referred him to a concussion clinic where Henry attended physical therapy sessions to correct some issues related to balance, according to medical records NC Health News reviewed with permission.

“It blew my mind that he could be in a medical facility and sustain a concussion and get zero treatment for it,” Nicole said.

Some patients were traumatized from witnessing frequent assaults or being caught up in the chaos themselves, according to former staff members.

‘I want to call my mom’

Emma Davies, a former mental health technician, described a 2020 incident during which she was taking a child’s vital signs and the patient suddenly pushed the blood pressure machine into her.

“We were trying to restrain her because she was trying to attack everybody,” Davies said. “Mental health techs were bit, scratched, spit on. Someone’s glasses were broken. I was kicked in the chest. And all they did was medicate her until she fell asleep pretty much and then put her to bed. Their [the patients’] needs were not being addressed.”

Afterward, she remembers other patients crying, saying: “I want to go home. I want to call my mom.”

Years later, the memory causes Davies to choke up.

Davies said that after the incident, she was in pain and had bruises on her chest that she wanted to get examined. But her supervisor told her she couldn’t go home and tried to convince her to come to work the next day, Davies said.

“They just really didn't care about us,” she said, “and they didn't care about the patients either.”

After five months working at the facility, Davies decided she’d had enough. At the end of a shift, she said, she put her hospital keys in an envelope with a note detailing her concerns and asked another technician to walk her out.

Every former employee interviewed for this story shared similar stories of violence and fear among staff and patients. Each said they received insufficient training and that patients weren’t given therapy interventions that would help curb the violence.

Waun, the Brynn Marr executive, said that the hospital values its staff and takes “their safety and well-being and concerns very seriously. We acknowledge, as with many others in the healthcare industry, high turnover is one of [Brynn Marr Hospital’s] challenges. However, we are actively working to enhance our recruitment and retention strategies.”

Waun added that in 2023, Brynn Marr brought in certified Crisis Prevention Institute trainers to retrain staff on how to apply safety interventions and disengagement techniques. She said that specialty instructors also trained staff on advanced techniques in verbal de-escalation and interventions for aggressive patients.

From January 2019 to September 2023, Jacksonville Police records show that officers made 116 visits to Brynn Marr Hospital due to calls about physical assaults and 129 visits due to allegations of sexual assault and rape. PHOTO: JAMIE MUNDEN/WRAL NEWS
From January 2019 to September 2023, Jacksonville Police records show that officers made 116 visits to Brynn Marr Hospital due to calls about physical assaults and 129 visits due to allegations of sexual assault and rape. PHOTO: JAMIE MUNDEN/WRAL NEWS

In Jacksonville, the local police frequently visit Brynn Marr to document assaults, but former staff members said they thought more should happen after they write their reports. From January 2019 to September 2023, local police made 116 visits due to calls about assaults at Brynn Marr Hospital, according to Jacksonville Police Department records. Former employees say that police weren’t called for every assault.

When state regulators reviewed one such incident — in which a patient was purportedly injured by another patient’s unprovoked attack — records indicate that law enforcement officers came to the hospital to document the injuries. An officer spoke with the local district attorney who said there would be no criminal charges “because most of the patients at the facility had behavioral issues and were in crisis,” according to state records.

When asked about another incident of alleged patient-to-patient “abuse,” MD #7 told state regulators they “did not recall the incident,” according to records. The doctor added that “many similar incidents take place at the facility due to the age group, psychiatric diagnosis and manipulative nature of some patients” and that “boundary issues were ongoing with the type of population.”

Federal investigators reviewed 200 violent incidents at a different UHS-owned psychiatric facility in Florida throughout 2022. The incidents resemble the stories recounted by the former staffers at Brynn Marr. In that case, federal officials documented incidents in which employees were “assaulted, confined by patients, and suffering broken bones and concussions and wounds from being scratched, bitten, punched and kicked.”

The federal investigators called their findings at the Florida facility “shocking.”

Keeping patients safe

Mental health industry experts interviewed for this article said the frequency of violent incidents described by former Brynn Marr employees and patients is not normal and preventable. They said that psychiatric facilities can provide patients with a calm, safe environment by having the appropriate number of well-trained staff. They said staffing facilities to that level is very expensive, which is where a lot of for-profit hospitals fall short.

