Raises at Mental Health Agency: Move Aims to Halt Psychiatrists’ Flight to Prison System.

By Andy Furillo, The Sacramento Bee, Calif.

Mar. 22–Gov. Arnold Schwarzenegger moved Wednesday to stem an exodus of psychiatrists and other employees from the Department of Mental Health to more lucrative jobs in the prison system by ordering up $43 million in pay raises for them over the next two years.

The pay hikes followed huge increases handed out to prison psychiatrists late last year by U.S. District Court Judge Lawrence Karlton in the ongoing federal class-action case that covers mental health care in the California Department of Corrections and Rehabilitation.

Since the court-ordered pay raises went into effect, prison psychiatrists are now making upward of $252,000 a year. By contrast, DMH psychiatrists are earning only on the order of $144,000, according to figures provided by the agency’s director, Stephen Mayberg.

“The governor was very concerned, very passionate about what’s happening because of the ripple effect of decisions that are made by the courts about salaries,” Mayberg said. “I think it’s really sort of a dramatic commitment by the administration to deal with the impending crisis created by federal court decisions made with little thought about the implications for other parts of the system.”

Karlton ordered the pay raises for the prison psychiatrists after surveys in the so-called Coleman case showed the corrections agency needed an estimated 500 more positions to push its mental health treatment toward constitutional standards, said plaintiffs’ attorney Michael Bien.

The salary increases went into effect in January, and the ensuing flow of psychiatrists and others from DMH to CDCR immediately depleted state mental hospitals to the point where its overall vacancy rate is now measured at 43 percent, Mayberg said.

At Atascadero State Hospital, the figure is tilting at 70 percent, Mayberg said. The San Luis Obispo County hospital houses more than 1,200 patients, including mentally disordered sex offenders, sexually violent predators, people declared not guilty of crimes they committed because they were insane at the time and others who are so mentally incompetent they can’t stand trial.

The staffing crisis became so acute at Atascadero that the hospital stopped taking admissions Jan. 23, according to a letter to Coleman special master Michael Keating received from Cynthia A. Radavsky, DMH’s deputy director of long term care services.

Bien said the impact of the staffing shortages at Atascadero, where each psychiatrist is handling a caseload of 100 patients, is “staggering.” He said the facility had only two patient suicides this decade before Jan. 1. It has equaled that number in the less than three months since, he said.

“I think that the state made this problem,” Bien said. “Not the court or the special master or the plaintiffs. It’s obvious to anyone that if you raise a salary for someone in a state position where they have the freedom to move and that they can get a substantial increase, people will move. And sure enough they did.”

Even with the increases, DMH psychiatrist salaries are still going to sit 5 percent below those in the prisons. Some other jobs in the mental health system will still pay 18 percent less than in the prisons.

The plaintiffs’ lawyer said he pleaded for pay raises for the DMH staffers at the same time he was trying to get them for the prison psychiatrists. Both agencies were paying mental health workers well below market rates even before Karlton raised them for the prison doctors, Bien said. “The state’s been cheating their employees for years,” he said.

Meanwhile, the salary hikes ordered by Schwarzenegger for the DMH psychiatrists, as well as for psychologists and recreational therapists, will go into effect April 1, said Department of Finance spokesman H.D. Palmer. The agency will absorb about $9 million of the increases in its current-year budget while the governor is asking the Legislature to fund $34 million in added psychiatrist pay in the 2007-08 budget, Palmer said.

Besides the Coleman case, Mayberg said the increases also resulted from pressure the state has been getting from the federal government after its investigation into staffing ratios and treatment options in the state mental hospitals. He said an agreement Sacramento reached with Washington on the matter is threatened by the departure of the DMH psychiatrists to the prisons.

Schwarzenegger ordered the raises about 4:30 Wednesday afternoon.

“It’s that high a priority, to get this started, to do the right thing,” Mayberg said. “It’s an issue of public safety and community safety and quality of care. If I can’t keep a hospital open without adequate clinical staff, those folks go out in the street.”

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Copyright (c) 2007, The Sacramento Bee, Calif.

Distributed by McClatchy-Tribune Business News.

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