Atascadero State Hospital

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. The only patients admitted are those that are referred to the hospital by the Superior Court, Board of Prison Terms, or the Department of Corrections.

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

History

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.[28] Psychiatrist salaries have been increased to levels just under the prison psychiatrist salaries, and ASH's psychiatrist staffing is now (2014) being rebuilt.

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

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

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

Employees

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

Department of State Hospitals -Atascadero has its own full service law enforcement agency of over 200 sworn personnel. 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.

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).

gollark: Apparently xscreensaver locks my account for 10 minutes after 3 failed logins somehow. How do I stop this?
gollark: <:bees:724389994663247974>, but <:bees:724389994663247974> and <:bees:724389994663247974>, so <:bees:724389994663247974>.
gollark: Maths only deals with 0, 1 and infinity.
gollark: Those aren't real numbers.
gollark: [INCOMPREHENSIBLE APIOFORMS UNREPRESENTABLE IN UNICODE]

References
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