Lawmaker Makes Quiet Visit to Napa State Hospital

LosAngelesTimes
August 5, 2011

By Lee Romney, lee.romney@latimes.com

http://articles.latimes.com/2011/aug/05/local/la-me-psychiatric-ward-20110805

Assemblyman Michael Allen recently spent a day at the facility where a technician was killed last fall. The former psychiatric nurse says he wanted an unvarnished look.

Michael Allen slipped on a pair of blue jeans and a short-sleeved polo shirt, forgoing his customary suit.

On this day, he would not be the Santa Rosa assemblyman who has championed safety at the state’s mental hospitals — documenting the tales of staff members who have been kicked, punched, bitten or splashed with bodily fluids by some of California’s most troubled patients.  

When the former psychiatric nurse passed behind the barbed-wire fencing of Napa State Hospital, where patients who have been accused or convicted of crimes are housed, he was introduced as “Michael,” a volunteer there to watch and listen.

“I just wanted a very unvarnished, unscripted slice of what it really is like at the state hospital. And I wanted free access to the wards,” said Allen, a first-term Democrat who has helped lift the veil on conditions in the hospital system in the wake of a psychiatric technician’s strangulation at Napa last fall.

Allen sought a firsthand study without the typical entourage of handlers. He kept the units he planned to visit close to the vest. Even the lone hospital police officer who accompanied him — a condition that mental health officials made clear was non-negotiable — was dressed in street clothes.

The lawmaker with the cropped gray hair and ready smile arrived at the verdant 19th century facility at 10 a.m. Wednesday. He emptied his pockets, cleared security and entered the compound known simply here as “behind the fence.”

His first stop was T4 — an admissions unit where three staffers and a patient were assaulted last week. There, men deemed too mentally ill to understand criminal proceedings or assist in their own defense often arrive unmedicated and combative. A bill Allen is sponsoring would speed up the process of ordering emergency medications for those who are violent.

The first task was an assessment of one patient’s competency, through interviews for which administrators budget about 20 to 30 minutes, Allen said. Staff members tracked down their charge in the shower and, by the time they finished prodding him with questions, an hour and a half had passed.

“The higher-ups don’t take into account that you are supposed to be doing individualized care,” Allen said in an interview, during which he said the nine-hour day had left him “dazed.”

At noon, Allen retreated to a meeting room to talk to several employees over pizza. Then it was on to Q3/4, a unit with a high assault rate where he witnessed staffing so thin, he said, that daily emergencies leave things “under control, but barely.”

Among the problems the lawmaker cited were paperwork demands that kept some personnel confined to the nurses station. “What I was seeing was a lot of patients wanting interaction,” Allen said. “One said: ‘Sometimes, instead of knocking on the door, I have to batter it down to get attention.'”

On Q3/4, patients suffering from delusions and paranoia are mixed with sociopaths who cannot be handily treated with medication. One such patient — Jess Willard Massey — this week pleaded no contest in employee Donna Gross’ slaying in October. Hospital staff are pushing for designated high-security units where predatory patients can be confined.

“There is a high concentration of folks who really should be in jail or prison,” Allen said. “They’re not really being treated for mental illness because they are sociopaths.”

As he talked to a charge in the unit courtyard, an alarm blared — one of a dozen Allen heard throughout the day. He bolted inside to witness one patient, who he later learned was responding to delusional commands, beating another so fiercely that it took five staff members to subdue him. While they took the man to a seclusion room, Allen said, “the rest of the unit was unstaffed. It doesn’t look like they have a safety margin.”

The current state budget includes $9.5 million for additional police officers and psychiatric technicians throughout the hospital system — and millions more for an outdoor alarm system at Napa. And in April, California Health and Human Services Secretary Diana Dooley lifted the hiring freeze for state hospitals in order to address safety concerns.

But staffers told Allen that the hires have been bogged down in red tape and the alarm system has not been installed.

The assemblyman has emerged as a champion for safety at the Napa facility and the other state hospitals in Norwalk, San Bernardino, Atascadero and Coalinga.

Statistics show that assaults have largely risen in recent years — particularly at Napa. In a 12-month period ending in May, there were 2,828 patient assaults on peers at Napa’s 1,100-bed facility, 54 of them requiring medical treatment or hospitalization. There were 855 assaults on staff in the same period, 128 requiring a doctor’s visit or hospital stay.

Allen plans to visit the other facilities this fall. He chairs the Assembly Select Committee on Hospital Safety, which is scheduled to hold hearings Aug 23.

Among Allen’s goals is exploring ways to take money spent on overtime — which amounted to $101 million for the state hospitals in the 2009-10 fiscal year — and hire full-time staff for the unit floors.

“Napa State Hospital is appreciative of Assemblyman Allen’s interest in and support of the hospital,” a Department of Mental Health statement said about his visit. “It provides an opportunity for him to witness the quality care and service our staff provide and better understand the complexities of the hospital.”

Allen acknowledged both.

 


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