Psychiatric cuts at ASH raise alarms

January 23, 2012

By DANIEL BLACKBURN

Deep budget cuts at Atascadero State Hospital have prompted administrators to slash positions of more than a dozen contract psychiatrists during the past three months, just as the hospital initiates a unique pilot program for collectively treating the system’s most dangerous patients.

But attacks by patients on four ASH employees last week were not associated with the facility’s new “enhanced treatment unit,” said hospital spokesman Craig Dacus.

“None of the incidents from the past Friday had anything to do with (that),” Dacus told CalCoastNews in an email.  “The level of aggression in January is consistent with the months preceding.”

He added, “It is important to note that the nursing staff-to-patient ratio has not changed, and they are the line staff responsible for the management and safety of the unit.”

As to the recent reduction (13) in contract psychiatrists, Dacus wrote, “(ASH has) enough psychiatrists on staff to meet the patients’ needs. We now have 30 active treatment units and one psychiatrist for each unit, plus a floating pool of ten psychiatrists to supplement each unit. This is improving patient treatment and care because it is providing consistency. The psychiatrist in the unit knows each patient and knows how they interact with staff members and the other patients.”

The administrative moves at ASH are in keeping with a cost-cutting effort by the California Department of Mental Health, one element of which will pump more of the department’s diminishing resources toward the mental health and prison systems’ most urgent patients.

The ASH program will provide a prototype for the state’s other mental health facilities, according to the plan.

A major reorganization plan was unveiled by the Brown Administration last week, calling for formation of a new Department of State Hospitals. Now, 6,300 high-risk patients will become the state’s primary focus. And to deal with the same system’s less dangerous patients, the state will ask county governments to pick up the slack.

More than 600 of the department’s 11,000 state hospital positions are being eliminated in an effort to stanch a current $133.6 million deficit in the department’s $1.3 billion general fund budget. ASH’s current budget is $200 million.

The moves at the state level accentuated a recent announcement by the U.S. Department of Justice that ASH “has been released from federal court jurisdiction.” The state’s mental health hospitals have been under federal microscopes over the past five years because of allegations of poor treatment, care, and of dangers to patients and staff. The November announcement said  ASH “is in substantial compliance” with a 2006 agreement between federal and state officials.


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Spirit Filled

I went to a lady shrink one time. My wife and I were going through an agonizing time in our lives and thought I might be helped. I have never been one to hide or be unaware of my feelings negative or positive but my wife suggested the doc might be helpful by listening to me about my pain.


She talked the whole hour. Tried to charge me $200.00 and said see you in a week. I almost fell over. She told me she would be able to help me sort out my feelings and gave me about 14 tapes to listen to.

My feelings didn’t require sorting out. I was very aware of my feelings.


Got home, told my wife, well that was a waste of time. Decided to talk to my dog instead. Worked much better for me. Skippy and I are pretty much on the same level intellectually. But I have to admit he does listen better than I do. I try to listen to him but he gets bored quickly and walks away. (I try not to run out of treats). He stays longer and doesn’t charge $200.00 an hour.


Doc also tried to prescribe meds for me when I told her I was an addict. Oh well if she had shut up for about three seconds she would have heard me when I told her about my problem.


I’m sure all doc’s are not bad. My wife had a great one.


Typoqueen

Well yeah, that’s the problem with shrinks 95% of them are more crazy then their patients. You really must take what they say with a grain of salt until you find a good one. I feel that everyone can benefit from therapy but the problem is finding a good a therapist. Due to the shortage of good/sane therapists it’s sometimes better just not to bother and stick with the dog.


Robert1

Best $200 dollars you ever spent, see your alright after all !


Spirit Filled

Refused to pay her. That made me feel much better, thanks Robert1.


oto

Getting rid of 13 shrinks that have had no effect on making ASH less violent sounds like a step in the right direction.


When I watched some of these guys testify in court, they can be downright frightening. Some of them are so cold, callous, and arrogant, that you have to wonder just how much insight they have into their patients’ illnesses and emotional problems, especially when their patients are of a different race.


These psychiatrists are complete immunity from civil actions based in tort because they are protected by virtue of their government positions. They have the power to “throw away the key,” simply by saying so, if they don’t like you.


They can force drug you. In some states, even lobotomies are still legal. The effect of psychotheraputic drugs can actually cause psychotic and violent behavior, as well as treat those symptoms. These drugs can actually mimick or induce the physiological changes that one would normally see in cases of alzheimer’s desease.


