By Lee Romney and Scott Gold, Times Staff Writers4:44 PM PDT, March 21, 2007 Inside Atascadero State HospitalTwo Atascadero State Hospital patients have killed themselves and four others have attempted suicide since early February--an alarming spike in such incidents at the Central Coast psychiatric facility that comes as it is rapidly losing key staff to more lucrative jobs in the prison system.Until February, the facility had not had a suicide since August 2005, and the one before that was in 2001. Over the past six years, Atascadero has averaged fewer than one suicide attempt per month.The recent spate of deaths and injuries occurred in the weeks after hospital administrators severely curtailed admissions for the first time in the institution's history, concerned that staff shortages were jeopardizing patient safety.Atascadero executive director Mel Hunter said he couldn't directly tie the suicides to the crisis. But he noted that acute staff shortages are clearly eroding care. In order to keep wards fully staffed, he said, the hospital has had to rely on overtaxed employees working large amounts of overtime."The best way to prevent suicides is to spend time with the men, to develop good clinical relationships," Hunter said. "In an institution running shortages from 52% to 80% on our clinical staff, we are bound to start seeing some bad outcomes."The two men who died, Matthew Miller and Roland James, had been sent to Atascadero from the California prison system, where mental health care was deemed by a federal judge to be so poor as to be unconstitutional. The court ordered reforms, including steep pay raises for clinicians.But those reforms have contributed to what one legislator called a "death spiral" at Atascadero, as psychiatrists and other clinicians have left the facility for much more lucrative prison jobs.Staff had already been leaving the hospital, frustrated by relentless mandatory overtime, increasing assaults by patients, and orders by the California Department of Mental Health to dramatically change the treatment philosophy. After the court-ordered prison pay raises, that trickle became a flood. By Jan. 18, Atascadero administrators closed the hospital doors to all but the most urgent admissions, saying safety could not be guaranteed.The prison system only sends its most severely mentally ill inmates to Atascadero, which aims to adjust their medication, stabilize them and keep them safe. But in the midst of its crisis, the hospital failed Miller and James."It's hard to accept. Your kids are supposed to outlive you," said James' shell-shocked mother, 62-year-old Christine James of Redding. "It's a mental hospital. I would have thought they would have watched him since they know mental patients are capable of such things." http://www.latimes.com/news/local/la-me-suicides22mar22,0,1606244.story?coll=la-home-headlines
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