Coalinga State Hospital

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Coalinga State Hospital
California Department of State Hospitals
Location Coalinga, Fresno County, California, United States
Beds 1260
Founded 2005
Lists Hospitals in California

Coalinga State Hospital (CSH) is a state mental hospital in Coalinga, California.

The facility opened on September 5, 2005 and was California's newest state hospital, the first to be constructed in the state in more than 50 years. It is a maximum security civil-commitment facility built to ensure that sexually violent predators stay out of the community.[1] Instead of being released after completing their prison sentences, they are transferred to CSH.[2] Currently, the hospital houses 941 sexually violent predators[3] (SVPs) and 200 mentally disordered offenders[citation needed]. The hospital also houses approximately 50 mentally ill prisoners from the California Department of Corrections and Rehabilitation (CDCR), but the California Department of State Hospitals aims to designate CSH as a civil-commitment facility only. The SVPs are men who fall under the SVP laws (first Megan's Law and later Jessica's Law), where the men are deemed too likely to reoffend to be released and are housed indefinitely at the hospital until they are deemed no longer a danger to the community.

Treatment is offered, but is not required. Approximately 1/3 of individuals accept California's sex offender treatment.[citation needed] The hospital has a 1,500-bed capacity (as of April 2016, the hospital is 99% full). The median age of SVPs is 47.1 and this is expected to increase as the hospital's population continues to age.

About the facility[edit]

The state began construction on Coalinga State Hospital in the fall of 2001. According to the hospital's official Web site, CSH has 1.2 million gross square feet (gsf) of floor space. This includes 900,000 gsf for clinical services and programs, 158,000 gsf for support services, 75,000 gsf for administration, and 67,000 gsf for plant operations.

The facility is meant to be "civil" and non-punitive wherein the "patients" are only to be subjected to restrictions necessary for legitimate non-punitive ends.[4] Such is due to the fact that none of the individuals, housed within CSH, are serving any prison sentences for any crimes whatsoever. Despite this mandate (that the conditions be non-punitive and the least restrictive necessary), CSH subjects the "patients" detained there to conditions that are clearly so excessively restrictive than necessary that CSH's draconian conditions bear no rational relationship to the purported non-punitive purposes of the confinement; rather, CSH "patients" are subjected to conditions that are similar or identical to those within prisons across the nation.

Instead of calling the population housed at CSH "inmates", facility policy is to call these individuals "patients" because they are purported to be "civilly committed" and are ostensibly "mentally ill". Thus, staff are supposed to address the "patients" by their last names (i.e., Mr. Jones) to provide a perception of a professional atmosphere. Some CSH patients identify as Transgender and are thus to be addressed as Miss.

The "hospital" is located at the edge of the Coastal Mountain Range in the heart of California just outside the City of Coalinga and shares a plot under the auspices of the California Department of Corrections and Rehabilitation (CDCR); specifically, it is next to the CDCR's Pleasant Valley State Prison. The property, which is encircled by barbed wired fences, has its perimeter guarded by CDCR prison guards. Thus, the facility is indistinguishable from a prison despite it being professed to be a "civil" "hospital".

As the land the "hospital" is built on is part of Pleasant Valley Prison, an agreement between CDCR and the then named California State Department of Mental Health (presently, California Department of State Hospitals), allows the facility to be somewhat independent of the CDCR; however, most outside security positions are manned by CDCR officers. These positions are the security towers, security berms, outside security patrol, staff entrance and vehicle sally port - all of which are similar to those found around this nation's prisons. State Hospital "Police Officers" also have an outside security patrol, help out at the sallyport, and conduct police, investigations, and security operations inside the secured area ("inside the wire")

The "hospital" is meant to be addressing the two issues that the "patients" are deemed to suffer from: "volitional impairment" and dangerousness (in that they are likely to re-offend not of their own free choice).[5] Despite such mandate, the "hospital's" "Sex Offender Treatment Program" does not require the notations of any evidence that the treatment is or is not working (regarding treating these two aspects of the "civil commitment") by noting wither a reduction, an increase or no observable change in the current symptoms of either aspect. Thus, the "patients" systematically note that the "treatment" is not legitimate and is no less fraudulent than the Minnesota scheme which Federal Court Judge Donovan Frank noted was unconstitutional as its "treatment" was likewise a "sham"[6].