“Anyone who is working in a behavioral health facility should be well-trained in de-escalation strategies, but beyond that, patients themselves should be understood,” said Nora Dennis, a psychiatrist and former behavioral health medical director at insurer Blue Cross and Blue Shield of North Carolina. “And this process of understanding them is core to the function of an inpatient behavioral health unit because you actually have access to the patient around the clock to observe them and to talk with them and to understand what is motivating and driving their behavior and then to preventively address violence.”

Another key component of an inpatient psychiatric facility is to provide what Dennis called a “healing milieu,” meaning a safe, predictable environment. Many patients come from homes and lives that feel chaotic. Therefore, a structured, consistent environment can help improve their condition even before any medicines kick in, said Dennis, who worked at Duke Health and the Veterans Affairs Hospital in Durham before founding her own mental health clinic and healing farm in Orange County.

When done right, inpatient mental health care is staff intensive and very expensive, according to industry experts. A surveyor who has investigated complaints against psychiatric hospitals across the United States for two decades for the Centers for Medicare and Medicaid said that it’s common to see private hospitals try to save money by cutting staff or by not filling vacancies.

When asked about Brynn Marr, state Health Secretary Kody Kinsley said his team cannot ensure safety and high quality care within the state’s psychiatric facilities without proper staffing at the Division of Health Service Regulation, which investigates complaints. He said complaints have risen sharply while the division grapples with a 16% employee vacancy rate and 15% turnover rate due in part to low state salaries.

“This is not a new story,” he said in a statement. “Our behavioral health system has been ignored and unfunded forever — leaving North Carolina’s families and children with impossible choices.”

A spokesperson for Senate Leader Phil Berger said that the state General Assembly has regularly increased salaries for state employees, including a 7% raise over two years included in the budget passed late last year, and dedicated funding for mental health needs.

State lawmakers granted the department funds last year to build more comprehensive mental health services in community settings rather than institutions and raise behavioral health rates for providers treating Medicaid patients. Kinsley noted that the department chose not to increase rates for psychiatric residential treatment facilities, saying “significant work needs to be done to ensure any future increase in PRTF payments are tied to quality outcomes and a higher staff-to-patient ratio.”

Brynn Marr operates a residential unit for teenage girls.

129 sexual assault calls

Local police also visit Brynn Marr Hospital to document frequent allegations of sexual assault made by patients and reported by hospital staff or a parent, guardian or outpatient therapist of a patient, records show.

One former Brynn Marr mental health technician recalled a series of sexual assault allegations as the patients were quarantined in their rooms — typically three to one room — during a COVID-19 outbreak on the residential girls’ unit in the summer of 2022. The technician worked the night shift and said she and other technicians were told not to go into the rooms to check on patients because they were sick. Instead, they looked through a window in the door to complete mandatory 15-minute checks.

The former technician said that many mornings during the quarantine, patients would allege that they woke up to find another patient touching them inappropriately or performing sexual acts without consent. According to the technician, the nursing staff reported these incidents to the police. Officers came to the hospital and interviewed the patients, staff and the alleged suspect in each case who was then moved to a single room.

From January 2019 through September 2023, local police responded to 129 calls reporting allegations of sexual assault and rape at Brynn Marr, according to police records. During summer 2022, officers came out 18 times to respond to sexual assault reports, including five visits between July 27 and Aug. 2.

Several staff members recalled times when patients would claim to be in relationships, openly flirt during groups or try to make out in common spaces.

Aaron McDonald, a former technician on the teenage boys unit, alleged the sexual assault reports he was made aware of were likely preventable. The allegations McDonald described occurred when children under 12 or teenage girls who were particularly violent were put on the teenage boys’ unit, he said, where some reported being assaulted by the boys there.

Other cases of alleged sexual assault occurred when “kids were roomed together that shouldn't have been because one kid was known for sexual aggression,” McDonald said.

“Ethically, I thought that the way that they placed patients was really dangerous,” he said.

