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State wants control of prison mental health care system

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POSTED March 24, 2013 8:40 p.m.

SACRAMENTO (AP) — Nearly two decades after a court takeover of California’s prison mental health system, a federal judge is set to consider this week whether the billions of dollars invested by California taxpayers have improved conditions enough that he can return control to the state.

Gov. Jerry Brown has aggressively moved to end the long-running lawsuit. The state has spent $1 billion for inmate mental health treatment facilities in recent years, reworked its suicide prevention policies and hired hundreds of new mental health employees at increased salaries. Base salaries for prison psychiatrists now range from $126,000 to $281,952, with chief psychiatrists paid more.

The Democratic governor argues that the state has done enough and cannot continue to bear such a high financial burden.

For all the expense and effort, the law firms advocating for inmates and the court’s own supervisors say conditions remain so poor that they still violate prisoners’ basic rights. They say inmates die by suicide at the rate of one every 11 days, the state still has too few mental health staff and beds, and inmates can wait weeks before they receive mental health treatment.

“The governor has wishful thinking,” said Michael Bien, the lead attorney representing the welfare of mentally ill inmates.

The state and inmates’ attorneys will argue Wednesday before U.S. District Judge Lawrence Karlton in a Sacramento courtroom. Karlton must rule by early next month under the speedy legal process Brown set in motion in January.

It’s part of the Democratic governor’s larger effort to end a separate legal case requiring federal control of the prison medical system and to overturn an order backed by the U.S. Supreme Court that has forced the state to reduce the number of inmates in its 33 adult prisons. To comply, the state enacted a so-called realignment law that requires lower-level offenders to do their time in county jails. It also has been sending some inmates to private prisons in other states, a program Brown now wants to end.

Yet inmates’ attorneys, court experts and the judge himself say a series of missteps imperil the state’s efforts. Among them:

—The judge said he might refuse to consider reports from all four of the state’s mental health experts because of ethical violations. The experts, whose opinions are at the core of the state’s case, said they found constitutionally adequate mental health care at 13 prisons they visited last year. But attorneys representing inmates say they were not notified of the visits and were not present when their mentally ill clients were interviewed by the experts. The judge said the lapse appears to be a violation of a direct court order requiring that inmates’ attorneys be notified and present.

— A consultant hired by the state reported “continuing and chronic” problems with the prisons’ suicide prevention efforts in August 2011. However, an email from the Department of Corrections and Rehabilitation’s suicide prevention coordinator in June 2012 said the critical report and its recommendations were buried. Corrections officials deny ignoring the report.

— The court’s lead suicide prevention expert earlier this month reported that California’s suicide rate worsened last year to 24 per 100,000 inmates, up from 21 per 100,000 in 2011 and from an average of 16 per 100,000 between 1999 and 2004. The current rate far exceeds the national average of 16 suicides per 100,000 inmates in state prisons and the historical average of nine suicides per 100,000 inmates in federal prisons. Yet Dr. Raymond Patterson wrote that his recommendations have gone “unheeded, year after year” for the last 14 years.

The Brown administration also angered Karlton by suggesting that the court-appointed special master who oversees prison mental health care is keeping the case alive because he benefits financially. Karlton forced the state to withdraw what he called “a smear” or face the possibility of court sanctions. The state has paid more than $48 million since 1997 to special master Matthew Lopes, his predecessor and the prison experts they have hired.

Rosen Bien Galvan & Grunfeld of San Francisco and associated law firms representing inmates in the case have been paid $19 million by the state since 1997, according to data compiled by The Associated Press.

Four years after the class action lawsuit was filed in 1991, the federal judge ruled that prison officials were deliberately indifferent to the needs of mentally ill inmates. He assumed oversight and appointed the first special master to monitor the state’s efforts.

Corrections Secretary Jeffrey Beard said federal oversight is now impeding rather than helping the state’s progress.

Beard is a licensed psychologist who previously headed Pennsylvania’s prison system. Before he became corrections secretary in January, he spent a year touring the majority of California’s 33 adult prisons as a mental health consultant to the state.

He and Bien, the inmates’ attorney, drew dramatically different pictures of prison conditions.

Bien described mentally ill inmates crowded into tiny cells or housed in disciplinary isolation units for lack of proper treatment facilities. Psychiatrists are pressured to end treatment prematurely to artificially make it appear that there is no waiting list.

Inmates who commit suicide sometimes go unnoticed for hours — so long that rigor mortis has set in by the time their bodies are discovered.

“There’s nothing about this administration that gives me confidence that if they were in charge that these problems would be solved,” Bien said.

Yet Beard said the problems he described in 2008 as an expert testifying on inmates’ behalf have mostly disappeared. Most mentally ill inmates now get prompt and proper care, he said.

“It simply defies any common sense that a state that dedicates as much money and resources to treat mentally ill inmates as California does, could at the same time be indifferent to their needs,” the state said in one of recent court filings.

Beard acknowledged the suicide rate remains troubling but said it is unfair to compare California to other states because most shorter-term and non-violent inmates are now serving their sentences in county jails. The violent, long-term population left behind is proportionally more likely to commit suicide despite the state’s best efforts, he said.

“This suit had a place in time,” he said. “That time is passed.”

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