Violence and fear in state mental hospitals on the rise nationally

November 24, 2011

Thank you for your coverage of the increasing violence at the Clifton T. Perkins state mental hospital ("Perkins patients tough to treat: Shift from hospital care mean many have prison experience," Nov. 21).

I have been watching a similar set of cases in the California state mental hospital system and these may point to where Perkins is going unless it resolves its staffing issues quickly.

In October 2010, nurse Donna Gross was murdered at Napa State Hospital. She had taken a patient outside the building to another unit when she was strangled.

Since then, case after case of patient-on-staff or patient-on-patient violence has been reported. A staffer had his facial bones broken in a beating that left him in a coma in August. Staffers have had noses broken and arms wrenched. Nearly every week has seen incidents in which staff end up being sent to the hospital.

In the last year, there were reportedly over 600 cases of violent assault in mental health units. The incidents are covered on social media, and it is clear that, as at Perkins, the patient-on-patient violence is nearly uncontrollable.

The primary source of the increase in violence, as noted in the Perkins article, is the inclusion of criminally violent persons in the mix with mentally ill patients. However, what The Sun's story omitted to say is that some of these new patients at mental institutions openly admit that being declared mentally ill in prison is a way to get "easy time" at a state mental hospital.

As a result, an increasing number of people coming into the mental health system are violent predators who terrorize both staff and other patients. Imagine that you were delusional and committed to a state institution only to find yourself assigned to share quarters with a criminal roommate. Some patients live in terror of being beaten. That is not therapeutic treatment.

We need to discriminate between criminals, criminally insane and mentally ill patients, and not mix them together on the same units. Institutions like Perkins may have been declared capable of handling the criminally insane, but they need far higher staffing than other units. Staff on those units must be able to use physical and chemical restraints that might not be appropriate on a normal ward.

Mental health professionals are not police, and they need protection on these units. And those who are merely criminals rather than mentally ill patients need to go back to prison.

During a 90-day evaluation, however, it is often difficult to tell who is ill and who is faking it for an easier place to prey on others.

But Perkins will go the way of Napa State Hospital and there will be more deaths if funding is not increased to make the hospital safe. The prime consideration should be the safety of the staff and patients. You shouldn't have to go to work each day fearing you might never come home that night.

Raymond M. Hoff, Columbia

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