Earlier this month, NPR reported on the dramatic increase in violence at California's state psychiatric hospitals. At Napa State Hospital, an employee was killed last year, allegedly by a patient. Now, less than six months later, there has been another death at the hospital in Napa. This time, though, it was a patient who died.
William Roebling had attacked a fellow patient. As staff members tried to subdue him, Roebling stopped breathing. The coroner's preliminary report says that he died of natural causes, including coronary disease — not because of the staff intervention.
"I can only imagine how the staff that works there feels," says state Sen. Noreen Evans, who represents the Napa area. "They're not only frustrated, they are scared."
After Roebling's death, she and another lawmaker wrote to Gov. Jerry Brown demanding that something be done about the dangerous conditions at Napa State Hospital.
"I was willing to give the new administration some opportunity to try to address the problems," Evans says. "But that hasn't happened. And now we've seen the second death. In the meantime, we've had a number of attacks on staff and patient-on-patient attacks. It's just not acceptable."
But it will take some time to fix, says Diana Dooley, California's secretary of Health and Human Services.
"The conditions didn't occur overnight, and they're not going to be resolved overnight," Dooley says.
It's taken years, she says, for Napa's patient population to change. Now, more than 80 percent of patients there are committed through the criminal justice system, deemed not guilty by reason of insanity or incompetent to stand trial, for example. The hospital just wasn't designed to handle such patients. So late last week, Dooley lifted a hiring freeze to add more clinical and security staff.
"It is a small down payment, but I hope it illustrates that I am committed to working with all of the stakeholders to see that we create a safe environment for the staff as well as the patients," Dooley says.
She also met face to face with those stakeholders — including representatives from the Napa staff like Brad Leggs, a psychiatric technician and union representative. He says there was a fair amount of consensus on making changes that the staff has wanted for a long time.
"Having a decent alarm system in place, having good staffing ratios, and probably the creation of a unit that would house some of the individuals who are a little bit more difficult to handle," Leggs says.
One of those "difficult to handle individuals" is accused of murdering Napa staffer Donna Gross last fall. Last week, California's Occupational Safety and Health agency cited the hospital's failure to deal with that patient, Jess Massey, and other safety defects as violations of state labor law. The agency fined Napa $100,000 and gave the hospital just a few weeks to fix the problems.
But Cliff Allenby, acting director of the state Department of Mental Health, says those citations will be appealed, "because we believe they're not appropriate and they're not right."
Though Allenby wouldn't say what was wrong with them, he cautions that the appeal shouldn't be mistaken for a lack of commitment to improve safety at the hospital.
"We need to have protection for our employees and for the other folks that are in our system," Allenby adds.
But that's mostly still in the planning stages — just like it was before there was a second death at Napa State Hospital.