|Filling the anemic
ranks of state hospital staff with hefty pay increases could
have a two-pronged negative impact for San Mateo County,
officials said yesterday in reaction to Gov. Arnold
Schwarzeneg-ger’s most recent budget proposal.|
The proposal, county officials said, will winnow from the
jail mentally incompetent inmates whose hospitalization is
delayed by a lack of employees while making it difficult to
recruit and retain skilled mental health professionals.
The May budget revise proposes salary increases for
psychiatrists and psychologists between 66 percent and 74
percent and other staff increases ranging between 10 percent
and 40 percent. The higher pay scales are expected to fill
vacancies at institutions such as Napa, Patton and Atascadero
state hospitals whose patients include criminal defendants
deemed unable to aid in their own defense and sexually violent
predators whose terms are extended by the court. Currently,
some facilities are running at less than 50 percent staffing —
an employment drought that has kept defendants who would
otherwise be hospitalized in local jails like the overcrowded
Maguire Correctional Facility in Redwood City. As a result,
the jail stays packed and incompetent inmates are denied the
treatment and medication they need and to which they are
Competency refers to a defendant’s ability to aid in his or
her own defense after a crime. Sanity is the defendant’s state
of mind at the time the crime was committed. When a
defendant’s mental state is questioned, criminal proceedings
are typically halted while it is evaluated by two
court-appointed doctors. Defendants found incompetent
are supposed to be treated at state mental hospitals until
doctors there find them cured. At that point, the man or woman
returns to the county and stands trial on the original
The current backlog, however, means these defendants aren’t
necessarily being treated as they would in a hospital.
In December, Belmont resident Robert Simmons, 27, was
deemed incompetent before standing trial for allegedly running
a pot house in 2005. Despite the finding, the man who declares
himself a reverend was not immediately transported, said Chief
Deputy District Attorney Steve Wagstaffe.
Likewise, Curtis Commo, 25, returned to court a number of
times since being deemed incompetent in September. Commo and
another man were accused of robbing two South San Francisco
pedestrians and committing the takeover robbery of the Boys
and Girls Club on bingo night.
During one hearing, the court was advised that Atascadero
State Hospital refused to admit any new inmates because of the
loss of psychologists to the Department of Corrections. The
court asked Commo’s defense attorney and jail psychologists to
create a competency treatment program for him locally.
Both men and approximately six other incompetent inmates
were eventually hospitalized after Judge Jack Grandsaert
threatened the hospital administration with an order to show
cause, Wagstaffe said.
The hospital gave in but the real test, he added, will be
when the next county inmate is deemed incompetent.
By then, the state may have taken action itself to ease the
In February, Federal Judge Lawrence Karlton ordered mental
health officials to draft a plan to attract new hires, such as
a headhunter and loan repayment plan, but vacancies continued
increasing while workers left for state prisons.
Attorneys for some patients called the plan inadequate and
argued the shortages jeopardize the safety of both them and
Karlton then ordered the state Mental Health Department to
raise some salaries to equal those in the state prison system.
Atascadero State Hospital workers picketed outside the
facility Monday demanding raises, according to published
While the federal order and May budget revise proposal
could stem the tide of outgoing professionals at state
hospitals, San Mateo County Manager John Maltbie said it isn’t
helping the employee ranks locally.
A number of psychiatrists and psychologists have already
gone to the state prison system, lured by the higher wages,
and raises at the hospital won’t help matters.
The county has already seen its ability to recruit and
retain professionals in a shallow pool dented. Psychiatrists,
particularly the physicians at the San Mateo Medical Center’s
Psychiatric Emergency Service department, are especially
scarce, Maltbie wrote in an analysis of the May revision.
“We’re having one devil of a time trying to retain
psychiatrists in our own mental health programs,” Maltbie
The exact employment figures were not immediately available
yesterday, said hospital spokesman Dave Hook.
Maltbie warned the Board of Supervisors to expect to take
future action to retain mental health professionals, such as
“We’re trying to keep pace with these changes,” he
As the county scrambles to keep the professionals here, law
enforcement is hoping the mentally ill inmates will soon be
transported to state hospitals.
A similar backup happened in the fall of 2005 when more
than a dozen incompetent inmates accused of felonies as severe
as murder lingered at the jail when hospitals claimed a lack
of bed space. Hospital officials also refused to accept
patients who would not voluntarily agree to medication.
During that period, without the ability to force
medication, already stretched jail staff were left caring for
some inmates with severe mental trauma and violent tendencies.
The jail has a specific floor for inmates with medical
needs but is typically reserved for physical ailments or
mental illnesses, like schizophrenia, that don’t necessarily
play a role in incompetency.
Judge Mark Forcum ultimately ordered the director of Napa
State Hospital to accept inmates or be found in contempt. Some
of the incompetent inmates eventually acquiesced to
medication, allowing them to be hospitalized.
Michelle Durand can be reached by e-mail:
firstname.lastname@example.org or by phone: (650) 344-5200 ext.