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State prisons struggle with mental health

Posted: October 28, 2013 6:00 a.m.
Updated: October 28, 2013 6:00 a.m.

SAN FRANCISCO (AP) — Although California has spent hundreds of millions of dollars to improve psychiatric treatment for convicts, the biggest mental health unit in the state prison system for high security inmates remains in disarray, according to a court-appointed investigator and others familiar with the facility.

State officials acknowledge high turnover at the approximately 350-bed mental health unit at Salinas Valley State Prison in Soledad. But a court-appointed “special master” says that the departure of psychiatrists who were fired or quit has left the unit seriously understaffed, with doctors handling twice their case loads of the previous year.

The unit at Salinas Valley —operated by the Department of State Hospitals rather than the California Department of Corrections and Rehabilitation— is also plagued by problems ranging from a shortage of clean linens and undergarments to complaints that security protocols severely hinder patient treatment, the special master said.

In response to civil rights litigation, federal courts have seized control of the state prison mental health facilities and have managed them for the past 18 years.

Gov. Jerry Brown and top prison officials have been trying for more than a year to wrest control back. But emerging issues such as the conditions at Salinas have come to the attention of the court overseeing the mental health program and have kept the state from regaining complete control of the psychiatric facilities behind prison walls.
In April, District Judge Lawrence Karlton formally refused Brown’s request to end court oversight after lawyers for inmates cited problems and the judge’s own investigator agreed they were serious.

Hospital and prison officials declined requests for interviews about the conditions. But in a court filing this month, they insisted that the facility is delivering adequate care.

“Since I started as interim executive director, Salinas Valley psychiatric program has implemented new policies and has overall improved the quality of care to inmate-patients,” said Pam Ahlin, who took over supervision of the prison hospital in May. “Salinas Valley psychiatric program continues to implement new processes that will further improve care to inmate-patients.”

Karlton is currently presiding over an evidentiary hearing over issues that reach beyond Salinas Valley and into other parts of the system, which is comprised of five in-patient units and treats some 30,000 mentally ill prisoners among the state’s 124,000 inmates.

The judge is considering inmate complaints about the system’s discipline procedures for mentally ill inmates and whether inmates on death row at San Quentin State Prison receive adequate mental health treatment.

A separate three-judge panel that oversees the prison system’s medical treatment of inmates has also refused to relinquish court oversight and return management to the state. Judges in both cases, filed by prison rights advocates on behalf of inmates, have concluded that overcrowding is the main culprit behind the substandard mental health and medical care they’ve found throughout the prison system.

Still, lawyers for inmates, the special master and the former psychiatrist said Salinas Valley’s biggest problem was lack of mental health professionals to work with the mentally ill patients.



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