Hospital for Mentally Ill Is Criticized

Napa Valley State Hospital routinely fails to protect its 1,100 patients from harm and to provide them medical and psychiatric treatment, according to a scathing U.S. Department of Justice report released Tuesday.

In one case cited in the report, a patient’s family phoned the state mental hospital last December to tell nurses that the patient was “despondent, crying and in need of attention.” The staff failed to act and the patient was found dead less than an hour later, hanging from a sheet in his room.

Another patient died of hanging in March. In May, investigators cited the case of a patient who choked to death in the hospital’s cafeteria without receiving proper first aid.

“It is difficult to imagine why there was no staff person with sufficient training available to avert a death by choking,” they noted.

The report also alleged that three Napa Valley patients overdosed on amphetamines or cocaine last fall, while three others obtained and used heroin. Furthermore, the report says that a hospital physician testified under oath last year that staff “brings drugs into the facility in exchange for cash.”

The report, posted on the Justice Department’s website late Tuesday, also said that the state Department of Mental Health had denied federal investigators access to the Northern California facility and to two other state hospitals it wants to investigate: Atascadero on the Central Coast and Patton in San Bernardino County.

“As we repeatedly advised state officials, however, our investigations proceed regardless of whether officials choose to cooperate,” wrote Bradley J. Schlozman, an acting assistant attorney general, in the Napa Valley report.

Officials with the state Department of Mental Health and Napa Valley State Hospital could not be reached for comment Tuesday night.

Much of the report was based on inspections of the hospital this year by the U.S. Centers for Medicare and Medicaid Services and the California Department of Health Services.

The Centers for Medicare and Medicaid Services report found, for example, that one patient had to wait more than two years to get a proper psychiatric evaluation.

The Justice Department and the California Department of Mental Health have been at odds for months over patient care issues at the four major state hospitals.

In February 2004, the Justice Department released the second of two reports on Metropolitan State Hospital in Norwalk. The report alleged that patients were regularly misdiagnosed and wrongly medicated and that the hospital was unsafe for patients.

Four patients have died under questionable circumstances since then, according to Los Angeles County coroner’s reports, including an 18-year-old who hanged herself in late May.

State and federal officials have been negotiating a plan of correction for Metropolitan for months but have reached an impasse. The Justice Department can sue California under the Civil Rights of Institutionalized Persons Act to force changes.

After the investigation of Metropolitan, the Justice Department turned its attention to the other three large state mental hospitals, which serve as the safety net for some of the state’s most severely mentally ill.

Correspondence between the Justice Department and the California Department of Mental Health shows that the state has tried to keep federal officials out of the other three state hospitals until early 2006.

The letters were obtained by The Times through a request under the California Public Records Act.

In June 2004, state officials wrote to the federal government, offering to provide patient records to investigators but asking them to avoid visits to the hospitals, saying the visits strained scarce resources. The Justice Department rejected that request in a letter dated Aug. 27.