After a scathing federal probe in 2002, Metropolitan State Hospital set out to do more than just fix its failings -- it aspired to become a beacon in mental health treatment, a model for the other state hospitals to follow.
The locked Norwalk facility, state officials decided, would be first to shift its approach from relying on drugs and restraints -- which federal inspectors had found objectionable -- to helping patients develop the skills to live on the outside. It would encourage them to help plan their own recovery, to learn about their diseases, mimic normal daily routines and hone such basic skills as cooking.
Three years later, a Times review of state data and legal claims -- including four recent suicides -- indicates that Metropolitan's experiment has stumbled. Indeed, the facility is, in most respects, more dangerous for patients and staff today than it was in 2002. It is also more dangerous than any of California's three other long-established mental hospitals. (Coalinga State Hospital, which opened a few months ago, was not included in the review.)
More patients hurt themselves, attempt suicide, are caught with contraband, escape, allege physical abuse by staff and allege rape -- predominantly by other patients -- than at any of the other three state hospitals, state records show. This happens despite the fact that Metropolitan houses roughly 600 patients, about half as many as each of the other three hospitals.
The spate of suicides -- after more than five years without one -- prompted Metropolitan's president and chief of staff to suggest at a recent state Senate hearing that the so-called recovery model, adopted in 2002, might be imperiling patients.
"We're experimenting with our patients here with unproven treatments," Dr. Christopher Heh testified in September before a Senate committee. "I would say we need to revisit, re-look at the plan very carefully."
The soul-searching comes amid intensified federal scrutiny of California mental hospitals. Napa State Hospital is reeling from a critical report this summer, and federal investigators are investigating conditions at Atascadero State Hospital. A review of Patton State Hospital, near San Bernardino, began this week. And Metropolitan is still negotiating reforms with inspectors from the U.S. Department of Justice.
Despite Heh's concerns, state Department of Mental Health Director Stephen W. Mayberg and Metropolitan officials say their new approach has paid off, resulting in, for instance, shorter patient stays and fewer returns to the hospital.
