The PSR Mall is a centralized approach to delivering services where the patients and the staff from throughout the hospital come together to participate in services. Malls represent more of a centralized system of programming rather than a reference to a specific building or certain location. Mall interventions are provided, as much as possible, in the context of real-life functioning and in the rhythm of life of the patient.
Thus, a PSR mall extends beyond the context of a building or "place," and its services are based on the needs of the patient, not the needs of the program, the staff members or the institution. PSR Malls are designed to ensure that each patient receives individualized services to promote his increased wellness and ability to thrive in the world.
All decisions regarding what is offered through each mall are driven by the needs of the patients served. Mall services are provided in an environment that is culturally sensitive and strengths based. Services facilitated through the mall include courses and activities designed to help with symptom management, personal skills development and life enrichment. The mall capitalizes on human and staff resources from the entire hospital to provide a larger diversity of interaction and experiences for all patients in the mall.
Central Medical Services CMS provides definitive medical care and evaluation to all residents in the hospital.
These services include radiology, public health, laboratory, physical therapy, dentistry, pharmacy, medical clinics, unit sick call, contractual services inside and outside the hospital, and review of community-based consultations.
ASH's treatment programs have reflected the psychiatric assumptions of the times. Initially constructed to treat mentally disordered sex offenders MDSOs , initial programs focused on separation from society, albeit in an environment which provided freedom of movement.
This was restricted after patient escapes. Initial research and treatment programs aimed at understanding and reducing the risk of reoffense in sexual offenders. In the early s, the focus of the hospital's treatment programs shifted to patients found not guilty by reason of insanity NGRI and incompetent to stand trial; ASH was a pioneer in developing effective treatment programs for the latter.
In the s, California passed sexually violent predator SVP laws, imposing civil commitment upon prisoners meeting criteria upon the expiration of their determinate prison term.
Sidney F. Herndon was the Executive Director throughout the s and brought in a strong clinical and administrative team and built up the medical staff under Gordon Gritter MD as Clinical Director. Codman Award in the Hospital Category. In this era, ASH was an important center of research and teaching. Many clinical staff left ASH in the late s with the advent of the SVPs, which was believed by many clinicians to compromise the hospital's mission of providing excellent care for persons with serious mental illness, as opposed to containment of sexually dangerous offenders.
When salaries for California prison mental health staff, especially psychiatrists, increased dramatically as a result of federal litigation, ASH lost many of its psychiatrists and other clinical staff. Psychiatrist salaries have been increased to levels just under the prison psychiatrist salaries, and ASH's psychiatrist staffing is now being rebuilt. In , Mel Hunter, by this time ASH Executive Director, was removed from his position as a result of his refusal to alter the clinical operations of the hospital at the behest of the DOJ consultants.
He was replaced by new hospital leadership. A law review article reported that in then-CEO Mel Hunter had supported research showing that SVP reoffense was much lower than claimed: "This Article uses internal memoranda and emails to describe the efforts of the California Department of Mental Health to suppress a serious and well-designed study that showed just 6. The hospital does not accept voluntary admissions. The hospital operates approximately 1, beds. The commitment categories of patients treated at DSH-Atascadero are described below.
Incompetent to Stand Trial Penal Code Felony defendants found incompetent to stand trial by a court are placed in a state hospital, where the focus of treatment is to stabilize their condition and return them to trial competency so the court may adjudicate their pending charges. Those patients who are determined to be unlikely to regain competency are returned to the court to determine future conservatorship status.
Conservatorships are for severely disabled individuals who represent a danger to themselves or others due to mental illness. They have not been charged with a crime, but are instead referred by local community mental health programs through involuntary civil commitment procedures pursuant to the LPS Act. Those whose psychiatric conditions require a higher level of care and cannot be treated in locked facilities or board-and-care homes are sent to a state hospital for treatment.
LPS patients leave state hospitals when their county of residence places them in a different facility, or home with their families, or they have successfully petitioned the court to remove the conservatorship. If the person still requires treatment at the end of their parole term, they can be civilly committed under P. These commitments last for one year and may be renewed annually by the court.
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