Letting those at the top level of power in such a facility know that they, too, can be replaced, may not be a bad thing. I would like to know more about their methods of treatment; how much physical freedom they provide to inmates, which is a key to mental health, even for the criminally incarcerated.


I would like to know what their physical environment is like. Does it reinforce violence, or does it provide places of solitude and peace when a patient is in need of it. If employees are subject to violence, how much more liable are the patients themselves to be physically assaulted with no way to escape it?


Some people never respond, even to positive reinforcement, either because they have been so abused themselves, or because they are physiologically damaged in some way. Do they get the proper diagnostic tests that would identify physiological abnormalities? Is it proven beyond a doubt that the physical abnormality is the cause of the criminal behavior? Or is it something else?


Are the “abnormalities” identified subjectively, in the doctor’s “opinion,” or are these illnesses as easily identified and as consistent as looking at a broken bone in an x-ray?


What medications are routinely used on these patients? The answers to these questions must be made public in order to assure that abuses on the part of the psychiatric staff and supervisory employees are kept at a minimum.


Is there an effective means to complain about abusive staff? Where are these records kept, and what is the procedure by which violent employees can be identified. There is certainly a procedure by which patients are tracked. Employees should be tracked and disciplined as well.


Yes, I believe there is pure evil in the world. But it is an anomaly, an aberration. If I did not believe that, then I would also believe a “hospital” like the one in Atascadero would have no reason to be.


Rawhide

LOL…‘A unique pilot program for collectively treating the system’s most dangerous patients.”


ASH’s High paid Psychiatrists what a Waste of time and money!

Psychiatrists have had years and years of “collectively diagnosing, treating, (drugging) the system’s most dangerous patients” and they haven’t changed violent behavior one iota.


View:

Making A Killing: The Untold Story of Psychotropic Drugging

http://topdocumentaryfilms.com/making-a-killing-the-untold-story-of-psychotropic-drugging/


oldnurse

The state of California, like many others, wasted MILLIONS on federal court monitoring. Now that the feds are gone, it’s beforeack to business as it was AT A WASTE OF MONEY that could have been used to educate our children, provide for the homeless eing targetedand care for our mentally ill citizens in the community. But instead we flushed it down a rat hole. Now the level of care staff have to work with less (man) resources and are being targeted by the antisocial/psychopathic patients. If any of you worked 1 shift at any of the state hospitals, you would sing a different tune and probably RUN like he** at the end of your day. YOU HAVE NO IDEA WHAT A DIFFICULT PLACE THAT IS TO WORK, and somebody has to care for “the least of these, my bretheran”.


pasoparent5

Well said. I used to think the employees at ASH were a bunch of whiners. They seemed well-paid and I wondered what all the fuss was about.


Then we moved near a woman who’s worked there for 20+ years. She looks shell-shocked on a daily basis. She seriously looks like the life is draining out of her one workday at a time. After hearing her first-hand accounts of what REALLY goes on in that hellhole, I truly empathize w/anyone who works at ASH. The floor staff is literally risking their lives every day when they enter ASH.


One of our conversations ended with my neighbor gazing in the distance, looking exhausted and discouraged. She said, “It’s sad but true. Some of those ‘patients’ just cannot be helped. Many of them will never, ever get better. The minute they’re released, they’ll re-offend.”


Ted Slanders

pasoparent5,


How soon you forget! The problem with ASH is that the employees are paid way too much because they’re UNIONIZED and have great benefits, remember? Many of the flock here at CCN state that this is the problem, and who cares of the danger they have on a daily basis? Who cares about the concept of more pay for a more dangerous workplace?


This same faction says that ASH should be privatized with no union, and therefore less wages and benefits as well! Don’t you remember the previous threads relative to the Unions being the problem, and ASH being brought forth as an example? Tsk, tsk.


Jump on the band-wagon with the Consertives and tell your neighbor that her Union should be abolished, her job privatized, and she should only receive a little above minimum wage. See how long she and her brethren stay under these circumstances!


So many of the alumni of CCN have NEVER worked in dangerous positions and have absolutely NO concept of it’s ramifications, other than the fact that it should be privatized and non-unionized. I can’t call these people what I want too, therefore, I’ll just say they’re “ignorant!”


oldnurse

Your post is very confusing. What experience do you have on this issue? Yes, unions have gotten a bit out of hand but if it were not for CAPT and SEIU protecting staff rights, there would be nobody to take care of these men who have very difficult and complicated problems. As far as the drug issues, no this is not the way Psychiatrists would like to care for their patients but unfortunately insight oriented treatment doesn’t work when ones mind is racing and “voices” predominate. Psychiatric disorders are difficult to treat and more importantly, difficult for someone to live with. Do you really think anyone would choose to live with voices, delusions, chronic depression. Be greatful for your mental health.


