Some Ex-Patients Thrive on Outside, Others Struggle

The sun-bleached buildings and troubled patients at Camarillo State Hospital have always been secluded and set apart--out of sight and even further out of mind for most county residents.

But for Ventura resident Harvey Joseph Cannaday, the old mental hospital is still as familiar as any home he has ever known, a place burning with the memory of his game-winning grand slam in a softball match between the “Crazies” and the “Alcoholics” some two decades ago.

Daniel Whitney Anthony spent six months locked up there, learning stories of the ghosts that haunted the state institution before moving to his own apartment in Camarillo nearly two years ago.

And Thousand Oaks resident David Heyer still speaks fondly of his final years there, of how he eagerly traded his groundskeeper earnings at the hospital’s canteen for cigarettes, soda and the best chili cheese fries around.

Together with perhaps as many as 1,000 other former patients, Cannaday, Anthony and Heyer are part of the legacy of Camarillo State Hospital in Ventura County.

While the institution itself is set to close June 30, many of its former residents have settled in surrounding communities, promising to stay around long after the hospital empties out.

Some are in smaller institutional settings. Others live on their own. But almost all of them, at one time or another, are still in need of some kind of help.

And together they are the focus of a new and growing debate over what should be done to best help them now that Camarillo State is shutting down.

While mental health advocates generally agree that community placement should be the goal, there is growing concern that patients are being jeopardized by the current push to discharge them from institutional care.

It is a concern that extends beyond Ventura County, to the mentally ill and developmentally disabled across the state and the nation.

But it is one made more pressing than ever locally as officials plot the state hospital’s final days, preparing to remove what many advocates call a vital safety net for the region’s mentally disabled population.

“I definitely believe people should live in the community with the appropriate level of care,” said Julia Barnes, executive director of a watchdog group that monitors services provided to the developmentally disabled in Ventura County.

“But a lot of people have been really fearful that we’re not planning enough, that we don’t have enough services in place,” Barnes added. “I’d have to agree. And nothing is worse than putting somebody in the community at a risk to their health and safety.”

Pushed Into the Community

Peek behind the walls at Camarillo State Hospital, and the push to funnel patients into the community becomes quickly apparent.

Six years ago, there were about 30 mentally ill patients from Ventura County in the state hospital. Today there are only four, the rest having transferred to a range of community care programs, including a new residential treatment facility funded by the county on state hospital land.

Historically, the state set aside between 30 and 40 beds at Camarillo for Ventura County’s mentally ill population. But in the early 1990s, legislation changed the way those mental health services were funded statewide.

Instead of the state paying hospitals to keep beds open for local use, that money started going directly to counties to beef up local mental health services.

In Ventura County, officials began to reduce their reliance on the state hospital, opting instead to develop a range of community care programs for the mentally ill and hire additional staff to do intensive case management.

Those programs, funded with an additional $2 million annually in state money, included adding staff and resources to privately owned board and care homes for the mentally ill. Money also was diverted to a locked treatment center in Sylmar where Ventura County sends some of its most troubled cases.

Officials also funneled some money into independent living programs, where the mentally ill share private housing with some supervision. And they opened the county-run Las Posadas facility near the state hospital complex, a 30-bed residential program where many of the state hospital patients have ended up.

“We all have been extremely pleased with the outcomes,” said Dennis O’Connell, supervisor of the county’s adult residential services team. “The bottom line is we’re at the end of the institutional era for the mentally ill. So we’ve been pretty busy creating different types of supports and models to maintain them effectively in the community.”

On the developmentally disabled side, more than 350 patients have been discharged into community programs throughout the region over the last four years.

The vast majority of those--about 225--have gone into privately owned and operated community group homes. Those homes, which range in size from two beds to six, receive money from the state to provide shelter and services to the developmentally disabled.

Some of the patients are like 47-year-old Jim Oberlin, discharged into an Oxnard group home more than two decades ago after doctors at the hospital’s world-renowned research unit helped tame his runaway aggression.

Oberlin transferred to Camarillo in the early 1970s from a hospital out of state, where doctors had been unable to help him.

Researchers set out to motivate change. Realizing that money was important to him, they set up a program that allowed Oberlin to earn a dollar a day as long as he behaved. But he lost a dime each time he lost his cool.

Such incentives were combined with a social skills program that taught him to communicate his needs. The dual approach worked so well that he was eventually discharged to the Oxnard group home where he has lived ever since.

Oberlin’s speech is limited, and his memories of the state hospital have drifted out of focus.

But he remembers the hospital’s swimming pool and how he was one of the few patients allowed to test the deep end. And he remembers how the hospital’s research unit helped break the vise-like grip that autism had on him.

“I was on Unit 45, Unit 45 a long time ago,” he said, his speech erupting in fits and starts like the autistic character played by Dustin Hoffman in the movie “Rain Man.” “I graduated from Camarillo State Hospital. But that was a long time ago, a long time ago.”

For many of the former state patients, those now part of the larger community, there is a sense of self-sufficiency that comes with life outside hospital walls.

