California must explain to a federal judge why state prisons again have a backlog of seriously mentally ill prisoners waiting for inpatient care while there are hundreds of empty beds at a state psychiatric hospital.
U.S. District Judge Kimberly Mueller on Friday gave the state 30 days to address problems that were to have been corrected under court orders five years ago.
"I'm expressing my concern with what appears to have been some backsliding," Mueller said at a hearing on the issue Wednesday, according to a transcript. "Progress, yes, but some backsliding."
FOR THE RECORD:
State prisons: An article in the Aug. 22 California section about waiting lists for the care of mentally ill prisoners in California misidentified U.S. District Court Judge Kimberly Mueller as Claudia Mueller. —
In 2010, California had hundreds of mentally ill prisoners on long wait lists for inpatient treatment. The state was ordered to admit many of them to two psychiatric hospitals that also house people who are accused of crimes but judged innocent by reason of insanity or incompetent to stand trial.
Lawyers for inmates say the state abandoned that plan, admitting only two prisoners in the last year despite more than 200 empty beds at Atascadero State Hospital, more than 100 of those set aside for state prison inmates. Meanwhile, according to a court-appointed special master, wait lists have reemerged.
On Friday, Mueller ordered the state to report to her whether using those empty beds would "permanently eliminate the ongoing waiting list for inpatient mental healthcare and, if not, why not and what alternate plans are in place for wait-listed class members."
State Hospitals Director Pam Ahlin, summoned to appear before Mueller on Wednesday, told the judge, "You do have my commitment to make sure that we do take the ... court orders of serving our mentally ill patients seriously."
State prison inmates are not the only ones looking for room.
A lawsuit filed last month by the American Civil Liberties Union of Northern California accuses the Department of State Hospitals of failing to admit more than 350 mentally ill defendants who are in county jails awaiting psychiatric treatment before they can stand trial.
Department officials said the agency is expanding competency programs within jails instead.
The civil rights group does not necessarily want that.
"The state needs to explore alternatives such as diversion and services outside of jails and hospitals," said staff attorney Micaela Davis.
In their legal filings, state hospital and corrections officials cite security reasons for the empty psychiatric beds.
A single prison allows room for 50 mentally ill inmates in a low-custody setting. The remainder of such housing is in state hospitals, where dorm rooms are unlocked.
At the same time, court records show the state hospital system often regards low-risk inmates who are mentally ill as security threats and reclassifies them as high-risk.
"A patient's clinical needs are prioritized over custodial eligibility," states a report to the court by Ahlin and the corrections department.
Those who require hospitalization in a locked cell include inmates with hallucinations, paranoia, or functional problems such as being "malodorous."
They are ineligible for the unlocked rooms at Atascadero.
"Not all mentally ill prisoners referred from [corrections] can safely be treated in this environment," state hospitals department spokesman Ken August said in a written response.
Michael Bien, the lead attorney representing California's nearly 37,000 mentally ill inmates in class-action litigation that has carried on now for 25 years, alleged the state hospital system is "afraid" of prisoners and therefore reluctant to admit them to Atascadero.
"They have this overreaction to the violence in state hospitals," Bien said. "It's not the patients' fault they are psychotic."
Last year, an Atascadero patient was strangled to death by another patient in the same dormitory. The last killing before that occurred in 2008.