A state psychiatrist committed emotional maltreatment when he threatened a mentally ill patient at the Minnesota Security Hospital with electroshock therapy, a top state official has determined. The decision by Human Services Commissioner Lucinda Jesson overrules the department’s inspector general, who decided last month that the psychiatrist’s threats didn’t merit a finding of maltreatment.

“The reasonable person on the street of St. Paul or St. Peter probably would find a psychiatrist saying — in a raised voice with some anger — that he was going to ‘shock your brain’ to a committed patient to be threatening,” Jesson said in a letter released Tuesday that explained her decision.

“Clearly, this interaction was improper, inconsistent with the manner expected of a professional caregiver … I believe the preponderance of evidence shows the conversation constitutes abuse.”

Jesson’s action is significant because it comes in response to a rare, formal objection filed against the DHS by a state official whose office advocates on behalf of those with mental illness and developmental disabilities. The official asked Jesson to review Inspector General Jerry Kerber’s initial decision to reject the maltreatment finding that was made by his own licensing investigators.

The psychiatrist, Dr. James Christensen, has now been warned that he will be automatically disqualified from working for the state if he commits any further maltreatment over the next seven years, according to a state licensing report.

Christensen, who denied to state investigators that he made such a threat against the patient, is the only full-time psychiatrist at the St. Peter treatment facility, where more than 300 of the state’s most dangerous and mentally ill patients are housed. He has not responded to interview requests.

‘Power differential’ at issue

Roberta Opheim, the state ombudsman for mental health and developmental disabilities, is the official who asked Jesson in December to reconsider Kerber’s actions.

“I’m gravely disturbed because there is a huge power differential between the doctor and the patient as shown in that threat,” Opheim said at the time she filed her complaint. “That’s a coercive statement the doctor made. Wouldn’t any ordinary person be hurt, alarmed, if that threat was used against them?”

In a following interview, Kerber acknowledged that Christensen’s threats to the patient “would certainly cause me distress,” but said he still didn’t believe it rose to the level of maltreatment.

On Tuesday, Kerber said he did not feel slighted that Jesson had overruled his finding.

“The reversal shows that the system we have works, that we have a state government that is willing to review its decisions on request and change those decisions when appropriate,” he said. “When a decision is reversed, it is not a personal matter. It’s a sign that the system is working.”

‘Shocked and upset’

Christensen’s confrontation with the patient last April was witnessed by a psychologist at the treatment center.

The psychologist described hearing Christensen warn the patient, “You should be afraid of me. I am the one who is going to shock your brain with electricity,” according to a licensing report.

The patient was described as being “shocked and upset” upon hearing the threat, according to the report.

The psychologist then asked a colleague, “Did I hear what I think I heard? Did the (psychiatrist) just threaten to put electricity into the (the patient’s) brain?”

The colleague replied, “Yes, that is what you heard,” the report said. Christensen denied to investigators that he made such a threat.

After the investigators completed their findings, Kerber said he directed them to conclude that Christensen’s “interactions with the patient appeared to be inconsistent with the manner expected of a professional caregiver in a facility licensed by DHS.” In the revised version, Kerber concluded that Christensen’s maltreatment “was responsible for the emotional abuse of the vulnerable adult … it was a single incident and the vulnerable adult did not sustain an injury as a result of the psychiatrist’s actions.”

Christensen’s actions have also been reported to the state Board of Medical Practice to determine whether he violated any patient rights outlined in the Medical Practices Act.