Hospital ordered to fix deficiencies

REPORT: The Department of Justice says patients at Patton are not being protected from others.

10:00 PM PDT on Friday, May 5, 2006

The Press-Enterprise


Officials at Patton State Hospital say they are trying to fix a laundry list of deficiencies in treatment at the state mental facility in San Bernardino, but a lack of money and staff are slowing those changes.

The U.S. Department of Justice reported this week that Patton staff members failed to protect patients from harming themselves or others, regularly misdiagnosed and improperly medicated patients, and relied on physical restraints instead of treatment, among other failings.

The findings, made by investigators during a December visit, were made public in a letter from Assistant Attorney General Wan J. Kim to Gov. Schwarzenegger.

"We're not there yet, but we're trying to improve in all the areas they're talking about," said Cindy Barrett, a spokeswoman for the hospital.

The Department of Justice also announced earlier this week that it has reached a settlement with the state to address civil-rights violations at Metropolitan State Hospital in Norwalk and Napa State Hospital. Patton and Atascadero state hospitals also will be included in the five-year agreement.

A fifth state hospital, Coalinga, opened in September and was not a part of the federal investigation but will implement the changes outlined in the agreement, state Department of Mental Health officials said.

The hospitals have three years to implement the changes, because the original investigation at Metropolitan was carried out two years ago, Barrett said.

"We've been working on this for two years," Barrett said. "A lot of the issues are systemwide."

Problems Detailed

The flaws detailed in Kim's letter paint a bleak picture of the quality of care afforded the 1,500 patients at Patton.

In the six months leading up to investigators' December visit, Patton reported more than 500 assaults among patients.

In September, two Patton patients were arrested in connection with the death of their 50-year-old roommate. Three months later, a Patton patient died after a fellow patient attacked him, police said.

"Patient-on-patient violence is commonplace at Patton," Kim wrote. "Patton also fails to keep patients reasonably safe from self-harm."

Investigators noted a disturbingly high number of suicide attempts by hanging.

They also found that psychiatric medications were handed out on in quantities that were "strikingly high and inadequately monitored," and in lieu of attempting to treat patients' underlying conditions.

Psychiatrists at Patton routinely diagnose patients without properly assessing them, leading to frequent misdiagnoses and failure to diagnose patients' illnesses, the report said.

And staff failed to recognize disabling and potentially irreversible symptoms of prolonged treatment with antipsychotic medications.

"A fundamental problem at Patton is that the treatment it offers does not address the patients' actual treatment needs," Kim wrote.

A New System

Barrett said many aspects of patient treatment -- including assessments, medication and treatment goals -- are expected to be dramatically improved by a computer system being implemented at all five hospitals.

John Rodriguez, deputy director of the state mental-health department, said budget and staffing needs are likewise shared by all five hospitals.

The computer system, which will be phased in starting this year, is expected to cost more than $6 million.

The mental-health department is requesting an additional $40 million for hundreds of new psychiatrists, nurses and other staffers, Rodriguez said.

Barrett said Patton officials have already made some changes to comply with the federal mandates.

Large wooden lockers behind which patients were able to hide have been pushed up against walls to prevent assaults and suicides.

The hospital also is asking for 15 more psychiatrists, six more psychologists and additional other staff members, Barrett said.

Kim stressed that the report was not meant to condemn staff members at Patton, many of whom he said are "highly dedicated individuals who are genuinely concerned for the well-being of the persons in their care."

Reach Gregor McGavin at (909) 806-3069 or