Typoqueen

No Ted is referring to the majority on this site that blame everything on the unions. They complain that state workers are all over paid and for the most part that it’s the unions fault. Ted’s post was him being sarcastic and he’s 100% spot on. I can’t speak for him but I would guess that he agrees with you. The hatred for unions on this site is really insane. The worlds problems are due to two things, Obama and Unions. Personally I thank goodness that prison workers have unions to protect them, without them their lives would be in even more danger.


Ted Slanders

Typoqueen,


Thank you, I couldn’t have said it better myself!


Rawhide

“So many of the alumni of CCN have NEVER worked in dangerous positions and have absolutely NO concept of its ramifications”…


Ted, you take too much for granted!

Not all, but many people who post here (alumni of CCN ) have family members who work in the “system” and or in dangerous positions.


Ted Slanders

Rawhide,


English 101. The term “so many” that I proffered, does not preclude that ALL, but only “some, more so than not”, of the CCN alumni have not worked in a dangerous position, get it?


Whereas you, to support your argument, erroneously and ambiguously, state that “ALL, but MANY who post here…” is saying the exact same thing that I was presenting!


For your homework tonight, get a basic English book and read about the meanings of words and understand about how important it is to have the correct syntactical sentence structure to get your point across.


You’re welcome. :)


Typoqueen

This is a good place to make big cuts. Prison psychiatrists are the biggest drain on the prison system IMO. They get paid top dollar and yet we are lucky if they work more than 10-15 hours a week. I know someone that is a psych person that works for a prison and I hear this all the time. The nurses do all the work, the docs are supposed to work full time but NONE of them do. From what I’ve been told the nurses need more security and less doctors (shrinks).


manyworries

I was told by someone VERY close to a Dr. who worked at and was told that the psychiatrists at CMC didn’t have to come in on Fridays and usually it was cool to take off Monday too.! Whatever they can get away with was fine. Part-time workers for $250,000 per year, plus a huge benefit plan. Many have side practices too. They are cleaning up and I bet they only spend minutes a day actually seeing patients. Hmmm…. now why is our country going bankrupt again? Oh yeah, let’s just keep blaming it on Wall Street. Guess what? It’s tremendous wastes of $$ such as this, times tens of thousands of others scamming the system without a conscience. I’m getting really sick of hearing about the food stamp nation. Typoqueen is right, they barely work 10-15 hours a week :((


Daniel Blackburn

I’ll be on Dave Congalton’s Home Town Radio show, 920KVEC, today at 4:35 p.m. to discuss this article and its implications for county residents.


Cindy

I seriously doubt that this cut will effect the effective level of treatment to the “patients”. Psychiatrists specialise in the wide array of drugs used to treat the mentally ill and the naturally violent, mean, aggressive personalities who reside at ASH. It’s not as if they are the type of patients that visit the couch once or twice a week. Talk won’t cure them, for now all we have is drugs to treat them and it’s easy enough to keep trying out those scripts until the right or best combo produces some reasonable civility .


Cindy

Come to think of it, too bad we can’t include medical marijuana to their wide array of psychiatric drugs. I wouldn’t be surprised to find that it produces an immediate 98% decrease in aggression. We should use ASH as a test project for MM. It can’t hurt anybody, they can’t over dose and it’s chemical effects are innocuous as compared to the powerful, addictive, benzodiazipines [sic] we now prescribe, so why not try it. What do we or the patients have to lose?


jimmy_me

Excellent suggestion! Can you imagine all the different entities that would come out in force to oppose such a great idea?


manyworries

Excellent idea Cindy! I’m dead serious about it too.


IronHub

I’m no expert on violent behavior… but isn’t this comment by Dacus interesting? “The level of aggression in January is consistent with the months preceding.”


Paso_Guy

This is good news.


The state is broke and we can’t afford the fat built into the prison/state mental health systems. This is an appropriate and needed reduction of the state budget.


Kudos to whoever made the call.


sloweb

I cautiously agree Paso_Guy. But knowing how the State manipulates facts and tells half-truth, I am looking for the 9/10ths of the iceberg that will still sink us.