RALEIGH - Consultants who reviewed a troubled state mental hospital in Goldsboro have issued a report that describes a dysfunctional institution with managers too detached to effectively solve problems.

The state Division of Mental Health hired Compass Group, an Ohio-based health-care consulting firm, to assess conditions at Cherry Hospital last month after a patient death and beatings spurred federal regulators to cut off Medicare and Medicaid funds.

The report, completed last week and released by the state Tuesday, says workers at Cherry are distrustful of their leaders. It says they are often hesitant to report incidents of patient neglect or abuse for fear of retaliation and doubt it will do any good.

Top managers, including hospital director Jack St. Clair, communicate poorly with those they supervise, often sending mass e-mail messages rather than talking face-to-face. They rarely visit wards where patients are cared for, the consultants wrote.

Though the report says the hospital's leaders are deficient, the consultants advised against firing them.

"These leaders have not demonstrated that they are collectively up to the challenge of managing organizational change," the report says. "[However] leadership instability interferes with mounting a sense of urgency. Changing the players will not, by itself, create a leadership team strong enough to enact changes quickly."

Leza Wainwright, co-director of the Division of Mental Health, said she was impressed with the thoroughness of the report and would take the consultants' recommendations to heart.

"We will do what needs to be done to bolster the management team," she said.

The staff at Cherry is so demoralized by recent media reports about the hospital's problems, employees often remove their name badges when leaving the hospital so people won't know where they work, the report said.

The frontline workers constantly fear for their safety and react by more frequently using physical force for "takedowns" of problem patients -- the opposite from the intended outcome.

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