The annual operating budget of CSH is over $200 million (i.e. over $200,000 per "patient").

Intake and occupancy[edit]

In California all prisoners convicted of sexual assault or child sexual abuse are flagged and reviewed six months prior to parole.[citation needed] To be classified as a SVP, an individual must have at least one identified victim, have been diagnosed with a serious mental illness resulting in volitional impairment (most commonly paraphilia NOS or pedophilia are deemed to meet such criteria), and must have established a relationship with a person with the intent to cause victimization. Paraphilia NOS is a catch-all diagnosis used to describe most individuals who have committed sexual assault (i.e., rape). Prior to parole, the designation of SVP is assessed by two independent evaluators (licensed mental health professionals). If both evaluators agree that the prisoner meets the criteria, he is sent to CSH for treatment. If one agrees and the other does not, an additional two evaluators review the prisoner's history. If those final two reach agreement, the prisoner is considered a ward of the state and civilly committed to CSH.

Evaluations of current and potential "SVPs" are inconsistent, and there is no protocol used to determine whether those being assessed meet the criteria for confinement that most mental health scholars deem either scientific or rational. Evaluators lack clinical supervision and training, and Coalinga has a significant backlog of annual evaluations that further violates the rights of patients.[7]

California law allows SVPs to be committed to the hospital indefinitely (under Jessica's Law) while they are ostensibly receiving treatment. It was believed that holding the "sex offenders" indefinitely at the mental hospital would prevent them for committing additional sex crimes.[8] But treatment is in short supply.[9] Significant treatment at Coalinga is rare.[10] Moreover, 80% of sexual offenders have refused therapy.[9] Three-quarters of CSH's 850-plus detainees refuse to participate in a core treatment program, undermining a central piece of Coalinga State Hospital's purported mission.[11] The vast majority refuse to participate beyond the first phase of a five-phase therapy regimen.[9] Only 25 to 30 percent of sexually violent predators consent to participate in the active phases of California's sex offender treatment program.[12]

Treatment is intensive, and requires admission of guilt and the use of institutionally mandated language, as well as polygraph and phallometric testing. As of November 2007, 26 of the 37 budgeted staff psychiatrist positions were vacant. Some inmates camped out to get to see a clinician. As of April 2009 the facility had released only 13 inmates in its history.

Most detainees at Coalinga have little hope that they will ever be released.[13] Critics say California's sexually violent predator program looks more like upscale incarceration.[14] There's a growing sense among detainees that they have been effectively railroaded into a life prison term.[15]

"It's hopeless," said one detainee, who was sent to Coalinga after serving a prison term for committing a lewd and lascivious act. "This is a therapeutic setting, supposedly. But it's nothing more than a mock-up prison. They can call it what they want. But it's prison."[10] Civil commitment for sexual predatory acts is, as a practical matter, a life sentence.[16]

A federal judge ruled a similar program in Minnesota to be unconstitutional.[17] A British High Court ruled that California's involuntary commitment law violated human rights, that the punishments violated the European Convention on Human Rights, and refused to extradite a man based on the risk that he might be committed to Coalinga.[18]

Representation in other media[edit]

Filmmaker Louis Theroux directed a BBC television documentary based on Coalinga Hospital; it is entitled A Place for Paedophiles (2009), showing the lives of CSH "patients" who are indefinitely incarcerated at the hospital. The one-hour program first aired on BBC Two in the United Kingdom on 19 April 2009, and in Australia in December 2012, as the seventh in a series of Theroux specials. This special will not be shown in the United States. Patient health care laws, primarily the Health Insurance Portability and Accountability Act (HIPAA), forbid the disclosure in the US of a person's illness (including mental health issues) without their consent.[19] These laws only apply within the U.S., so that is why the show is allowed to be shown outside the U.S.

