With a federal court order looming, the psychiatric unit at California’s Salinas Valley State Prison (SVPP) violated its own policies and made risky admissions to reduce its patient waiting lists.

As a three-judge panel was about to decide whether it should continue the decades long oversight of California’s prison mental health care, their attention was drawn to SVPP. That focus came after nine psychiatrists signed letters to SVPP’s executive director, Charles DaSilva, in January and February 2013.

The letters said that psychiatrists were working under protest because low staffing levels made conditions dangerous for both staff and prisoners. Despite the staff shortages, SVPP’s administration pushed to lower patient waiting lists to convince the court its continued oversight was unnecessary.

“There was general feeling – and I felt this way – that we were under pressure from administration to move the old people out, the old patients out, and take in new patients so as to keep our waiting list down,” said Dr. John Brim.

To facilitate movement, psychologists – not psychiatrists – accepted patients for transfer into SVPP in February and March. Records obtained by The Herald show that Dr. Troy Martin, a psychologist, accepted 10 patients into SVPP on February 25, March 4, and March 11. Another patient was accepted on February 22 by Dr. Brad Barckley, another psychologist.

The acceptance of patients by those psychologists violated SVPP policy, which requires a psychiatrist to “determine mental health stability” as part of the pre-screening process. SVPP staffs say that pre-screenings were regularly bypassed in February and March.

The policy is in place because non-physicians are “not qualified or licensed to determine whether a symptom is caused by mental illness or a non-psychological medical illness.” said Dan Willick, general counsel for the California Psychiatric Association. “There is the danger that life-threatening medical problems not due to the mental illness will be ignored.

“As a psychologist, Dr. Newton only accepted patients,” says Ralph Montano, spokesman for the Department of State Hospitals. He stressed that “accepting” means approving a potential patient’s transfer and “admitting “means officially becoming a patient.

“Accepting” a patient without a psychiatrists input was “outside the program’s standards and practices,” said Dr. Joel Badeaux, a psychiatrist who worked at SVPP. “To my knowledge, none of us [psychiatrists] were in the loop as far as the decision whether to accept referrals for admission.”

When The Herald raised questions about the matter, it was provided a spreadsheet that showed two specific psychiatrists made the February and March admissions. Officials later acknowledged that at the time of these admissions, one of the doctors had left his job months earlier and the other had just stepped down. Montano blamed computer software for the misinformation.

Conditions at SVPP proved to be deadly for one prisoner in March. Desmond Watkins, 36, died from a psychiatric condition that causes cravings for water. The Monterey County coroner found he died from over-hydration as a result.

Yet, just a few weeks later DaSilva presented the court with a sword declaration that the care at SVPP was more than adequate. He also said, “There is presently no shortage of clinical staff at SVPP.” At the time he made that declaration, the psychiatrist-to-patient was half that which state standards recommend.

The three judge panel ruled it would continue its oversight of California’s prison mental health system. DaSilva and others have left their post and new leadership was installed.

Sate hospital’s chief deputy director Kathy Gaither said, “We remain committed to providing the treatment and environment necessary to produce positive changes for our patients, and we are confident the new team is well-equipped to address the ongoing challenges at Salinas Valley.”

Confidence and commitment are admirable traits, but the court, prisoners, and human rights advocates are waiting to see those traits turn into tangible change.

Sources: The Herald; presstelegram.com

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