Atascadero State Hospital

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California Department of State Hospitals
Geography
LocationAtascadero, California, United States
Organization
Care systemPsychiatric ward
Hospital typeForensic psychiatry
Services
Emergency departmentDepartment of State Hospitals- Atascadero Police Department (DSHAPD, ASHPD, or DPS)
Beds1239
History
Opened1954
Links
WebsiteOfficial website
ListsHospitals in California

Atascadero State Hospital, formally known as California Department of State Hospitals- Atascadero (DSHA), is located on the Central Coast of California, in San Luis Obispo County, halfway between Los Angeles and San Francisco. DSHA is an all-male, maximum-security facility, forensic institution that houses mentally ill convicts who have been committed to psychiatric facilities by California's courts.[1] Located on a 700+ acre grounds in the city of Atascadero, California, it is the largest employer in that town.[2] Due to security measures, DSHA and its grounds are not open to the public, and those wishing to enter the grounds must have a lawful reason to enter. DSHA does not have a medical Emergency Room, those seeking medical assistance should seek a medical hospital. Members of the general public seeking mental health assistance are referred to SLO County Mental Health. DSHA does not take voluntary admissions, only patients that are referred to the hospital by the Superior Court, Board of Prison Terms, or the Department of Corrections.

History[edit]

ASH opened in 1954, as a state-run, self-contained public sector forensic psychiatric facility. It is enclosed within a security perimeter, and accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Patients are referred to the hospital by the Superior Court, Board of Prison Terms, or the Department of Corrections.

According to the historical documentary Stonewall Uprising by PBS, this hospital was known as the "Dachau for Queers" because of its treatment for homosexuality which was thought at that time (1960s) as a medical condition.

Its treatment programs have reflected the psychiatric assumptions of the times.[3][4] Initially constructed to treat mentally disordered sex offenders (MDSOs), initial programs focused on separation from society, albeit in an environment which provided freedom of movement. This was restricted after patient escapes. Initial research and treatment programs aimed at understanding and reducing the risk of reoffense in sexual offenders.[5][6][7][8][9][10][11][12] In the early 1980s, the focus of the hospital's treatment programs shifted to patients found not guilty by reason of insanity (NGRI) and incompetent to stand trial; ASH was a pioneer in developing effective treatment programs for the latter.[13] In the 1990s, California passed sexually violent predator (SVP) laws, imposing civil commitment upon prisoners meeting criteria upon the expiration of their determinate prison term. SVPs were housed in ASH until the new state hospital in Coalinga opened around 2004.

In the mid-1980s, a US Department of Justice investigation under the Civil Rights of Institutionalized Persons Act (CRIPA) led to important and positive clinical reforms at ASH. Sidney F. Herndon was the Executive Director throughout the 1980s and brought in a strong clinical and administrative team and built up the medical staff under Gordon Gritter MD as Clinical Director. David Saunders MD led the development of a forensic psychiatry fellowship, affiliated with UCSF-Fresno and UCLA. Harold Carmel MD and Mel Hunter JD MPA established the Atascadero Clinical Safety Project (ACSP) which conducted groundbreaking research into staff injuries from patient aggression [14][15] and, after Carmel left to become CEO of the Colorado Mental Health Institute at Pueblo in 1991, under Hunter and Colleen Love developed important programs to improve staff safety,[16][17][18] which won awards from the American Psychiatric Association[19] and, in 1998, JCAHO's Ernest A. Codman Award in the Hospital Category.[20] In this era, ASH was an important center of research and teaching.[21][22][23][24][25][26][27]

Many clinical staff left ASH in the late 1990s with the advent of the SVPs, which was believed by many clinicians to compromise the hospital's mission of providing excellent care for persons with serious mental illness, as opposed to containment of sexually dangerous offenders.

