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Rules put staff at risk at ASH

It’s becoming such a common occurrence that we could leave a standing headline in place here: “Another employee(s) assaulted at Atascadero State Hospital.”

The most recent string of attacks at ASH happened last Sunday and Monday when an employee, an ASH police officer and a patient were assaulted. As of today, two of the alleged assailants are looking down the barrel of felonies for assault likely to cause great bodily harm, battery with serious injury and serious bodily harm on a police officer.

The only reason we even know of these events is through the digging of reporter Stacy Daniel, who received a tip about the attacks and contacted ASH. When she didn’t receive a reply, she went to the State Department of Mental Health in Sacramento for verification.

That resulted in a Kafkaesque exercise of the state wanting to know what Daniel knew and Daniel wanting to know what the state knew about the attacks. After much back and forth, the state released a statement about the assaults. Transparency? Not so much.

As far as I can tell, the reason for this bureaucratic veil can be traced to ASH’s roots. Built in 1954, the hospital earned the dubious reputation in the ’50s, ’60s and early ’70s as the “homosexual Dachau,” according to international human rights activist David Mixner.

In a June 15 article, Mixner wrote: “At Atascadero State Hospital, doctors (I use that term loosely) were permitted under obscure California law to commit those who practiced sodomy into the hospital. Once admitted, normal men and women were rendered mentally disabled through the torture of castration, lobotomies, forced chemical treatments and experimental treatments. The horrors experienced by hundreds are almost too hard to comprehend in America.”

Rules to uphold rights

It’s not too great of a leap to see where this ended up. In 1980 a federal law called the Civil Rights of Institutionalized Persons Act (CRIPA) was passed to protect the federal rights of people in prisons, public mental health facilities and public nursing homes.

According to a Tribune report by Tonya Strickland published earlier this year, “The new federal rules — known as the enhancement plan — limit the use of seclusion, restraints and psychotropic medications on patients so their basic human rights are upheld.” The program stemmed from a 2006 settlement between the state Department of Mental Health and the U.S. Department of Justice.

The “Human Potential Consulting Group” out of Alexandria, Va., proposed the enhancement plan. These folks act as both consultants and court monitors of CRIPA.

“Under the terms of the settlement,” according to Strickland’s report, “the state was told to first offer alternatives to patients who were about to become violent before restraining them. That meant instead of offering on-the-spot medications or restraints to calm them, staff had to first present an alternative. That included taking a walk outside or offering a snack.”

Chemical cuffs or a snack?

That’s the crux of the nut that state Sen. Sam Blakeslee is cracking in order to bring a measure of safety to the 2,000 employees — our friends, neighbors and family members, I hasten to add — to ASH and the other state mental institutions.

“Beginning Jan. 1, all state mental hospitals will employ a new streamlined process to involuntarily medicate patients who require immediate treatment and pose a significant risk to staff and other patients,” says Erin Shaw, spokeswoman for Blakeslee.

“AB 366 (coauthored by Blakeslee) requires a court order for involuntary medication when a patient enters a state hospital if the patient meets certain existing criteria, such as if they pose a danger to themselves or others.

“Currently, the law only allows the court to provide an order for treatment if the patient consents to the medication at their original court hearing. If the patient withdraws that consent after the hearing and upon entering the state hospital, a new court hearing is required for the patient to be medicated without their consent, a process that can often take months.

“AB 366 streamlines the process by requiring a court to make involuntary medication decisions at the same trial where the defendant is committed to a state hospital. Due process rights for patients are not violated by AB 366 because it adds a periodic court review of medication orders.”

Employees at risk

So here’s the count and the amount: Our state mental institutions at one time performed atrocities on those committed to their care. CRIPA was enacted to put a halt to those practices — and rightly so. However, the situation seems to be out of whack with regard to employee safety.

To his credit, Blakeslee is doing what he can to bring a sense of balance and safety into a situation that is taking a toll on our friends, neighbors and family members who work at ASH and other institutions. Good on him.

But here’s one final thought: If all of those “patients” at ASH are committed by the criminal justice system for their behavior, isn’t it time they be called inmates rather than patients?

Isn’t it time that the inmates quit running the asylum?

Bill Morem can be reached at bmorem@thetribunenews.com or at 781-7852.