Site of Violence Is Practically City Unto Itself

There are a petting zoo and classrooms where the simplest of tasks are taught, such as how to paste a business card on a piece of paper. It is almost a city within a city, with its own police force, beauty parlor and power plant.

Fairview Developmental Center, hidden behind a public golf course off Harbor Boulevard, has nearly 1,100 patients--97% of them mentally retarded. And these aren’t folks like “Benny” on “L.A. Law” or Dustin Hoffman’s character in “Rainman.”

Nearly all those at Fairview are classified as “severely or profoundly retarded,” with an average mental age of 18 months, according to Lou Sarrao, clinical director. The youngest patient is 1 year old, the oldest in his 80s. The average age is 29.

There has been trouble at Fairview in its 32-year history--a supervisor was so badly bitten by a patient two months ago that his finger was cut to the bone and broken--but nothing like Tuesday’s. A staff painter, not a patient, shot three staff members, killing one of them. The wounded include Fairview Executive Director Hugh Kohler.

If there was to be violence at Fairview, officials had figured it would probably involve the patients. In fact, experts happened to be at the institution Tuesday to install a new security system intended to help protect the staff from patients--not from each other.

But few patients even knew of Tuesday’s shooting, according to Costa Mesa Police Capt. Tom Lazar. Alan Reed, a Fairview supervisor in a residence for patients with behavioral problems, agreed.

Most were unaware of the violence “because they were in different programs, classes and so forth” at the time, Reed said. One patient who heard of the violence “was very upset about it,” but was calmed down by staff members.

Workers at the hospital had “a feeling of disbelief” through much of the day, Reed said. “I think we all feel very strange. It was very difficult for me to do any work today because (work) paled in comparison. . . . There’s a very unreal feeling floating around the facility right now.”

The facility was semi-rural when it opened 32 years ago on land sold to the state for $410,000. Sheep grazed next door, tended by a shepherd. Harbor Boulevard was two lanes. Businesses were far away, recalled Francis McOlash, who came to Fairview as its Protestant chaplain months after it opened and who stayed on, now working as director of programs.

As development crept closer to the hospital, Fairview changed, reflecting California’s change in the treatment of the retarded.

It opened as a “state hospital,” but now is called a “developmental center.” The onetime “patients” are usually called “clients” by the staff. The “mentally retarded” have been “developmentally disabled.”

Fairview is also the newest large state hospital for the developmentally disabled, even if it is 32 years old. In Fairview’s later years, the state started moving as many of its patients as possible into smaller facilities in towns and cities across California, opting against the big “warehouses.”

“In 1959, when this was opened, it was considered the quintessence of enlightened treatment,” Frank Crinella, former executive director who now heads a research department on the Fairview grounds, said in an interview last month.

As the buildings rose, animals fled. One day a king snake wandered into a building. McOlash said the state originally planned to have a farm attached to Fairview as it did at other state hospitals, to make the institution self-sustaining. But unlike patients from farm country, those at Fairview knew nothing about farming, and it was soon clear that it was cheaper to buy a peach than to grow one.

The potential farm was sold to the city of Costa Mesa, which built two 18-hole public golf courses on the property, and Fairview’s original 752 acres dwindled to just over 500.

Clinical Director Sarrao said Fairview’s population peaked at nearly 2,600 in 1968. There were 14 teachers with credentials on the staff then. With less than half the patients these days, the number of teachers has tripled to 42, he said. The ratio of one nurse for 16 or 20 patients has improved to one to eight patients now, and the facility’s annual budget is $72 million. In all, nearly 1,000 people work there.

A key change in thinking and treatment came in the Kennedy Administration, stemming in large part from the fact that one of President John F. Kennedy’s sisters was mentally retarded, Fairview officials said. There was more research done on the problems, and a decision to separate the mentally ill from the profoundly retarded.

McOlash said that in 1959 there were only three sizes of clothes for patients: small, medium and large. “If you needed a small and all they had was a large, well, you looked pretty silly. If you were a large and all they had was a small, you looked even siller.”

When McOlash asked why there were only three sizes, he was told, “They’re mentally retarded, they don’t care how they look.” Eventually, he said, “we discovered that’s not the case.” In the old days there were “gang toilets,” six or eight next to each other, with no seats, no partitions, no privacy. If patients wanted toilet paper, they had to ask for it. “How demeaning,” McOlash said. There were gang showers too, with men or women lined up 60 to 70 at a time, naked, waiting to be paraded beneath the spray.

Today those practices have been changed. Residence buildings, drab on the outside, are surprisingly bright inside. Decorations abound and workers often bring in flowers.

New laws required that patients 21 and younger receive some kind of education; those that are able are bused off the grounds to special schools. Buildings that once held 80 patients were redesigned, with the number of residents cut to 32. Families were encouraged to bring patients’ clothing, so they could be seen as individuals. A foster grandparent program was instituted, and a common sight now is an elderly man or woman wheeling a gurney carrying a patient along the pathways.

Making the outside community more receptive to the mentally retarded has sometimes been difficult, McOlash said in an interview last month.

Four or five years ago, when a group of clients was taken to the county fair, there was an abrupt announcement over the loudspeaker, he said: “All Fairview patients, please leave the grounds immediately.” McOlash assumed that a fair-goer had been bothered by someone’s behavior and had complained.

In another instance he recounted, a psychiatric technician who spent more than a year training a cerebral palsy sufferer in basic table manners took the patient to a restaurant as a reward. First a table of patrons on one side walked out, leaving their food half-eaten. Then the group on the other side left. One woman in that group came over to the Fairview table and stood with hands on hips, shaking her head, and said, “How disgusting.”

McOlash said that another time six women began living in a community residence and one Sunday went to a local church. They were told, “You can’t come in today and can’t come in until the (church) board meets and decides if you have a soul or not.”

Police Capt. Lazar said Tuesday that the Costa Mesa police have occasionally investigated unusual deaths at the hospital and reviewed complaints about patient abuse, but he said the police had never before faced anything like the events of Tuesday.

An investigator at the hospital looks into incidents varying from sexual harassment by one staffer against another to patient abuse, Fairview officials said.

In the past fiscal year, nearly 20 people at the center died of natural causes, Sarrao said, a death rate about equal to that of the population at large. The county coroner’s office looks into each Fairview death, Lazar said.

Matthew J. Guglielmo, who for 14 years has been president of a Fairview support group known as Fairview Families and Friends and who is chairman of a Fairview advisory board, called the shooting “a sad situation” but said he was happy “it isn’t a client who did it.”

Officials say only a minority of the patients have “behavioral problems” so severe that they are potentially violent. But ironically it was just that minority that Fairview officials were worried about when they decided to increase security.

Craig Stahl of San Francisco-based McMillan Technology was working with partner Elio Sciacqua Tuesday afternoon, hours after the shooting, to install a new system to protect the staff.

Nurses, technicians, supervisors and others will carry pagers which can be activated in case of trouble. The pagers will create a system of lights that will identify their location so that other staff members can come to their aid.

But Stahl said there were no plans to install the system in the administration building, where Kohler was shot, because patients are not allowed in that part of the building.

Contributing to this story was staff writer Catherine Gewertz.