McDonald said patients with documented histories of sexual aggression are supposed to be in single rooms or have one-on-one staff-to-patient supervision overnight. But due to staffing shortages, he alleged it was often difficult to provide that necessary supervision.

Waun, Brynn Marr’s CEO, said the hospital has no confirmed reports of young children or teenage girls being assaulted in the boy’s unit. Additionally, she said, calls to police in alleged assault cases “are made in order to ensure that patient safety is maintained. Many of the allegations turn out to be unsubstantiated,” she said.

State regulators found that the facility failed to maintain investigative summaries in seven of the nine patient-to-patient sexual abuse allegations that they reviewed in December 2022. Of those cases, regulators noted in their report that the facility also failed to track the completion of sexual abuse allegation investigations.

NC Health News previously reported the alleged sexual assault of an 11-year-old patient at Brynn Marr who said the purported incident occurred when she was sick and quarantined in a room with a teenaged patient with a history of aggression.

‘No real group therapy’

Most days, there should be about eight group therapy sessions for patients at Brynn Marr, according to former day shift employees, but they told NC Health News those sessions often didn’t happen.

Nurses and therapists are responsible for one group each and the rest are led by mental health technicians. However, former staff members said, some of the groups simply involved going outside or coloring.

Former technicians interviewed for this article said that many groups were interrupted or skipped altogether due to regular fights that would break out between patients. There were also other disruptions, they alleged, such as patients barricading themselves in a room or having a panic attack.

MD #7, the doctor interviewed by state regulators, said that patients should attend programming as part of their treatment but stated that “no real group therapy” happens at Brynn Marr. The doctor told regulators that patients had no mid-level assistance after their sole physician assistant quit and that there were “no acute clinicians” because the facility had “lost lots of staff.”

According to state records, there was a “distressing incident of aggression from one patient” in 2021 which “triggered” many other patients. Regulators wrote that day’s other group therapy sessions “could not occur” after what took place. The details of that particular incident were redacted in the report.

Regulators who reviewed the incident also wrote that there was no psychiatric component established in the alleged aggressor’s treatment plan. The patient at the center of the incident was not placed on “aggression precautions” nor was the patient’s guardian notified of the incident, the report said. And the same patient went on to be involved in another patient-to-patient incident, according to the state investigation.

Most group therapy sessions at the hospital are led by mental health technicians who receive little training when they’re hired, according to former technicians. They said the job requires no prerequisites other than a high school diploma or GED, which is also reflected in Brynn Marr’s job description for the position. Before being hired at Brynn Marr, some of the technicians reported their previous jobs included waitressing, working in a big-box retail store and a child care center. One technician was a former correctional officer; another a military veteran.

Some former technicians said they didn’t feel qualified to lead groups on these topics. For therapy groups, the technicians said they could pick from a range of topics placed in a folder, including addiction, triggers and coping mechanisms or logical brain versus the emotional brain. Others said they felt like babysitters.

Meanwhile, staff members with formal mental health training, such as clinical counselors or psychiatrists, were either too overwhelmed to provide much therapy or unavailable, said all of the former staff members interviewed by NC Health News.

5-minute psychiatry visits

A staff member whose job included reviewing patient records alleged that therapists skipped a lot of the therapy meetings and groups with patients. “Even when they were supposed to be doing therapy, a lot of times there was nothing to indicate they had a therapy session” in patient charts, she said.

During treatment team meetings, where clinical staff would discuss each patient’s progress, nurses would often relay messages from patients’ parents who would call repeatedly for days asking to speak to their child’s doctor, according to the former staff member, who spoke on condition of anonymity for fear it would negatively affect her career.

The former employee told NC Health News that doctors would refuse to call the parents back.

Waun, Brynn Marr’s CEO, said that psychiatry visits happen seven days a week and that the hospital’s “policy includes having the child’s physician contact parents with daily updates.”

Nicole, 11-year-old Henry’s mother, and more than a dozen other parents told NC Health News that doesn’t happen. Frustrated by the lack of communication, Nicole started recording her phone calls with members of the hospital’s staff after failing to reach a doctor or get updates about Henry’s care.

“They would dodge my questions or say they couldn't answer it or say ‘that's up to the doctor,’” Nicole said. “But then I wasn't able to even talk to the doctor about my own child’s care. Which was insane to me.”

