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State Hospital problems getting fixed after harsh report

Thursday, September 22, 2005

By JULIET WILLIAMS
Associated Press Writer

SACRAMENTO -- California's mental hospitals will rely less on restraining, isolating and medicating patients and more on counseling, the head of the state Department of Mental Health promised Tuesday.

Stephen Mayberg testified before a state Senate committee reviewing a scathing U.S. Department of Justice report. It found systemic problems at several hospitals, including patients who overdosed on illegal drugs or were left for up to 12 hours in soiled diapers.

Mayberg said the report was a wake-up call, although he took issue with its harshness.

"We didn't feel we had anything to hide and we actually felt we were doing better than the report would indicate," Mayberg said. State hospitals are "not as bad as portrayed but they're certainly not as good as they could be."

He said the hospital culture has been to use seclusion and restraint rather than treatment, which doesn't prepare patients for a life outside the psychiatric ward. He said the department already was working on a program of comprehensive changes when the DOJ report was released in July.

But patients' advocates told the Senate Select Committee on Developmental Disabilities and Mental Health that the plan hasn't translated into changes in the hospitals.

"The issues identified in the reports are the same issues we see every day when we are out at the hospitals, and they remain despite the DOJ review," said Catherine Blakemore, executive director of Protection and Advocacy Inc., a nonprofit advocacy group. "Sadly we've seen little progress or change in the lives of the residents."

The DOJ found widespread and systemic deficiencies at Napa State Hospital and Metropolitan Hospital. At Napa, the report said, some patients went as long as four weeks without a bath.

One patient strangled his roommate, another assaulted other patients at least 20 times in five months, and several patients hanged themselves, despite showing warning signs to staff, the report said.

Napa patients also have access to illegal drugs, according to the report. Three patients overdosed on methamphetamine or cocaine in the fall of 2004. One patient died, and three other patients obtained and used heroin during this time.

Many of those who testified Tuesday told horror stories about the conditions.

Kathryn Trevino, a member of the Napa Hospital Board and the California Network of Mental Health Clients, said she approached administrators with allegations that some staff humiliate, antagonize and threaten patients.

"The administration's response was that this will help train them to deal with difficult people on the outside," Trevino said.

Several testified that more money is needed, noting that private-sector nurses and doctors earn much more and work in better conditions.

Kimberly Cowart, a nurse at Napa, said she's burned out after continually having to work mandatory overtime to make up for staff shortages. She said exhausted nurses can't give the one-on-one care patients deserve, and bureaucracy isn't helping.

"Why do we have to spend more time doing paperwork than doing actual patient care?"

Sen. Wesley Chesbro, D-Arcata, the committee's chairman, called the report's allegations "devastating and all-inclusive."

The committee will hold a hearing on seclusion and restraint Sept. 28 in Los Angeles.


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