Oberlin now holds down a job at a south Oxnard pizza parlor, the result of a work program developed by the Institute for Applied Behavior Analysis, a nationwide group with offices in Camarillo.

Funded by the Tri-Counties Regional Center--the umbrella group responsible for the developmentally disabled in Ventura, Santa Barbara and San Luis Obispo counties--IABA has developed a range of services to help patients live as independently as possible.

Established by state law, regional centers are private, nonprofit agencies that contract with the state Department of Developmental Services to oversee the treatment of the developmentally disabled. There are 27 regional centers statewide, and they funnel money to agencies such as IABA to provide services for the developmentally disabled.

IABA has 37 clients in its work program, 23 of whom are also enrolled in its independent living component.

Mirroring some of the techniques developed at the state hospital, IABA counselors work with Oberlin throughout the week.

In addition to earning about $55 every two weeks at his minimum-wage job, Oberlin also earns a quarter for going a few hours without showing verbal or physical aggression. And he gets a baked potato if he can go the whole day without cursing or talking back to his boss.

To be sure, there are risks involved with community living. Oberlin was beaten up by some street toughs a few months ago while out in the neighborhood near his group home.

But advocates for independent living say those risks are worth the trade-offs. Oberlin has a freedom he never knew in institutional care. He can hop on a bus when he wants to go somewhere, and he is putting money away for an upcoming vacation.

Just as important, they say, he is a tax-paying, contributing member of the community rather than a drain on state resources as a lifelong hospital patient.

“Our philosophy is that our folks are trying to have as much of a normal life as possible,” said Teresa Valencia, supervisor for IABA’s work program. “If we give them choices, we let them have the opportunities any of us would have. I think if we’re focused on making life better, that’s the important thing.”

Too Few Programs

While it all sounds good to Jerry and Bev Heyer, the reality is that there aren’t enough programs like IABA’s available to former Camarillo State patients.

Their son, 37-year-old David Heyer, spent several years in the state hospital, bouncing from unit to unit during his three admissions there. He is schizophrenic and developmentally disabled, a challenging combination well-suited for the hospital’s range of treatment programs.

But what Heyer remembers about some of his time there is a place that was both a sanctuary and a madhouse, where fights were not uncommon and restraints were routinely the answer for unruly behavior.

“I kept harming myself and harming others,” Heyer said. “I went first to Unit 16, but I got put in restraints there. Then I got put on 26, which was a lock-down unit. Then I went to Unit 14 for my violent temper and destroying property after I put my hand through a window. Then I went on Unit 31 for a while, but there were some real bad people there.”

During his first two stays, Heyer said, he often tried to run away. But he fared no better on the outside, where he washed out of a series of group homes.

Finally, after ending up homeless, a suicide attempt landed him back in the state institution for the last time in 1993. That’s when he became a patient on the hospital’s research unit, responding well to a new drug for the treatment of schizophrenia.

He got a job, earning minimum wage as a groundskeeper. He sold his artwork, painted as part of the hospital’s art therapy program. And he would travel down to the local deli, The Hub, where he would stock up on junk food and gobble chili cheese fries by the handful.

“I miss the old hospital so much, I really do,” said Heyer, who left Camarillo last July. “I miss my job and I miss my old friends. I was busy all the time, doing things. I was finally happy.”

Heyer is not happy now. He has not taken well to group-home life, and his parents have tried in vain to find someplace else for him. They say his case is a good example of how the community care system is falling short.

And, they say, it highlights the need to save places such as Camarillo State Hospital from closure.

“Somebody has to wake up to the fact that these facilities are needed,” Jerry Heyer said. “I agree that people should not be locked up forever, but there’s a place for the state hospitals. That was David’s salvation.”

Senate Hearing

Across the state, the debate is heating up.

At a special Senate hearing last month in Sacramento, critics attacked the state’s system of caring for the developmentally disabled, charging that patients were being forced out of large institutions into community programs unprepared to care for them.

The hearing came on the heels of a federal lawsuit filed by a doctor at Fairview Developmental Center in Costa Mesa, alleging that disabled patients were being transferred to “ill-equipped” community group homes.

About 150 of Camarillo State’s patients are expected to transfer to Fairview, starting next month.

To many critics, the deinstitutionalization effort is reminiscent of a similar effort in the 1970s to empty mental hospitals, a policy that pushed many of the mentally ill onto the streets.

Moreover, critics say the effort is being driven by the state’s desire to save money, rather than the desire to provide decent care for the disabled. It costs about $100,000 year to keep a patient in a state hospital, compared with as little as $8,000 a year for a group home.

“I think economically the pressure has been there to put people in the community,” said Clyde Reynolds, executive director for Turning Point, a Ventura-based treatment program for the mentally ill.

Reynolds and other mental health advocates have been waging a battle to set aside at least a portion of the hospital campus as a treatment center for patients with local families, writing local lawmakers to press the issue.

“I am a strong advocate for moving people into the community,” Reynolds said. “The concern here is we do need a broader range of treatment options for the mentally ill.”