After she “raised a lot of hell” with hospital support staff, Nicole said, the psychiatrist called her once, 10 days after Henry arrived at Brynn Marr. During the seven-minute phone call, Nicole asked the doctor why her son was still being held at Brynn Marr under an involuntary commitment, stating that Henry was no longer suicidal.

“I’m not really going to go into detail with you about that,” the doctor said during the recorded call, which was reviewed by NC Health News.

“Why not?” the mother asked.

“Because I don’t really feel like doing that right now,” the doctor responded. “I’m not here to defend why we are keeping your child in the hospital. He’s just not ready to go yet.”

Nicole continued to press the doctor for what issues she was working on with Henry that met the criteria of an involuntary commitment, but the doctor didn’t give specifics.

When Nicole kept asking questions, the doctor said: “Would you like him to be discharged tomorrow? Would that make you feel better?” Then the doctor agreed to discharge Henry the next day.

NC Health News reached out to Brynn Marr’s medical director at the time of these events, but he didn’t respond to multiple requests for comment.

Several mental health technicians reported that patients also expressed frustration by the lack of time they received with a counselor or psychiatrist. Every former day shift employee interviewed for this article described patients’ visits with psychiatrists averaging between three and five minutes. They were “more like check-ins,” said one former staff member.

The allegations are consistent with those made in previous reports by other patients and reported by NC Health News: State regulators found that Brynn Marr failed to ensure daily visits from a psychiatrist.

A clinical counselor who completed a master’s-level internship at Brynn Marr said the hospital is “the least therapeutic place you could go."

“In defense of the two social workers I worked under, they were so overworked and understaffed. I don't necessarily even blame them, because they have so much work that it was impossible,” said Victoria, the former intern who asked her last name be omitted for fear it would hurt her professional reputation.

Jordan Wenzel, the former mental health technician, said she was disappointed that Brynn Marr had “no therapeutic response” to several suicide attempts that she claimed occurred on the teenage girls unit in 2022. She alleged the protocol response to the attempts was to put the patient alone in a room dressed in what staff called a “turtle suit” — clothing that cannot be torn and is used to prevent patients from hurting themselves — and place a technician outside the door to watch the patient.

“It was never, ‘Hey, they are having a crisis, let’s get a team in to talk to them,” Wenzel said. Instead, the response was: “‘You want to hurt yourself, now we’re going to seclude you in a room so you’re thinking about all the thoughts you just had. And we’re going to sit here for 12 hours and make sure you don’t harm yourself,’” she said.

Waun, Brynn Marr’s CEO, said that after each incident of suicidal behavior, the therapeutic responses and interventions discussed and implemented by the treatment team are documented in the patient’s medical record.

‘Drugged out of their minds’

According to the former employees, Brynn Marr heavily relied on medication for treating patients. The doctor interviewed by state regulators, identified as MD #7, said that “most of the patients’ treatment” at the hospital consisted of “medication therapy.”

A former therapist told NC Health News that drugs were pushed over therapy.

Another former staff member claimed that after patients took their medication, they often were like “zombies.” Other terms former staff members used to describe how patients appeared after medication include “zonked out,” “lethargic,” “drugged out of their minds,” or “falling asleep in the middle of the day.”

“You couldn't have dumped a bucket of water on some of the kids and woke them up because of how sedated they were from some of the medicine,” said McDonald, the former technician.

Three former staff members recalled different incidents when patients were taken from Brynn Marr to the emergency room due to reactions from psychiatric medications.

Some former Brynn Marr Hospital employees recalled times when patients had adverse reactions to psychiatric drugs and were taken to the local emergency room in Jacksonville. PHOTO: JAMIE MUNDEN/WRAL NEWS
Some former Brynn Marr Hospital employees recalled times when patients had adverse reactions to psychiatric drugs and were taken to the local emergency room in Jacksonville. PHOTO: JAMIE MUNDEN/WRAL NEWS

One former Brynn Marr nurse said there were times when the high doses of medication seemed like a way of maintaining control over patients. The nurse described one patient who purportedly ended up in a medical hospital. The nurse said the patient was overmedicated and had toxic levels of lithium.

