Coalinga State Hospital

Coalinga State Hospital
California Department of State Hospitals
Geography
Location	Coalinga, Fresno County, California, United States
Services
Beds	1500
History
Founded	2005
Links
Website	www.dsh.ca.gov/Coalinga
Lists	Hospitals in California

Coalinga State Hospital (CSH) is a state mental hospital in Coalinga, California.

The facility opened on September 5, 2005 and was California’s newest state hospital, the first to be constructed in the state in more than 50 years. It is a maximum security civil-commitment facility built to ensure that sexually violent predators stay out of the community. Instead of being released after completing their prison sentences, they are transferred to CSH. Currently, the hospital houses 850 sexually violent predators (SVPs) and 100 mentally disordered offenders. The hospital previously housed 50 mentally ill prisoners from the California Department of Corrections and Rehabilitation (CDCR) and still maintains the contract and resources to house this forensic population, but the California Department of Mental Health aims to designate CSH as a civil-commitment facility only. The SVPs are men who fall under the SVP laws (first Megan's Law and later Jessica's Law), where the men are deemed too likely to reoffend to be released and are housed indefinitely at the hospital until they are deemed no longer a danger to the community.

Treatment is offered, but is not required. Approximately 1/3 of individuals accept California's sex offender treatment. The hospital has a 1,500-bed capacity (as of August 2010 the hospital is 63% full). The median age of SVPs is 47.1 and this is expected to increase as the hospital's population continues to age.

About the facility

The state began construction on Coalinga State Hospital in the fall of 2001. According to the hospital's official Web site, CSH has 1.2 million gross square feet (gsf) of floor space. This includes 900,000 gsf for clinical services and programs, 158,000 gsf for support services, 75,000 gsf for administration, and 67,000 gsf for plant operations.

Instead of calling the population housed at CSH "patients" or "inmates," hospital policy is to call them "individuals" because they are civilly-committed. Staff address the individuals by their last names (i.e., Mr. Jones) to maintain professional boundaries. This is because many of the charms that allowed the offenders to compromise their victims are also used on hospital staff to acquire drugs, trade goods, or sex. CSH provides extensive training for all new employees on how to manage and report manipulation.

The hospital is located at the edge of the Coastal Mountain Range in the heart of California just outside the City of Coalinga, nestled up against the adjacent Pleasant Valley State Prison.

The hospital uses a five-phase treatment program for SVPs that was developed when SVPs were still mostly all treated at Atascadero State Hospital. The rigorous program focuses on helping SVPs manage their impulses, take responsibility for their actions, and see their crimes and victims from a realistic perspective. The hospital also has recreational facilities including a gym, softball field, arts and crafts, graphic design room, woodworking opportunities, and a music room. Individuals are allowed to purchase electronic goods, rent DVDs, and other perks with a token economy system called the "By Choice" program. This system is designed to reward positive behaviors, which are designated by each individual's treatment team. Up to 100 points can be awarded per day (a bar of soap sells for 500 points in the point exchange store). The annual operating budget of CSH is $152 million (or $157,894 per individual).

Intake and occupancy

In California all prisoners with sexual assault or pedophilia crimes are flagged and reviewed six months prior to parole. To be labeled under the category of SVP an individual must have at least one identified victim, have a serious mental illness (most commonly paraphilia NOS or pedophilia), and must have established a relationship with a person with the intent to cause victimization. Paraphilia NOS is a catch-all diagnosis used to describe most individuals who have committed sexual assault (i.e., rape). Prior to parole, the designation of SVP is assessed by two independent evaluators (licensed mental health professionals). If both evaluators agree that the prisoner meets the criteria he is sent to CSH for treatment. If one agrees and the other does not, an additional two evaluators review the prisoner's history. If those final two reach agreement, the prisoner is then a ward of the state and civilly committed to CSH.

Evaluations of current and potential "SVPs" are inconsistent, and there is no standard protocol used to determine whether those being assessed meet the criteria for confinement. Evaluators lack clinical supervision and training, and Coalinga has a significant backlog of annual evaluations that violates the rights of patients.

Currently, California law allows SVPs to be committed to the hospital indefinitely (under Jessica's Law) as long as they are receiving 'treatment'. The reasoning behind the law is that by holding the sex offenders indefinitely at the mental hospital, they are unable to commit additional sex crimes. But treatment is in short supply. Significant treatment at Coalinga is rare. Moreover, 80% of sexual offenders have refused therapy. Three-quarters of CSH's 850-plus detainees refuse to participate in a core treatment program, undermining a central piece of Coalinga State Hospital's purported mission. The vast majority refuse to participate beyond the first phase of a five-phase therapy regimen. Only 25 to 30 percent of sexually violent predators consent to participate in the active phases of California's sex offender treatment program.

Treatment is intensive, and requires admission of guilt and the use of institutionally mandated language, as well as polygraph and phallometric testing. As of November 2007, 26 of the 37 budgeted staff psychiatrist positions were vacant, with some inmates having to camp out waiting for a clinician to show up. As of April 2009 the facility had released only 13 inmates in its history.

Many detainees shun treatment because they have become convinced -- not without reason -- that no matter what they do, they are never going to win their freedom. Most detainees at Coalinga harbor little hope that they will ever get out. Critics say California's sexually violent predator program looks more like upscale incarceration, and there's a growing sense among inmates that they have been effectively railroaded into a life prison term.

"It's hopeless," said one detainee, who was sent to Coalinga after serving a prison term for committing a lewd and lascivious act. "This is a therapeutic setting, supposedly. But it's nothing more than a mock-up prison. They can call it what they want. But it's prison." Civil commitment for sexual dangerousness is, as a practical matter, a life sentence.

A federal judge ruled a similar program in Minnesota to be unconstitutional.

A British High Court ruled that California's involuntary commitment law violated human rights, that the punishments violated the European Convention on Human Rights, and refused to extradite a man based on the risk that he might be committed to Coalinga.

Louis Theroux BBC documentary

The hospital formed the basis of a Louis Theroux BBC television documentary entitled A Place for Paedophiles, showing the lives of once-convicted pedophiles who are indefinitely incarcerated at the hospital. The one-hour program aired for the first time on BBC Two in the United Kingdom on 19 April 2009, and in Australia in December 2012, as the seventh in a series of Theroux specials. This special will not be shown in the United States because patient health care laws, primarily the Health Insurance Portability and Accountability Act (HIPAA), forbid the disclosure of a person's illness without their consent in the US.

See also

Sex offender registries in the United States

External links

• Official Coalinga State Hospital website
• OSHPD database project: Coalinga State Hospital in the CA Healthcare Atlas
• BBC iPlayer: "A Place for Paedophiles" by Louis Theroux.