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Central Valley mental hospital to lighten Napa State's patient load

Saturday, October 15, 2005

By DAVID RYAN
Register Staff Writer

State mental health officials are moving patients to a new institution in the Central Valley, actions they say could mean Napa State Hospital will be able to serve more mentally ill now living at Napa County Jail.

Public defenders from Napa and around the Bay Area complain about their clients' right to a speedy trial being violated by backups in the mental health system, a trend they say has been exacerbated in the last couple of years. Terry Davis, Napa County public defender, said many of her clients found incompetent to stand trial sit for months in jail, instead of being treated at Napa State Hospital, where many would ideally end up as soon as possible.

Department of Mental Health officials said Napa State has a 66-patient waiting list for jail inmates found incompetent to stand trial, and on average the hospital takes in an additional 30 patients each month. After the county files paperwork with the hospital, the average patient waits about two months for admission.

"It's really involved a lot of jockeying to get people in," Davis said. "In the jail they can get medications, but the medications aren't necessarily those that they need to restore their competency ... they may just help them to be easier to deal with in jail."

Davis said the only alternative to having her clients sit in jail is to let the inmates go free, where they are unlikely to receive any kind of treatment. Napa State has a special section devoted to treating mental disorders for male patients found incompetent to stand trial -- complete with mock courtrooms where patients get familiar with the legal system.

Kirsten Macintyre, a spokeswoman with the Department of Mental Health, said that since Coalinga State Hospital opened last month -- the first new state hospital in 50 years -- it will have a ripple-effect throughout the five-facility system, easing the burden on older hospitals like Napa State.

Thomas Hunt, a spokesman with Coalinga State Hospital, said the facility is serving only 50 of its 1,500-patient capacity while it waits for state officials to issue licenses to open more of its treatment centers. Hunt said Coalinga State is designed to treat patients labeled sexually violent predators, a group of mentally ill that meet strict criteria of illness that distinguish them from many rapists or other sex offenders.

Napa State Hospital is not allowed to house sexually violent predators or any other judicially-committed patients who are major escape risks. However, state officials' planned transfer of some sexually violent predators from Atascadero State Hospital to Coalinga will open space in the system for other kinds of patients.

"I know in the last week we've been trying to shuffle around patients," Macintyre said.

According to the Department of Mental Health, Napa State has been running at or near its 980 judicially-committed patient limit for at least the last year. According to a state law, there are more than 1,300 licensed beds at Napa State. About 20 percent of Napa State's patients are not judicially-committed.

Napa State's cap on judicially-committed patients can be traced back to Rep. Mike Thompson, D-St. Helena. In 1997, when then-state Sen. Mike Thompson worked to allay Napa County residents' fears about the state's plans to admit more judicially-committed patients to the hospital, he cut a deal with state bureaucrats to limit the number and type of patients that could be admitted.

At the same time, he won approval to speed construction of an additional 250 beds at Atascadero State Hospital to relieve pressure on Napa State. Later that decade, the hospital built high security fences and beefed up its police force. It also stopped letting penal code patients leave the hospital without an escort.

In recent months the hospital has come under fire from state regulators and the U.S. Department of Justice for the way it treats its patients.

In June, the DOJ complained that in addition to being barred from touring Napa State, hospital staff didn't do enough to stop patient violence, drug overdoses and a string of suicides in recent years.

It also said a Napa physician testified that hospital employees sold street drugs to patients. State regulators pressured the hospital to comply with federal civil rights laws limiting the amount of time patients could be held under restraints.

Department of Mental Health officials have said they've cooperated with their critics, negotiating with them and improving the hospital's services where they can. Napa State Hospital spokeswoman Lupe Rincon has said the hospital adopted a new system of treatment in 2004. Hospital officials also claim to have cut the number of hours patients are placed in seclusion or restraints by 77 percent.


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