State under the gun

Court-ordered psychiatric evaluations of Daryl Johnson found the 32-year-old was unaware of his surroundings and was dangerous when he wasn't medicated.

Despite a Sacramento judge's order that Johnson be sent immediately to Napa State Hospital to undergo treatment so he could stand trial, he languished in jail for 10 months because there were no beds available.

The delay in transferring Johnson and other mentally ill criminal defendants for treatment prompted a lawsuit. Another Sacramento Superior Court judge ordered state officials to drastically reduce the time inmates wait in jail before moving to a state mental hospital.

Judge Steve White ruled that state mental health officials, who in the past have taken six to eight months to accept a new patient, will have to find room for inmates within seven days of their being found incompetent to stand trial.

"The court's order is simple and narrow: The Department of Mental Health may no longer fail to provide the treatment required by law and the constitution," White said of his ruling, which takes effect at the end of the month.

Sacramento County Public Defender Paulino Duran, whose office filed the suit on behalf of four inmates, said: "Our jails are not treatment settings. No human being wants to see the mentally ill in cages."

While Judge White's ruling applies only to Sacramento County and Napa State Hospital, it could have a ripple effect across the state as Sacramento inmates get priority status when beds become available. John Rodriguez, deputy director for long-term care services at the Department of Mental Health, said he can't comment on whether the agency will appeal, but he assumes White's order will be implemented.

"Sacramento County has moved to the top of the priority list," Rodriguez said. "Other counties will be filing their own suits."

Yolo County Public Defender Barry Melton said the California's mental health system is "dysfunctional," and state officials should take swift and meaningful actions to avoid a "spate of litigation."

Sacramento's mentally ill criminal defendants -- there were 41 when counted in March -- are among 4,000 in California, according to the Department of Mental Health. But Napa and four other state mental health hospitals have filled their beds allocated for mentally ill criminals or defendants, although in some cases there are beds available for other mentally ill patients.

Napa State Hospital, the facility closest to Sacramento, has a backlog of about 260 patients who are to be admitted on a "first-come, first-served" basis, according state officials. Spokeswoman Lupe Rincon said Napa has a state-imposed cap limiting its number of patients charged with crimes to 980.

The other state mental hospitals -- Atascadero on the central coast, Patton in San Bernardino and Metropolitan in Norwalk -- are filled to capacity with criminal defendant patients. Even with a new 1,500-bed Coalinga hospital built in the Central Valley last year, the backlog will continue throughout the year, Rodriguez said.

Coalinga, which eventually will house the state's violent sexual predators, reported earlier this year that it had only 139 patients because the department was having difficulty finding clinical staff willing to work there.

Public defenders who represent the mentally ill charged with crimes say Judge White's 75-page decision illuminates a broader problem.

"We are creating leprosy colonies because we are not willing to accept certain offenders in our communities," San Francisco County Public Defender Jeff Adachi said.

During testimony and in hearings for the Sacramento County suit filed Oct. 18, attorneys for the four men named in the action argued that the men did not receive treatment to help them become competent to stand trial. Lawyers for the state said county agencies can provide such treatment. However, Sacramento County mental health officials told the judge they are not equipped to do so.

"We don't have armed guards, and there are safety issues in the community," Ann Edwards-Buckley, director of mental health services for Sacramento County, said in an interview.

Sacramento County Sheriff's Lt. Scott Jones, a lawyer for the Sheriff's Department, said in an interview that jail officials are not trained to provide such treatment, either.

The four men named in the suit were charged with a variety of felonies, including discharge of a firearm, arson, sexual molestation and theft. They and Johnson since have been sent to Napa.

In a statewide count earlier this year, there were 1,013 defendants who had been found incompetent to stand trial. According to testimony during the suit, those represent one of five groups of the mentally ill who are locked up by court order.

Others include those who are found not guilty by reason of insanity; mentally disordered sex offenders; sexually violent predators; and a smaller group of those who are not charged with a crime but are committed by county agencies.

Under state and federal law, when someone is found incompetent to stand trial, immediate transfer is expected to the closest mental hospital, where treatment is administered to help defendants understand the criminal justice system and the consequences of their charges.

With the implementation of White's April 26 ruling, defense attorneys in Northern California worry that some low-risk or non-threatening inmates bound for Napa will be sent to Patton and Atascadero, where some of the state's most dangerous patients are held.

Sonoma County Public Defender John Abrahamson said his clients' conditions will worsen with the longer waits, and they will shipped farther from their family and friends.

"I think (Sacramento County) will be moving ahead of the line," Abrahamson said. "That will slow down every other county."