By Julia Reynolds, The Monterey County Herald, Calif.
May 01–A federal judge in Sacramento has ordered the construction of a multimillion-dollar mental health hospital inside Salinas Valley State Prison, while insisting that officials also add beds immediately to the prison’s psychiatric treatment programs.
U.S. District Court Judge Lawrence Karlton approved plans last week to build a $111 million mental health care hospital inside the walls of the prison, bringing with it jobs for doctors and health workers in Salinas Valley.
The long-range expansion plan should bring the Salinas Valley an infusion of money and jobs. Prison activists also hope the project will alleviate a decade of treatment delays for California’s 31,000 mentally ill prisoners.
Karlton, who first ordered an overhaul of prison psychiatric care 11 years ago, indicated last week that delays from the California Department of Corrections and Rehabilitation have gone on too long.
The cost of delays is not just numbers, but human life, said attorney Michael Bien, who represents mentally ill inmates in an ongoing class-action suit that began in 1990.
“People are dying because there are not enough beds,” Bien said.
Lack of crisis beds|
Documents and evidence submitted to the federal court last week described one 60-year-old man diagnosed as acutely psychotic, who had been in and out of prison on charges related to his alcoholism.
Speaking after the hearing, Bien referred to the man as Wayne, declining to give a last name.
Wayne had attempted suicide in prison more than once, according to documents submitted to the court. In and out of prison for years, Wayne was sent back inside on Nov. 17, 2005, on a psychiatric parole revocation. At Deuel Vocational Institution in Tracy, he was put on suicide watch in the prison’s Outpatient Housing Unit — what used to be called the infirmary.
“But they couldn’t get him a crisis bed,” Bien said. “There are 200 people referred to crisis beds and waiting.”
Wayne was put under suicide watch on Nov. 29. A real-time video monitor and correctional officer were assigned to keep an eye on him at all times.
“The cell had no toilet or sink, only a hole in the floor,” Bien said. “No mattress or blanket. He was only wearing what’s called a suicide smock. They found him dead in his cell at 6:45 a.m. on Nov. 30, 2005. The smock was wrapped around his neck.”
The court documents state that footage from the time of Wayne’s death is missing from the videotape provided by the prison.
In another case submitted to the court, a 28-year-old, whom Bien called Joshua, was in the OHU at San Quentin State Prison on Nov. 20, 2005.
In what Bien described as an agonizing segment of videotape, Joshua, stripped naked in his cell, is banging his head on the wall and gouging his eyes for more than an hour with no intervention from guards.
Surgeons at Marin General Hospital later tried to save Joshua’s vision, but could not.
“I don’t necessarily blame the officers,” Bien said. “He should have been in a medical facility. He was supposed to have treatment. He should have been in a crisis bed.”
Terry Thornton, spokeswoman for the California Department of Corrections and Rehabilitation, said Friday she was unfamiliar with the cases of Wayne and Joshua, but said because they are presumably under investigation, she would not be able to comment.
At the two-day hearing last week, Judge Karlton told Salinas Valley and several other prisons they must add more mental health beds right away.
Years of indifference|
Part of a plan to invest nearly $600 million in overhauling prison mental health care, the orders came 11 years after Karlton first called California’s treatment of mentally ill inmates “cruel and unusual.” He said the prison system must end its “deliberate indifference” and issued orders to improve inmate mental health programs statewide.
At least 20 percent of the state’s 169,000 inmates have diagnosed mental illnesses, Thornton said.
Salinas Valley already has a well-regarded 64-bed hospital run by the state’s Department of Mental Health that focuses on giving intermediate mental health care to maximum-security inmates.
There are 123 additional prisoners on a waiting list for those beds, according to court documents.
To handle its most urgent needs, Salinas Valley is in the process of converting regular inmate housing into 36 intermediate-care beds by summer.
But Karlton said last week that is not enough, and another 36 beds must be converted “within six to nine months,” according to Bien.
New facilities by 2011|
While the court indicated serious problems in delivering proper care in the short term, all sides appear to be in agreement about long-range plans.
The Department of Corrections and Rehabilitation’s Thornton was enthusiastic about plans that include building and staffing two new hospital facilities at Salinas Valley by 2011.
“We’ll be making every effort to hire local residents for those jobs,” Thornton said. She said she didn’t know yet how many new jobs will be created by the project, which will be phased in over five years.
The new facilities will eventually provide more than 200 new mental health beds at the prison. While the number may sound low given the tens of thousands of mentally ill prisoners in the system today, the majority of inmates requiring treatment are what’s called Triple CMS, a group that requires only medication and counseling. Triple CMS patients usually live within the general prison population.
But the most critical need is for beds for Level IV, high-security inmates with serious mental problems, and Salinas Valley is the only prison focused on serving those patients.
A study last year found more than 400 undiagnosed prisoners who had an urgent need for immediate mental health treatment, a finding that Thornton acknowledges took the department by surprise. Half of those were Level IV inmates.
Desirable area|
Thornton said Salinas Valley, which sits just north of Soledad, offers the ideal location for the state’s maximum-security inpatient hospital.
“In Salinas Valley, they already have a facility. They have licenses. And the employees have training and superior experience in providing mental health care,” she said.
Despite its high cost of living, Monterey County is also a desirable place to live, and the department hopes that will attract top doctors and psychiatric workers.
It’s an important factor, considering that a brand-new mental health facility built to treat sex offenders in Coalinga has had serious hiring problems. Planners apparently didn’t realize that professionals just weren’t attracted to the idea of living in that remote corner of Fresno County, and the facility designed to hold 1,500 houses only a smattering of patients today.
When Thornton recently visited the Salinas Valley mental health unit, she said Department of Mental Health workers there were “extremely proud” of the facility and the treatment offered.
Requests by The Herald to tour the facility went unanswered, and a prison spokesman could not be reached for comment Friday.
Frustration in short term|
Bien said that while he is basically pleased with the long-range plans ultimately carved out by both parties in the case, he is frustrated by delays in providing better mental health care now.
Thornton said the department also feels some of that frustration, saying there are forces pushing and pulling at the Department of Corrections and Rehabilitation that slow its progress. Among those are demands imposed by other court orders, legislators, and the powerful guards’ union, all factors admittedly made more difficult by poor planning years ago.
Finally, there is the severe overcrowding that Thornton said is “near crisis level,” as the system creeps perilously toward its maximum-capacity level of 172,000 inmates this year.
Yet in the last year, she said, there have been unsung efforts deep within the department to bring about real change.
Since July, meetings to reorganize the troubled organization have been held at the department’s headquarters in Sacramento. Some of the plans developed since then will unfold in coming months, said adult facilities director John Dovey, who added he and others spent “many 12-hour days” in the effort.
Thornton said she is satisfied that her department has been complying with Karlton’s orders and will continue to do so.
“I think we’ve made significant progress,” Thornton said. “They’re complex issues and they take time.”
montereyherald.com.
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Mental health patients in Salinas Valley State Prison — Basic Outpatient Care:Diagnosed: 1,309; Capacity: 999; Percent over capacity: 31% (In general population treated with counseling and medication.) — Intermediate Care PatientsDiagnosed: 187; Capacity: 64; Percent over capacity: 190% (Intermediate care beds for maximum security inmates, with licensed mental health staff.) — Sources: California Department of Corrections and Rehabilitation, April 6, 2006; Coleman v. Schwarzenegger filings
Julia Reynolds can be reached at 648-1187 or jreynolds@
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Copyright (c) 2006, The Monterey County Herald, Calif.
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