W hen Vyonce Lawson was first hired by the Psychiatric Institute of Washington in February 2025, she could hardly believe her good fortune. Lawson felt called to care for people struggling with mental illness or substance abuse. But in the one and a half years since she’d graduated from Howard Uni versity with a psychology degree, the now 24-year-old had been unable to land a job working with such patients full-time. Lawson was thrilled to begin her career as a mental-health technician at PIW, a 152-bed, privately owned psychiatric hospital in Northwest DC that is, in many ways, the linchpin of the city’s mental-health safety net. The facility, she says, “seemed like the perfect place for me.” Once inside, Lawson was troubled by what she found. Decrepit patient housing units smelled of urine and feces. Patients frequently attacked one another or staff. A chronic worker shortage occasionally left Lawson alone with as many as 19 patients, many in the throes of acute psychiatric crisis. Her superiors didn’t respond to requests for assistance, her coworkers sometimes slept on the job, and her employer often failed to provide patients with basic necessities, such as enough food. “Honestly, a lot of the violence revolves around food,” Lawson says. “Because, like, if people feel hungry, they’re going to get more agitated, and [if] they’re not getting snacks and things like that, they’re going to lash out.” After a few weeks on the job, Lawson no longer saw PIW as a big-hearted treatment center helping locals. Rather, she says, “it felt more like a prison” where danger was routine. In the coming months, she too would be victimized. Last September, Washingtonian published a detailed investigation into PIW, where the bulk of the city’s involuntary commitments are sent. Drawing on watchdog reports, legal filings, regulatory documents, and interviews with a dozen former patients and employees, the article detailed a pattern of alarming conditions—including lackluster treatment, medicating patients to keep them docile, and a near-constant threat of violence and sexual assault. Some former staffers told Washingtonian that the facility routinely sacrifices patient well-being for profit. An ongoing class-action civil lawsuit brought by former PIW patients in February 2025 also connects allegations of poor care and unsafe conditions to the alleged financial priorities of Universal Health Services, the Pennsylvania conglomerate that owns PIW. Responding to Washingtonian, a lawyer for PIW said the facility denied the allegations in the class-action suit, the conclusions of a watchdog report cited in the article, and some specific claims in the article. PIW declined to comment on other claims, and UHS did not respond to a request for comment. Since the article’s publication, Washingtonian has spoken with additional former PIW staff and two psychiatrists who spent time working at the hospital. These sources—most of whom requested anonymity to speak candidly—have made disturbing new allegations. They describe employees coming to work high as well as wheelchair-bound patients being left to sit in their own feces. One former PIW psychiatrist says they regularly arrived at the hospital to find the patient population struggling with “multiple, serious medical issues that have been ongoing, that haven’t been addressed, that I suddenly need to figure out what the hell is going on [with] to make sure people don’t die.” Taken together, the sources paint a portrait of a facility even more dysfunctional than was previously understood—and raise serious questions about the priorities and decision-making of PIW’s leadership. “When you come in,” says a former tech, “it’s like, ‘Who the hell is running this place?’ ” Responding to a Washingtonian request for comment on a detailed list of claims and allegations in this story, a lawyer representing PIW declined, stating that many were “similar to allegations in pending litigation” and that PIW would “address them through the legal process.” The lawyer also said that PIW is “committed to providing high-quality care to patients with special, and often complex, mental-health needs. The safety, dignity and well-being of PIW’s patients and staff remain its highest priority.” Last summer, a challenging new patient arrived on Lawson’s unit. The man, whom we’ll call Arthur, had profound developmental difficulties and a history of violence. Following his August 2024 arrest on charges of felony assault with intent to commit sexual abuse, a judge found him incompetent to stand trial and sent him to St. Elizabeths psychiatric hospital in Southeast DC. He was released on July 18—and, three days later, involuntarily admitted to PIW. Arthur was a giant of a man—around 6-foot-4 with a heavy build, according to public records—who had a limited ability to speak. His time at PIW was turbulent. On July 26, five days into his stay, Arthur “became out of control” and “physically assaulted multiple