When salaries for California prison mental health staff, especially psychiatrists, increased dramatically as a result of federal litigation, ASH lost many of its psychiatrists and other clinical staff.[citation needed][28] Psychiatrist salaries have been increased to levels just under the prison psychiatrist salaries, and ASH's psychiatrist staffing is now (2014) being rebuilt.[citation needed]

Another traumatic period came with another US DOJ CRIPA investigation in the mid-2000s. Mel Hunter, by this time ASH Executive Director, was removed from his position as a result of his refusal to alter the clinical operations of the hospital at the behest of the DOJ consultants. He was replaced by new hospital leadership. In the event, the imposition of the atypical views of consultants with no experience in forensic psychiatry led to a degradation of clinical operations and safety, with great spikes in patient violence that came to an end when the consultants left the hospital following exposés by the LA Times into apparent cronyism.[29][30][31]

A 2018 law review article [Assessing the Real Risk of Sexually Violent Predators: Doctor Padilla's Dangerous Data, 55 Am. Crim. L. Rev. 705 (2018)] reported that Mel Hunter had supported research showing that SVP reoffense was much lower than claimed. Three days after Hunter's removal, his successor issued a memo terminating the study and prohibiting the use of "the previously gathered data for publication, research, testimony, or any other purpose."[32] This suggests a second factor in Hunter's exit.

Patient-on-patient homicides[edit]

On May 28, 2014, a patient was killed and an employee was severely injured during an alleged attack by a patient.[1]

On March 30, 2008, 44-year-old inmate Earl McKee strangled a fellow inmate, 37-year-old Lawrence Rael, to death with a knotted towel. McKee was originally institutionalized as a "Mentally Disordered Offender". Last year, after making abusive threats to other inmates, he was reclassified as a "Sexually Violent Predator". The murder came in the wake of federal court-mandated changes that reduced the usage of medication and restraints on patients, as well as a large turnover in staffing resulting in less experienced personnel working at the hospital.[33]

Drastic changes since appointment of court monitors[edit]

In recent years, the hospital, under the threat of a lawsuit by the United States Justice Department alleging violations of the Civil Rights of Institutionalized Persons Act, has been implementing a court-approved Enhancement Plan to bring the hospital into compliance with CRIPA. The Enhancement Plan was proposed and implemented by the "Human Potential Consulting Group" out of Alexandria, Virginia. This consulting group consists of various clinical professionals who have been contracted by other states to ensure compliance with CRIPA. In some states the consultants serve as court monitors while others serve as consultants. They regularly switch roles from Justice Department monitors to consultants, depending on the state.

Notable patients[edit]

Employees[edit]

Approximately 2,140 employees work at DSH-Atascadero providing round-the-clock care, including psychologists, psychiatrists, social workers, rehabilitation therapists, psychiatric technicians, registered nurses, and other clinical and administrative staff. There are approximately 173 different job classifications at the facility, including hospital police, kitchen staff, custodial staff, warehouse workers, groundskeepers, information technology staff, plant operations staff, spiritual leaders, and other clinical and administrative staff. DSHA provides on-site training programs for a variety of schools, including nurse practitioner programs, psychiatric technician training, clinical psychology and dietetic internship programs. DSH-Atascadero is also the regional training center for hospital police officers throughout the State of California.

Police Department[edit]

Department of State Hospitals -Atascadero has its own full service law enforcement agency of over 200 sworn personnel. The DSHA Police Department is dedicated to providing the highest level of safety and security to patients, staff and the community through competent, professional law enforcement services;[38] Police Officers are sworn law enforcement officers whose authority is granted under California Penal Code Section 830. DSH police officers are not affiliated with California Department of Corrections and Rehabilitation (CDCR). The police officers of the Department of State Hospitals are peace officers whose authority extends to any place in the state for the purpose of performing their primary duty or when making an arrest pursuant to Section 836 as to any public offense with respect to which there is immediate danger to person or property, or of the escape of the perpetrator of that offense, or pursuant to Section 8597 or 8598 of the Government Code provided that the primary duty of the peace officers shall be the enforcement of the law as set forth in Sections 4311, 4313, 4491, and 4493 of the Welfare and Institutions Code. DSH police officers are granted authority by the California Welfare and Institutions Code to enforce policies and directives set forth by the administration of Department of State Hospitals.

