Atascadero State Hospital

Last updated
California Department of State Hospitals
Atascadero State Hospital
Geography
Location Atascadero, California, United States
Organization
Care system Psychiatric ward
Type Forensic psychiatry
Services
Emergency department Department of State Hospitals- Atascadero Police Department (DSHAPD, ASHPD, or DPS)
Beds1239
History
Opened1954
Links
Website Official website
Lists Hospitals 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] DSHA is not a general purpose public hospital, and 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.

Contents

History

Atascadero State Hospital (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 a 1978 Federal study of sex offender treatment programs: [3] "An informal history of [ASH], distributed in 1975, reports that Atascadero opened “with the philosophy that good therapy could be carried on in a security setting and that modern methods of psychiatric treatment, based on a therapeutic community' concept, would most likely succeed.“ The problems of 'therapy vs. security' and 'prison vs. hospital' immediately developed and hindered successful treatment. The belief that criminals should be punished for their crime and not 'babied' haunted the hospital program. For several years beginning in 1959, a series of unfortunate and tragic accidents occurred at the hospital. A number of escapes and violent incidents in addition to widespread community concern led to a special investigation of the hospital's problems which ultimately resulted in a revamping of its organization, administration, and treatment programs” beginning in 1961. The 1960's were also a troubled decade for Atascadero, plagued by internal dissension, staff rebellions, and occasional scandal."

As early as the 1970s, ASH was referred to as a "Dachau for Queers." The term appeared in a March 16, 1972 L.A. Free Press article, with an Editor's Note stating: "The following story is an edited version of Don Jackson’s article "Dachau For Queers" which originally appeared in The Gay Liberation Book by Ramparts Press." [4] [5] A 2009 California Law Review article commented, "One reason for this appellation was that inmates [sic] were subjected to experimental therapies - electrical and pharmacological shock treatments in addition to lobotomies - to "cure" them of their "sex perversion."" [6] [7] Recent appearances of this term include a 2011 PBS American Experiences documentary "Stonewall Uprising", which was rebroadcast in 2020, [8] and a 2012 New Yorker article. [9] In 1976 Michael Serber MD (then ASH Clinical Director) coauthored a paper commenting: "The history of treatment for the homosexual at this institution has mainly centered around inadequate and sometimes cruel attempts at conversion to heterosexuality or asexuality. There is an intermittent history of aversive conditioning. These aversive techniques had extended even to the use of succinylcholine and electroconvulsive shock treatment as punishment for homosexual offenders who had 'deviated' within the hospital. At the very minimum, homosexuals were frequently degraded by staff whose attitudes concerning homosexuality were punitive and judgmental. More homosexual patients than heterosexual had been defined as unamenable to treatment after a period of hospitalization and then were sent to prison via the courts under the ambiguous judicial system that determines the fate of sexual offenders in the state of California.” [10] Through an NIMH "Hospital Improvement" grant (1971–75), Dr. Serber [11] and his coauthor Claudia Keith MA led improvements in ASH's programs. [3]

ASH's treatment programs have reflected the psychiatric assumptions of the times. [12] [13] 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. [14] [15] [16] [10] [17] [18] [19] [20] [21] 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. [22] 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. [23] [24] [25] [26] After Carmel left to become CEO of the Colorado Mental Health Institute at Pueblo in 1991, Hunter and Colleen Love developed important programs to improve staff safety, [27] [28] [29] which won awards from the American Psychiatric Association. [30] and, in 1998, JCAHO's Ernest A. Codman Award in the Hospital Category. [31] In this era, ASH was an important center of research and teaching. [32] [33] [34] [35] [36] [37] [38]

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 ] [39] 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. In 2007, 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. [40] [41] [42]

A 2018 law review article [43] reported that in 2004 then-CEO Mel Hunter had supported research showing that SVP reoffense was much lower than claimed: "This Article uses internal memoranda and emails to describe the efforts of the California Department of Mental Health to suppress a serious and well-designed study that showed just 6.5% of untreated sexually violent predators were arrested for a new sex crime within 4.8 years of release from a locked mental facility. ... these results undermine the justification for indeterminate lifetime commitment of sex offenders." Three days after Hunter's removal in 2007, 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." [44] This suggests a second reason for Hunter's exit and is a coda to ASH's history as a research center.

Patient-on-patient homicides

On July 17, 1990 a 59 year old property clerk of the hospital was fatally attacked by a patient named Terry Caylor. [45]

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". In 2007, 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. [46]

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

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 unarmed 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.

Related Research Articles

Involuntary commitment, civil commitment, or involuntary hospitalization/hospitalisation is a legal process through which an individual who is deemed by a qualified agent to have symptoms of severe mental disorder is detained in a psychiatric hospital (inpatient) where they can be treated involuntarily. This treatment may involve the administration of psychoactive drugs, including involuntary administration. In many jurisdictions, people diagnosed with mental health disorders can also be forced to undergo treatment while in the community; this is sometimes referred to as outpatient commitment and shares legal processes with commitment.