See also[edit]


  1. ^ Lee Romney (March 5, 2006). "Coalinga State Hospital Is Sitting Nearly Empty". Los Angeles Times. Retrieved 18 September 2009. 
  2. ^ Scott Gold and Lee Romney (November 15, 2007). "Treatment replaced by turmoil". Los Angeles Times. Retrieved October 7, 2015. 
  3. ^ "CA Dept of State Hospitals - Coalinga". California Department of State Hospitals. Retrieved 10 July 2017. 
  4. ^ Jones v. Blanas, 393. F.3d 918, 926 (9th Cir. 2004)
  5. ^ "In re Howard (2005) 35 Cal. 4th 117, 129; Kansas v. Crane (2002) 534 U.S. 407, 412-413; Kansas v. Hendricks (1997) 521 U.S. 346, 358; People v. Williams (2003) 31 Cal. 4th 757, 759; Hubbert v. Superior Court (1999) 19 Cal. 4th 1138, 1156"
  6. ^ Minnesota sex offender program is ruled unconstitutional
  7. ^ Lee Romney (March 12, 2015). "State audit faults evaluations of sexually violent predators". Los Angeles Times. Retrieved October 6, 2015. 
  8. ^ Ryan Gabrielson (September 21, 2011). "Sex offenders at state hospital protest ‘violent predator’ designation". Los Angeles Times. Retrieved October 7, 2015. 
  9. ^ a b c Lee Romney (March 5, 2006). "Coalinga State Hospital Is Sitting Nearly Empty". Los Angeles Times. Retrieved October 7, 2015. 
  10. ^ a b Scott Gold and Lee Romney (15 November 2007). "Treatment replaced by turmoil". Los Angeles Times. Retrieved October 7, 2015. 
  11. ^ Scott Gold and Lee Romney (15 November 2007). "Treatment replaced by turmoil". Los Angeles Times. Retrieved 3 September 2009. 
  12. ^ Jeslyn A. Miller (December 2010). "Sex Offender Civil Commitment: The Treatment Paradox". 98 Cal. L. Rev. 2093 (2010). California Law Review. Retrieved October 7, 2015. 
  13. ^ Scott Gold and Lee Romney (15 November 2007). "Treatment replaced by turmoil". Los Angeles Times. Retrieved October 7, 2015. 
  14. ^ Lee Romney (March 5, 2006). "Coalinga State Hospital Is Sitting Nearly Empty". Los Angeles Times. Retrieved October 8, 2015. 
  15. ^ Lee Romney (March 5, 2006). "Coalinga State Hospital Is Sitting Nearly Empty". Los Angeles Times. Retrieved October 8, 2015. 
  16. ^ Amy Baron-Evans, Sara Noonan (September 2007). "Adam Walsh Act III: It’s Not the Sentence, It’s the Commitment . . ." (PDF). Prison Legal News. Retrieved October 7, 2015. 
  17. ^ Monica Vaughan (June 26, 2015). "State hospital civil commitment ordered for molester". Appeal-Democrat. Retrieved October 8, 2015. 
  18. ^ Hamilton, Matt (October 22, 2015). "British court blocks extradition of sex-abuse suspect, saying California law violates human rights". Los Angeles Times. Britain. Retrieved October 25, 2015. 
  19. ^ Theroux, Louis (17 April 2009). "Where they keep the paedophiles". BBC News Online. Retrieved 22 April 2009. 

External links[edit]

Coordinates: 36°7′51″N 120°14′25″W / 36.13083°N 120.24028°W / 36.13083; -120.24028