staff members by kicking and slapping,” according to regulatory documents obtained through a Freedom of Information Act (FOIA) request. On another occasion, according to police records, Arthur “grabbed [Lawson] by the back of the head and pulled her head toward his genital area.” Lawson immediately informed PIW of this incident but did not report it to law enforcement until later. Nevertheless, on July 29, a PIW manager assigned Lawson—5-foot-7 and 170 pounds—to conduct one-to-one continuous observation of the large and unstable patient, meaning she was not to let him out of her sight. Lawson says that as she and Arthur were walking through the unit around 9 am, a medical assistant came out from behind the desk and confronted Arthur about the distance between him and Lawson. “You’re a little too close for my liking,” the assistant said, according to Lawson. The encounter seemed to trigger Arthur, Lawson says, and he responded by swatting at the assistant’s breasts. Lawson and the assistant attempted to deescalate the situation by telling Arthur his behavior wasn’t okay, Lawson says, but he subsequently ripped off the assistant’s shirt and bra and choked a staff member who attempted to intervene. From there, all hell broke loose, according to Lawson, police records, and regulatory documents obtained through FOIA. Over the next several hours, Lawson recalls, Arthur rampaged through the unit—punching, strangling, and pulling out the hair of patients and employees alike. Groups of up to five staff members at a time attempted to wrestle him to the ground, Lawson says. Other employees injected him with powerful antipsychotic drugs designed to subdue aggressive behavior, she says. Finally, when Arthur seemed to have calmed down, Lawson served him his lunch. Subsequently, Lawson recalls, he jumped back up and charged at her. Arthur pinned Lawson against a door, groped her crotch, and grabbed her breasts, she says. During the attack, Lawson says, she called out to the only staff member who was close enough to help—but the employee, a senior manager, remained frozen in apparent shock. Lawson says she broke free of Arthur’s hold and ran for the hallway. By that point, PIW staff had spent roughly five hours battling with him, she recalls. “[It] was just completely a loss of control,” Lawson says. “The doctors, clinicians, everybody—there was really no one who was following any type of protocol or really knew what to do.” “The doctors, clinicians, everybody—there was really no one who was following any type of protocol or really knew what to do.” Lawson says she called 911 and requested police assistance. Around this time, she says, her superiors made an astonishing decision. After exhausting all other options for restoring order to the unit, Lawson says, they directed staff to unlock the doors and clear the stairways so that Arthur could simply walk out of PIW. “[They] basically just let him escape,” she says. Through an upstairs window, Lawson says, she watched Arthur—an involuntarily admitted mental patient in desperate need of effective care and currently in the grip of violent psychosis—step onto the streets of Northwest DC. By pure chance, when Arthur reached Wisconsin Avenue, he turned in the direction of police officers who had gathered near PIW’s entrance. He was arrested and charged with felony sexual assault for his attack on Lawson. Had Arthur only walked in the other direction, Lawson says, “he would have been free.” After the attack, Lawson struggled to process the violence she had endured. She stopped talking to friends, rarely left her apartment, and spent most of her time in bed. “It kind of just, you know, got dark,” she says. Lawson never returned to PIW. Traumatized by the sexual assault, she was upset at her colleague for failing to intervene—and appalled at her superiors for putting her in such a dangerous situation. “I could never work in a place like that—where I feel that unsafe—again,” she says. “I couldn’t think about actually doing my job to the highest point if I’m fearing for my life while I’m working.” The federal Occupational Safety and Health Administration subsequently investigated the incident. Finding that PIW “failed to protect employees from a recognized hazard,” the administration issued a citation for a “serious” violation, according to a January letter it sent to Lawson. A lawyer for PIW said in an email, “We strongly dispute OSHA’s findings and plan to contest the citation.” Other former PIW employees have told Washingtonian that the violence in the facility caused them to leave their jobs as well—creating a fear-driven exodus that compounded longstanding worker shortages previously detailed by a city-government review and the testimony of a former nurse during a 2024 DC Council hearing. According to one former employee, this flight meant that many of those who remained at PIW lacked the experience, compassion, and dedication needed in a difficult and