Photo: The Canadian Press

Inspectors who visited Washington state's largest psychiatric hospital found that safety problems that thrust the facility into the national spotlight after the escape of two dangerous patients a year ago persist, including neglected patients.

And a survey of Western State Hospital staff, conducted as part of federal oversight in December and January, found that administrators make decisions that "adversely affect patient safety" and there was a lack of trained or qualified staff, fear of retaliation from managers and too much focus on bureaucracy over staff safety.

The survey and the consultants' report were obtained by The Associated Press from someone close to the hospital who requested anonymity for fear of retaliation.

State officials say they are making progress, including hiring additional staff members, as they try to turn around the facility since the patients escaped in April 2016. They say correcting problems that have developed over decades will take time to resolve.

Dr. Joseph Wainer, a psychiatrist at the hospital, said the problems continue. He wrote a letter to the editor that recently appeared in the Tacoma, Washington, newspaper in which he alleged that management at the facility was traumatizing employees and patients.

"I see people who've been told that their perspective is ignorant, who have been ignored, shamed and intimidated into silence by an increasingly authoritarian leadership," he wrote.

Wainer told AP in an email this week that the hospital placed him "under investigation." Wainer said the investigation was "quite frightening" and "I still don't know exactly what they're suggesting I did wrong." Wainer said investigations are often used to "discredit and to intimidate both the person investigated and those who might question contemplating the executive leadership."

Kelly Stowe, a spokeswoman for the health department, said the agency couldn't confirm or deny an investigation because they don't comment on personnel actions. "What I can tell you is that we don't restrict an employee's right to free speech," she said