DSH police officers enforce the California Penal Code, as well as the California Vehicle Code, and are granted authority by the State of California to make arrests and issue citations. It is the primary function of the Department of State Hospitals' police officers to provide safety, service, and security to patients, employees and the public in and around each hospital. However, this police department does assist neighboring law enforcement agencies with police activities and functions, off-site of the grounds of DSHA. In addition to police responsibilities and investigations, police officers work closely with clinical staff to ensure the safe treatment of the patients of DSHA.

Popular culture[edit]

In the film Terminator 2: Judgment Day, Sarah Connor is institutionalized at "Pescadero State Hospital" - a mental institute heavily based on Atascadero State Hospital[citation needed].

One of radio host Phil Hendrie's recurring fictional characters is Herb Sewell, a former sex offender who was remanded for eight years at Atascadero State Hospital.

It also is referred to in the film The Grifters as the place where "Cole" is sent after his mental breakdown.

In James Ellroy's The Black Dahlia (1987), set in the late 1940s, there are several anachronistic references to characters having been committed to Atascadero State Hospital – which did not open until 1954. This includes a woman committed there at the end of the novel (ch. 35) – ASH has never admitted a woman patient. Similarly, a man just released from Atascadero anachronistically features in Ellroy's Perfidia (2014), set in December 1941 (see chapter 72, et seq).

References[edit]