challenging environment. This former staffer recalls watching a male employee issue physical threats to a frail psychiatric patient in his sixties, telling the patient, “I will fold your bitch ass up on the sidewalk.” The same former staffer also says that workers sometimes failed to transfer aggressive patients off the units where they’d committed acts of violence, occasionally forcing patients to remain in the same room with individuals who had attacked them. Some battered and frightened patients, the former staffer says, resorted to dragging their mattresses into the hallway at bedtime. “They’re in fear of sleeping in their room,” the former staffer says. Regardless of staffing levels, former PIW employees say leadership was focused on ensuring that the facility was at full occupancy. “There was always this state of panic that we had X amount of beds empty and we need X amount of referrals from Maryland and X amount from Virginia to balance out the budget,” says one former employee. (PIW receives voluntary patients via referrals from hospitals in both states as well as DC.) Another former employee said PIW’s leaders prioritized “keeping the patients the max amount of days,” regardless of their actual medical needs. Former employees say this push to maximize the revenue generated by patients—a claim consistent with Washingtonian’s previous reporting—is led by PIW’s CEO, Eric Amoh, who started in 2023. Amoh, one former staffer says, frequently boasted about his desire for personal remuneration. “ ‘I’m about my money,’ ” this former staffer recalls Amoh saying. “ ‘I need my bonus.’ ” Another former employee characterizes him this way: “Mr. Amoh’s priority was not improving patient care but generating more billable hours.” “I spend my day frantically trying to figure out, ‘What the hell is going on with people? Are they safe? It’s like a war—it’s like being on the battlefield.” Former employees say an imbalance of too many patients and too few staffers had a profound impact on the quality of care. A former PIW psychiatrist tells Washingtonian they once ordered that a patient who was actively self-harming be under constant observation by staff. The on-duty nurse, however, responded that the unit couldn’t accommodate the directive. “ ‘We literally don’t have any staff,’ ” the former psychiatrist recalls the nurse saying. In their class-action lawsuit, former patients report that their encounters with psychiatrists were rare and fleeting. According to two former PIW psychiatrists, caseloads were so large that it could be difficult to spend more than a few minutes—if that—with a patient on a given day. “I spend my day frantically trying to figure out, ‘What the hell is going on with people? Are they safe? Do they need to go to another hospital? Is there anything urgent?’ ” says one. “It’s like a war—it’s like being on the battlefield.” One former psychiatrist also says a member of PIW’s medical leadership instructed psychiatrists not to spend time talking to patients, because they believed that even brief supportive psychotherapy interventions offered no benefit. The guidance was so contrary to the former psychiatrist’s training that they felt like they were working “in an alternate universe.” The two former psychiatrists say some of their PIW colleagues also worked at other mental-health providers and therefore hustled through rounds so they could get to their second jobs. One so-called double-dipping psychiatrist, according to a former tech, regularly conducted their PIW rounds very early in the morning while many of the patients were still asleep. On one occasion, the tech says, this psychiatrist directed the tech not to wake a patient who had specifically requested to see the psychiatrist: “So it’s almost like [this psychiatrist] don’t have to see them. And now [they] can get out of the building really fast, and now [their] day is done over here.” When caring for patients, the two former psychiatrists say, they were dismayed by the guidance of PIW’s leadership. One says that after a young patient had reported experiencing significant abuse at home, a member of PIW’s medical leadership instructed the psychiatrist not to report this allegation to Child Protective Services, arguing that the patient had made a prior claim of abuse that investigators later discredited. Though failing to report such allegations is against the law, the psychiatrist ultimately chose not to inform CPS, out of fear that PIW would find out if they disobeyed the instruction. The psychiatrist was so alarmed, though, that they took notes on the incident and shared a written account of it with Washingtonian. On another occasion, the psychiatrist says, they were approached by a voluntarily admitted patient requesting to be released from the hospital against medical advice—a request within that patient’s rights, says Hadley Truettner, a former DC public defender who spent three decades advocating for PIW patients. But