Paraphilia is the experience of recurring or intense sexual arousal to atypical objects, situations, fantasies, behaviors, or individuals. It has also been defined as a sexual interest in anything other than a consenting human partner.

Hypersexuality is a term used for a presumed mental disorder causing people to engage in or think about sexual activity to a point of distress or impairment. It is controversial whether it should be included as a clinical diagnosis used by mental healthcare professionals. Nymphomania and satyriasis were terms previously used for the condition in women and men, respectively.

Hebephilia is the strong, persistent sexual interest by adults in pubescent children who are in early adolescence, typically ages 11–14 and showing Tanner stages 2 to 3 of physical development. It differs from pedophilia, and from ephebophilia. While individuals with a sexual preference for adults may have some sexual interest in pubescent-aged individuals, researchers and clinical diagnoses have proposed that hebephilia is characterized by a sexual preference for pubescent rather than adult partners.

Penile plethysmography (PPG) or phallometry is a measurement of blood flow to the penis, typically used as a proxy for measurement of sexual arousal. The most commonly reported methods of conducting penile plethysmography involves the measurement of the circumference of the penis with a mercury-in-rubber or electromechanical strain gauge, or the volume of the penis with an airtight cylinder and inflatable cuff at the base of the penis. Corpora cavernosa nerve penile plethysmographs measure changes in response to inter-operative electric stimulation during surgery. The volumetric procedure was invented by Kurt Freund and is considered to be particularly sensitive at low arousal levels. The easier to use circumferential measures are more widely used, however, and more common in studies using erotic film stimuli. A corresponding device in women is the vaginal photoplethysmograph.

Criminal psychology, also referred to as criminological psychology, is the study of the views, thoughts, intentions, actions and reactions of criminals and suspects. It is a subfield of criminology and applied psychology.

<span class="mw-page-title-main">Forensic psychiatry</span> Subspeciality of psychiatry, related to criminology

Forensic psychiatry is a subspeciality of psychiatry and is related to criminology. It encompasses the interface between law and psychiatry. According to the American Academy of Psychiatry and the Law, it is defined as "a subspecialty of psychiatry in which scientific and clinical expertise is applied in legal contexts involving civil, criminal, correctional, regulatory, or legislative matters, and in specialized clinical consultations in areas such as risk assessment or employment." A forensic psychiatrist provides services – such as determination of competency to stand trial – to a court of law to facilitate the adjudicative process and provide treatment, such as medications and psychotherapy, to criminals.

<span class="mw-page-title-main">Centre for Addiction and Mental Health</span> Hospital in Ontario, Canada

The Centre for Addiction and Mental Health is a psychiatric teaching hospital located in Toronto and ten community locations throughout the province of Ontario, Canada. It reports being the largest research facility in Canada for mental health and addictions. The hospital was formed in 1998 from the amalgamation of four separate institutions – the Queen Street Mental Health Centre, the Clarke Institute of Psychiatry, the Addiction Research Foundation, and the Donwood Institute. It is Canada's largest mental health teaching hospital, and the only stand-alone psychiatric emergency department in Ontario. CAMH has 90 distinct clinical services across inpatient, outpatient, day treatment, and partial hospitalization models. CAMH has been the site of major advancements in psychiatric research, including the discovery of the Dopamine receptor D2.

Elissa Panush Benedek is an American psychiatrist specializing in child and adolescent psychiatry and forensic psychiatry. She is an adjunct clinical professor of psychiatry at the University of Michigan Medical Center. She served as director of research and training at the Center for Forensic Psychiatry in Ann Arbor for 25 years and was president of the American Psychiatric Association from 1990 to 1991. She is regarded as an expert on child abuse and trauma, and has testified in high-profile court cases. She also focuses on ethics, psychiatric aspects of disasters and terrorism, and domestic violence. In addition to her own books, book chapters, and articles, she has collaborated with her husband, attorney Richard S. Benedek, on studies of divorce, child custody, and child abuse.

Psychiatric nursing or mental health nursing is the appointed position of a nurse that specialises in mental health, and cares for people of all ages experiencing mental illnesses or distress. These include: neurodevelopmental disorders, schizophrenia, schizoaffective disorder, mood disorders, addiction, anxiety disorders, personality disorders, eating disorders, suicidal thoughts, psychosis, paranoia, and self-harm.

<span class="mw-page-title-main">Coalinga State Hospital</span> Hospital in California, United States

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

Pedophilia is a psychiatric disorder in which an adult or older adolescent experiences a primary or exclusive sexual attraction to prepubescent children. Although girls typically begin the process of puberty at age 10 or 11, and boys at age 11 or 12, psychiatric diagnostic criteria for pedophilia extend the cut-off point for prepubescence to age 13. People with the disorder are often referred to as pedophiles.

Psychopathy is a mental health condition characterized by persistent antisocial behavior, impaired empathy and remorse, and bold, disinhibited, and egotistical traits. Different conceptions of psychopathy have been used throughout history that are only partly overlapping and may sometimes be contradictory.

