Coalinga State Hospital

Patients gather in an outdoor courtyard during a lunch break at Coalinga State Hospital. There are more than 600 detainees at the hospital.  (Robert Gauthier / Los Angeles Times)

Deirdre D’Orazio, director of program development and evaluation services at the hospital, acknowledged that just a handful of patients will complete the treatment program in the next year. “I wouldn’t be working in this field if I thought it was a scam,” she said. “I don’t believe that there are any wastebasket cases, individuals who are so abnormal that they can’t learn to put aside their deviant impulses.”  (Robert Gauthier / Los Angeles Times)

Many residents at the hospital refuse to participate in a core treatment program, protesting rules that they say prevent them from ever earning their release. “Nobody can decide what we are,” said Niles Carr, 38, who served time for child molestation before being routed into the mental hospital system in 1998. “But as long as we’re stuck here, we need to be treated properly.”  (Robert Gauthier / Los Angeles Times)

In August, according to staff members, a group of patients taped protest fliers to their hospital-issued identification tags.  (Robert Gauthier / Los Angeles Times)

Patients have access to a number of courtyards at the hospital. The facility’s sleek architecture and tidy topiaries present a jarring contrast to the tumbleweeds and dust devils that dominate the surrounding landscape.  (Robert Gauthier / Los Angeles Times)

Patients pass the main mall area as they walk to and from their rooms. Almost all the detainees at Coalinga have served time for serious sexual offenses.  (Robert Gauthier / Los Angeles Times)

Patients gather for a group session. Some patients have declined to eat for days at a time, while many have boycotted educational and improvement programs, which include anger management workshops, computer training and Spanish classes.  (Robert Gauthier / Los Angeles Times)

Art hangs on the walls at the hospital’s library.  (Robert Gauthier / Los Angeles Times)

Coalinga State Hospital police officers escort visitors into the treatment unit labeled Muir Woods.  (Robert Gauthier / Los Angeles Times)