when the psychiatrist sought to obtain the required forms, a member of PIW’s medical leadership objected, saying that the psychiatrist shouldn’t help such patients leave. “And if a patient ever even asks about it,” the psychiatrist recalls being told, “I should try and convince them otherwise.” To keep insurance dollars flowing, the two former psychiatrists say, a member of PIW’s medical leadership sometimes told psychiatrists to fudge patient records—for example, never recording “substance-abuse disorder” as a primary diagnosis, regardless of how a patient presented at admission, but rather using “mental-health issues,” because insurers wouldn’t pay for the former. At one point, says a former psychiatrist, PIW’s medical leadership issued written guidelines detailing exactly how psychiatrists should describe patients’ conditions in records. According to a photograph of a portion of these guidelines obtained by Washingtonian, they read, in part: UNACCEPTABLE: “No withdrawal symptoms” ACCEPTABLE: “Need to continue to monitor for withdrawal symptoms.” UNACCEPTABLE: “No complaints” ACCEPTABLE: “Patient working on . . .” UNACCEPTABLE: “stable” ACCEPTABLE: “Patient requires slow taper of medications and close monitoring for side effects.” The “acceptable” language, the two former psychiatrists say, was more likely to convince insurance companies to keep paying for care at PIW. One of the former psychiatrists says this practice wasn’t necessarily malevolent: “You can think about this as nefarious or you can think about it in terms of dysfunction with insurance systems and trying to make sure that the hospital gets paid for the work that actually needs to be done.” The second psychiatrist, however, says the practice crossed ethical lines because it was done not to serve patients but to financially benefit PIW. These records, this psychiatrist adds, were so wordsmithed that staff sometimes joked “about how we were creating works of fiction.” Since the publication of Washingtonian’s previous investigation, little has changed at PIW. While there has been some staff turnover, Amoh remains CEO. The watchdog group Disability Rights DC has repeatedly called on the District to demand improvements at the facility, but the willingness and ability of city government to do so remains unclear. According to DC Council member Christina Henderson, officials at DC Health and the DC Department of Behavioral Health are conducting joint visits to PIW and both agencies are updating their regulations related to psychiatric hospitals. However, she tells Washingtonian that the District’s oversight efforts are complicated by its reliance on PIW, where nearly six in ten people involuntarily committed to the city’s mental-health system are sent. “I think that this is one of those issues of when you have these monopolistic relationships that make it really difficult to do the oversight,” Henderson says. If regulators concluded that the situation at PIW was “truly troubling” to the point of “we have to shut this down,” Henderson says, could the city follow through? “I don’t think we could,” she says. “PIW is our largest provider [for emergency involuntary commitments]. That makes me nervous, just in terms of having capacity. Again, UHS can pack it up and walk away. They’ve done that in other jurisdictions. UHS is a corporate entity. This is dollars and cents for them, and if something is not working financially, they will make an adjustment.” Asked if she has confidence that PIW’s parent company can provide high-quality care and a safe environment, Henderson’s answer is brief. “To an extent,” she says. Vyonce Lawson’s life is finally beginning to stabilize. Unable to obtain a psychiatric evaluation until last November—and still working to find a suitable therapist—she credits the support of family and friends with helping her emerge from a depression. Now reengaging with the world, she’s focusing on accountability and reform. Lawson has filed complaints about the July 29 incident with federal and local authorities and has urged PIW to conduct an internal investigation. She’s also talking with attorneys about filing a lawsuit against the facility. “I could never work in a place where I feel that unsafe again. I couldn’t think about actually doing my job if I’m fearing for my life” Lawson’s goal, she says, is not just to seek redress. She also hopes to force PIW to adopt new safety protocols so that no other employee ever finds themselves in similar peril. “We do need good people in the field and people who are passionate,” she says, “not people who are scared for their lives when they come to work every day.” Washingtonian’s previous investigation of the Psychiatric Institute of Washington is in our September 2025 issue and online. Read Here   This article appears in the March 2026 issue of Washingtonian. The post Continuing Chaos at DC’s Troubled Psychiatric Hospital first appeared on Washingtonian. ...read more read less