<span class="mw-page-title-main">Forensic psychotherapy</span> Psychological treatment of violent offenders

Forensic psychotherapy is the application of psychological knowledge to the treatment of offender-patients who commit violent acts against themselves or others. This form of treatment allows for a therapist to potentially understand the offender and their mental state. It gives the individual providing treatment the opportunity to examine further whether the offender’s criminal behavior was a conscious act or not, what exactly their association with violent behavior is, and what possible motives could have driven them. The discipline of forensic psychotherapy is one that requires the involvement of individuals other than simply the therapist and patient. A therapist may collaborate with other professionals, such as physicians, social workers, and other psychologists in order to best serve the offenders’ needs. Whether the treatment is successful or not relies on a multitude of things, but typically ensuring that a systemic approach is taken and that all involved in the treatment process are well informed and supportive has proven to be the most effective. In addition to group work, forensic psychotherapy may also involve therapeutic communities, individual interaction with victims as well as offenders, and family work. In order for this specialized therapy to be as effective as possible, it demands the compliance of not only the patient and therapist, but of the rest of society as well. The main focus of forensic psychotherapy is to obtain a psychodynamic understanding of the offender in order to attempt to provide them with an effective form of treatment. Guidelines have been set to ensure proficiency in the field of Forensic Psychology.

Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of deleterious mental conditions. These include various matters related to mood, behaviour, cognition, and perceptions.

Political abuse of psychiatry, also commonly referred to as punitive psychiatry, is the misuse of psychiatry, including diagnosis, detention, and treatment, for the purposes of obstructing the human rights of individuals and/or groups in a society. In other words, abuse of psychiatry is the deliberate action of having citizens psychiatrically diagnosed who need neither psychiatric restraint nor psychiatric treatment. Psychiatrists have been involved in human rights abuses in states across the world when the definitions of mental disease were expanded to include political disobedience. As scholars have long argued, governmental and medical institutions code menaces to authority as mental diseases during political disturbances. Nowadays, in many countries, political prisoners are sometimes confined and abused in psychiatric hospitals.

Ronald Lindsay André "Ron" Langevin is a Canadian forensic psychologist at the University of Toronto. He is the founding editor of Annals of Sex Research, now titled Sexual Abuse: A Journal of Research and Treatment.

The following outline is provided as an overview of and topical guide to psychiatry:

J. Paul Fedoroff was a Canadian forensic psychiatrist, sexologist, and researcher who specialized in treating individuals with certain problematic paraphilias and/or individuals with developmental delay. He was the first director of the Sexual Behaviours Clinic (SBC) at the Institute of Mental Health Research at the Royal Ottawa Mental Health Centre located in Ottawa, Ontario. He was a full professor of forensic psychiatry, criminology, and law at the University of Ottawa.

<span class="mw-page-title-main">Herschel Prins</span> British professor of criminology (1928–2016)

Herschel Albert Prins (1928–2016) was a British professor of criminology. His career spanned over 60 years in work pertaining to forensic psychiatry, and his appointments included positions at the universities of Leeds, Loughborough, Leicester and Birmingham. His roles included HM probation inspectorate, parole board engagement, and involvement in mental health review tribunals and the mental health act commission. He worked with people with malicious activity, antisocial and disinhibited behaviour, unusual sexual deviations and people who behaved dangerously.

References

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  2. ↑ "Atascadero Chamber of Commerce - Economic Profile". atascaderochamber.org. Archived from the original on March 14, 2016. Retrieved April 2, 2016.
  3. 1 2 Brecher, Edward M. (December 16, 1978). "Treatment Programs for Sex Offenders". Department of Justice, Law Enforcement Assistance Administration, National Institute of Law Enforcement and Criminal Justice. Archived from the original on January 27, 2021. Retrieved November 28, 2020– via Google Books.
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  5. ↑ See also Don Jackson, "Dachau for Queers”, in The Gay Liberation Book, ed. Len Richmond & Gary Noguera, Ramparts Press, San Francisco (1973), 42-50; and LaStala, John, “Atascadero: Dachau for Queers?”. The Advocate, April 26th, 1972
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  47. ↑ "Judge refuses to release killer" . Retrieved 10 July 2016.
  48. ↑ 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. Archived from the original on 19 August 2016. Retrieved 10 July 2016.
  49. ↑ "OBITUARY -- John 'Bunny' Breckinridge". mailer.fsu.edu. Archived from the original on 4 February 2013. Retrieved 19 March 2022.
  50. ↑ "People v. Norman, No. D054896 | Casetext Search + Citator". casetext.com. Retrieved 2022-12-30.
  51. ↑ "Edmund Kemper Biography". www.biography.com. A&E Television Networks. January 9, 2017. Archived from the original on 2015-04-13. Retrieved May 27, 2023.
  52. ↑ "Thorpe pleads guilty to murder". The Union. Nevada County, California. March 21, 2003. Archived from the original on September 30, 2018. Retrieved September 30, 2018.

35°27′49″N120°38′06″W / 35.46361°N 120.63500°W / 35.46361; -120.63500

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