  1. ^ a b "Atascadero State Hospital patient killed in attack". U-T San Diego. May 29, 2014.
  2. ^ "Atascadero Chamber of Commerce - Economic Profile". atascaderochamber.org. Archived from the original on March 14, 2016. Retrieved April 2, 2016.
  3. ^ Serber, Michael (September 1972). "Teaching the nonverbal components of assertive training". Journal of Behavior Therapy and Experimental Psychiatry. 3 (3): 179–183. doi:10.1016/0005-7916(72)90070-5.
  4. ^ Serber, Michael; Nelson, Philip (July 1971). "The ineffectiveness of systematic desensitization and assertive training in hospitalized schizophrenics". Journal of Behavior Therapy and Experimental Psychiatry. 2 (2): 107–109. doi:10.1016/0005-7916(71)90022-X.
  5. ^ Sturgeon, Vikki Henlie; Taylor, John (1980–1981). "Report of a Five-Year Follow-Up Study of Mentally Disordered Sex Offenders Released from Atascadero State Hospital in 1973 Symposium: Differential Treatment of the Sex Offender in California 4 Criminal Justice Journal 1980-1981". Criminal Justice Journal. 4: 31. Retrieved 10 July 2016.CS1 maint: date format (link)
  6. ^ Rada, Richard T.; Laws, D. R.; Kellner, Robert (1976). "Plasma Testosterone Levels in the Rapist. : Psychosomatic Medicine". Psychosomatic Medicine. 38 (4): 257–68. doi:10.1097/00006842-197607000-00004. PMID 940905.
  7. ^ Serber, Michael (September 1970). "Shame aversion therapy". Journal of Behavior Therapy and Experimental Psychiatry. 1 (3): 213–215. doi:10.1016/0005-7916(70)90005-4.
  8. ^ Marques, Janice K.; Wiederanders, Mark; Day, David M.; Nelson, Craig; Ommeren, Alice (2005). "Effects of a Relapse Prevention Program on Sexual Recidivism: Final Results From California?s Sex Offender Treatment and Evaluation Project (SOTEP)". Sexual Abuse: A Journal of Research and Treatment. 17: 79–107. doi:10.1007/s11194-005-1212-x.
  9. ^ Laws, D. R. (1977). "A comparison of the measurement characteristics of two circumferential penile transducers". Archives of Sexual Behavior. 6 (1): 45–51. doi:10.1007/BF01579247. PMID 836143.
  10. ^ Melnyk, John; Derencsenyi, Anna; Vanasek, Frank; Rucci, Alfred J.; Thompson, Havelock (25 October 1969). "XYY Survey in an Institution for Sex Offenders and the Mentally III". Nature. 224 (5217): 369–370. Bibcode:1969Natur.224..369M. doi:10.1038/224369a0. PMID 5343882.
  11. ^ Laws, D. Richard (1974). "Failure of a Token Economy, The 38 Federal Probation 1974". Federal Probation. 38: 33. Retrieved 10 July 2016.
  12. ^ Haynes, Robert L.; Marques, Janice K. (1 June 1984). "Patterns of Suicide among Hospitalized Mentally Disordered Offenders". Suicide and Life-Threatening Behavior. 14 (2): 113–125. doi:10.1111/j.1943-278X.1984.tb00342.x. PMID 6334911.
  13. ^ Noffsinger, Stephen G. (1 June 2001). "Restoration to Competency Practice Guidelines". Int J Offender Ther Comp Criminol. 45 (3): 356–362. doi:10.1177/0306624X01453007.
  14. ^ Carmel, Harold; Hunter, Mel (1 December 1993). "Staff Injuries from Patient Attack: Five Years' Data". J Am Acad Psychiatry Law. 21 (4): 485–493. Retrieved 10 July 2016 – via www.jaapl.org.
  15. ^ Carmel, Harold; Hunter, Mel (1 September 1991). "Psychiatrists Injured by Patient Attack". J Am Acad Psychiatry Law. 19 (3): 309–315. Retrieved 10 July 2016 – via www.jaapl.org.
  16. ^ Love, CC; Hunter, M (1999). "The Atascadero State Hospital experience. Engaging patients in violence prevention". J Psychosoc Nurs Ment Health Serv. 37 (9): 32–6. PMID 10486772.
  17. ^ Hunter, M. E.; Love, C. C. (1996). "Total quality management and the reduction of inpatient violence and costs in a forensic psychiatric hospital". Psychiatric Services. 47 (7): 751–754. doi:10.1176/ps.47.7.751. PMID 8807690.
  18. ^ Becker, Mark; Love, Colleen C.; Hunter, Melvin E. (1997). "Intractability is relative: Behaviour therapy in the elimination of violence in psychotic forensic patients". Legal and Criminological Psychology. 2: 89–101. doi:10.1111/j.2044-8333.1997.tb00335.x.
  19. ^ Hamilton-Wentworth Health Service o (1999). "Significant Achievement Awards". Psychiatric Services. 50 (11): 1481–1485. doi:10.1176/ps.50.11.1481. PMID 10543868.
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  21. ^ Marques, Janice K.; Haynes, Robert L.; Nelson, Craig (March 1993). "Forensic treatment in the United States: A survey of selected forensic hospitals". International Journal of Law and Psychiatry. 16 (1–2): 57–70. doi:10.1016/0160-2527(93)90015-7. PMID 8500969.
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  32. ^ https://scholarship.law.berkeley.edu/facpubs/3006/
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  34. ^ "Judge refuses to release killer". Retrieved 10 July 2016.
  35. ^ LYNCH, RENE (17 December 1992). "Slayer of Seven Is Sent Back to Atascadero : Treatment: Ex-janitor who shot nine people at CSUF in 1976 is found 'not appropriate' for Napa State Hospital". Los Angeles Times. Retrieved 10 July 2016.
  36. ^ Biography.com Editors (January 9, 2017). "Edmund Kemper Biography". www.biography.com. A&E Television Networks. Retrieved 2017-02-15.
  37. ^ "Thorpe pleads guilty to murder". The Union. Nevada County, California. March 21, 2003.
  38. ^ "Law Enforcement". dsh.ca.gov. Retrieved 2019-12-01.

External links[edit]

Coordinates: 35°27′49″N 120°38′06″W / 35.46361°N 120.63500°W / 35.46361; -120.63500