Future Care for Mental Patients a Question Mark

Both 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” two decades ago.

The hospital was also home for Thousand Oaks resident David Heyer, who 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 and Heyer are part of the legacy of Camarillo State Hospital. 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 the hospital is shutting down .

Although mental health advocates generally agree that community placement should be the goal, there is growing concern that patients are being jeopardized by the 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.”

Some of the patients already living on the outside are like Jim Oberlin, 47, discharged into an Oxnard group home more than two decades ago after doctors helped to tame his runaway aggression.

Oberlin transferred to Camarillo in the early 1970s from a state hospital in Michigan, where doctors had been unable to help him. His speech is limited, and his memories of the state hospital have drifted out of focus.

But he remembers being one of the few patients allowed to test the deep end of the hospital pool. And he remembers how the research unit helped to break autism’s vise-like grip.

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

Oberlin holds a job at an area pizza parlor, thanks to a work program developed by the Institute for Applied Behavior Analysis, a nationwide group with offices in Camarillo.

To be sure, there are risks to community living. Oberlin was beaten up by 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 tradeoffs. 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 a vacation.

Just as important, they say, he is a taxpaying, contributing member of the community rather than a lifelong hospital patient draining state resources.

“Our philosophy is that our folks are trying to have as much of a normal life as possible,” said Teresa Valencia, supervisor for 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.”

While it all sounds good to Jerry and Bev Heyer, the reality is that there aren’t enough such programs available to former Camarillo State patients like their son, David, 37.

He spent several years in the state hospital 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 most is a place that was both sanctuary and madhouse, where fights were not uncommon and restraints were routine for unruly behavior.

He fared no better on the outside, however. Finally, he ended up homeless, and in 1993, a suicide attempt landed him back in the state institution. That’s when he became a patient in the hospital’s research unit, responding well to a new drug for treating 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 to stock up on junk food and gobble down those chili cheese fries.

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

Across the state, the debate over what do with these patients as they exit is intensifying.

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

Moreover, critics say the effort is driven by the state’s desire to save money, rather than the desire for decent care. It costs about $100,000 year to keep a patient in a state hospital, compared to 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, which runs treatment programs for the mentally ill.

He says he is a “strong advocate” for community care, but “the concern I have is the current lack of residential treatment options for these clients.”

But for Bill Coffelt, the hospital’s closure 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 shift the money already being spent to services for them to live on their own.

“People should receive services that help them live the way that people without disabilities live,” Coffelt said. “People without disabilities don’t live in institutions or group homes.”

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

Harvey Cannaday checked into the state hospital 30 times over a period of 10 years that ended around 1978. He was a schizophrenic and an alcoholic, suffering a mental breakdown while he was a few units short of earning a college degree.

For years, “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.

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.”