Israel Perel, director of a project at Camarillo State Hospital to move developmentally disabled patients into the community and help support them once they are there, said there are clearly not enough community services for all the hospital patients who need them.

And he added that budgets are tight and the competition is fierce for money to support those patients in community programs. But the reality is that the days of the mass warehousing of patients in large institutions are rapidly coming to an end.

“Every single person who is here at Camarillo is here because the supports and services they need are not currently available in the community,” Perel said. “But I think folks are realizing that development centers, for whatever reason, are becoming less of an option and that the notion that their children can be there for life just isn’t true anymore.”

For Bill Coffelt, the end can’t come soon enough. Coffelt, a Northern California resident whose son is developmentally disabled, was the lead plaintiff in a 1990 lawsuit demanding that parents have more options outside of state institutions.

In settling the lawsuit, the state agreed to move 2,000 patients out of large developmental centers and spend millions of dollars more for services for them to live on their own.

Still, Coffelt agrees that not enough is being done to support the developmentally disabled in the community.

“People should receive services that help them live the way that people without disabilities live,” said Coffelt, whose son, Bill, will soon move into his own home, supported by live-in help.

“People without disabilities don’t live in institutions or group homes,” he said. “I think the model should really be changed over to supported living, and I think what’s really needed is committed leadership to developing those types of options. Anything else is just another name for people living in institutional care.”

The New Safety Net

For some former Camarillo State patients, a developing web of community care programs will have to serve as the new safety net.

Ventura resident Harvey Cannaday checked into the state hospital some 30 times over the span of a decade, ending in about 1978. He was a schizophrenic and an alcoholic, suffering a mental breakdown a few units short of earning a college degree from what is now Cal State Northridge.

“Up until 1987, they considered me a total schizophrenic nut,” said Cannaday, 48, who now lives on his own, buoyed by government aid and the county’s mental health network. “It was a wild thing that was happening to me. I just dealt with it the best I could.”

What was happening to Cannaday was a deeply held belief that an exploding supernova had rained down subatomic particles, spurring a worldwide epidemic of mental illness.

He felt it his mission to spread the word about the event, and that regularly earned him admission to the state hospital.

Most of the time, he said, he was on Unit 16--a ward for people who were a danger to themselves or others. While his longest stay was 30 days, he frequently was held on 14-day observations for his fits of madness and delusions of grandeur.

Inside were students like himself who had suffered nervous breakdowns. He remembers he had a roommate once, and together they would pencil physics formulas on the walls searching for the key to leaving the hospital for good.

Troubled Vietnam veterans were part of the mix, Cannaday recalls. And there were always new people showing up. The mixture sometimes produced hospital wards that were loud and crowded, he said, where tensions smoldered and once in awhile bubbled over.

As the elected dorm leader, on one occasion, Cannaday tried to make peace. He organized a softball game between the schizophrenics and the alcoholics, trying to make everyone get along.

“It was kind of a rough way of living,” said Cannaday, his hands shaking uncontrollably as he snapped the filter off a cigarette before lighting up. He believes the tip is what really causes cancer.

“But I didn’t look at it as a bad situation,” said Cannaday, who is thin as a rail with a salt-and-pepper beard that shoots out in all directions. “I felt fortunate I was at the state hospital at the time.”

These days, Cannaday can be found roaming the streets of downtown Ventura, striding along Main Street on his way to or from appointments at the county’s mental health clinic.

He lives with a roommate, paying his own way on the $630 he gets each month from the government. He says he has been sober for three years and is no longer considered a mental health patient.

“I hit my bottom a long time ago,” Cannaday said. “I think the mentally ill are always going to be with us, but I think things are going to be getting better.”

Daniel Whitney Anthony is another former Camarillo State patient who is thriving in the community. Through IABA’s supported living and work programs, the 21-year-old developmentally disabled man has found a part-time job in Camarillo and a roommate willing to split the cost of renting an apartment.

Less than two years ago, Anthony was sent by court order to a locked unit at Camarillo State Hospital after running into trouble with the law.

Even though he was only there for six months, he was far from happy with the experience. The food was bad, he said. And half the time the showers didn’t have any hot water. He was most alarmed when the heater in his bedroom shorted out, filling the hospital ward with smoke.

“I didn’t really belong there, but I was forced to be there,” he said. “I never considered it home, it was more like a motel or something.”

Now part of the community, Anthony said he’s never been better. He’s off all medication, which he now blames for most of the behavioral problems that got him into trouble.

And for the first time in his life, he can make some real choices about how and where to live.

“I like where I’m living now,” he said. “I’m close to all the restaurants I like, I’m close to people I like. I can take the bus out to areas I couldn’t go before. It’s a lot better. I live like a regular person.”

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About This Series

“A Community Says Goodbye: The Closing of Camarillo State Hospital” is an occasional series chronicling the final days of one of the most famous institutions in Ventura County. This installment focuses on how former patients have moved out of the hospital and have continued their lives in surrounding communities. And it examines the growing debate over what should be done to help patients now that the institution is closing.