Among the most serious incidents the report documented were an October brawl among six patients that left one needing surgery, and an autistic patient being forced to perform oral sex in November. The report also included allegations that a woman was raped and that a 14-year-old was forced to engage in oral sex by a 16-year-old.

All four incidents occurred after the highly publicized death of Esmin Green, a Jamaican immigrant with a history of depression, who collapsed on the floor of the emergency waiting room after waiting nearly 24 hours to be seen. A surveillance video showed Ms. Green, 49, lying on the floor for nearly an hour; during that time, a guard came in to check on her by wheeling his chair along, and another staff member prodded her with a foot.

“While perhaps unique in the extent of the harm that resulted, the tragic case of Ms. Green typifies the patterns of inadequate care and treatment,” reads the report, from Loretta King, an acting assistant attorney general, and Benton J. Campbell, the United States attorney in Brooklyn.

The report, a summary account of the federal investigation that resulted from a 2007 lawsuit by the New York Civil Liberties Union and others, found at least three cases, including Ms. Green’s, when employees falsified records to hide their neglect.

The report became public when Alan D. Aviles, president of the city’s Health and Hospitals Corporation, convened a news conference on Thursday to announce that “radical changes” had been made at Kings County, which treats many of the city’s most severely mentally ill. While questioning some details of the report, he admitted that the unit “too often failed” its patients.