Brynn Marr’s CEO, Waun, confirmed that there have been a few cases when hospital staff sent patients to the emergency department out of an abundance of caution due to adverse drug reactions.

Additionally, she wrote, federal and state regulators reviewed the hospital’s records in unannounced visits in the past year and “never cited our physicians for inappropriate medicating of patients.”

Nurses are responsible for dispensing medications prescribed by a psychiatrist. The former nurse said she saw more psychiatric medications given to Brynn Marr patients than she had ever seen at three other mental health inpatient facilities where she has worked.

Former staff members said many patients would tell them they felt bad or tired on the medication and some refused to take them at the hospital. Patients would also go home with prescriptions for high doses of medication which they just stop taking because of the negative side effects, former staff members said.

The nurse said she believes that contributed to relapses and readmissions. Instead of learning coping skills and working through some of their issues, they’re only medicated.

‘We were going to get hit’

Most of the former employees said that they expressed their frustrations to the hospital management before they left, but they said they felt brushed off.

“We knew going in every day that we were going to get hit,” said McDonald, a former technician. “I actually addressed it with the CEO at the time, and his words were, ‘You're a man. I'd rather you get hit than a woman,’ which I don't disagree with. But, I mean, telling an employee that I'd rather you get hit than somebody else tells them ‘I don't really give a [expletive] if you get hurt or not.’”

At staff meetings, people would raise issues with the overtime hours they’d worked, the need for more seasoned staff, or the lack of time for basic employee accommodations such as bathroom breaks, according to one former technician. She claimed that the management’s response was essentially to quit complaining and get back to work.

Waun, Brynn Marr’s CEO, said: “Staff schedules purposely build in time to allow staff members to take their breaks without leaving units short-staffed. Support staff also regularly assist with providing staff breaks as needed.”

Most former employees interviewed said it was a culmination of issues that led them to quit. The last straw for each varied.

One former technician described weeping every morning before going to work, dreading the sight of how patients were treated. Even after the technician was promoted, she decided to leave, and said she still suffers from nightmares because of the job.

Another technician said she would have panic attacks when she got home from work, saying her experience at the hospital was like being in continual fight or flight mode. She quit before she had a new job lined up and subsequently took a job delivering pizza.

Another technician said she quit on a day she was asked to work on a unit she was never trained for. And a former therapist said she quit because she worried that working at Brynn Marr could compromise her professional licensure.

One former staff member said she remembers often crying after work toward the end of her time at the hospital. She said she once contemplated the outcome of driving off a bridge: She wouldn’t have to return to Brynn Marr.

She quit the next day.


This article was co-published in a collaboration between WRAL News and North Carolina Health News, an independent, nonpartisan, not-for-profit news organization dedicated to covering health care in North Carolina.

Coming Tuesday: Several former Brynn Marr employees claim the hospital engaged in patient record falsification and insurance manipulation.


About the reporting

NC Health News interviewed 13 former Brynn Marr employees who worked at the hospital for varying lengths of time between 2017 and 2023 in different positions including: mental health technician, nurse, social worker, unit coordinator, receptionist and in the finance department.

NC Health News initially connected with employees in different ways and conducted one-on-one interviews. Four responded to previous coverage of the hospital. We connected with some former employees on LinkedIn and Facebook. We connected with additional employees through the referrals from employees we connected with via the first two methods. NC Health News verified their employment by reviewing documents including copies of W-2 tax forms, pay stubs and Brynn Marr identification badges.

NC Health News requested records of inspections completed at Brynn Marr Hospital by the NC Department of Health and Human Services. Over a year later, we received 222 heavily-redacted pages from a survey completed by regulators on Dec. 22, 2022, that examined incidents and complaints from the prior few years. The details and descriptions of incidents from the state records correspond with the experiences shared with NC Health News by the former employees.


Taylor Knopf writes about mental health issues for North Carolina Health News.

If you're having suicidal thoughts or a mental health crisis, call or text 988. Veterans can press “1” after dialing 988 to connect directly to the Veterans Crisis Lifeline. For texts, veterans should continue to text the Veterans Crisis Lifeline short code: 838255.

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