Last Update: Apr 2018

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Coalinga State Hospital Report

​​​​​Welcome to 

Coalinga State Hospital

A Broken Facility

Patient abuse, police and administrative corruption,

and gross operational deficiencies






Patients Cry Out for Help

A place of mental suffering, anguish, and death.






  • 1:32:00

Patients Cry Out for Help

A place of mental suffering, anguish, and death.










Coalinga Conference Call - February 27, 2018


On February 27, 2018, CSHAbuse.com, and several patients at Coalinga State Hospital, posted a successful and dynamic conference call where presentations were made regarding the ongoing crisis and a variety of alarming deficiencies at the facility.  In attendance by telephone were: Professor Eric Janus (from Mitchell Hamline University, in St. Paul, Minnesota); Dr. Fred S. Berlin, M.D. (from the National Institute, in Baltimore, Maryland); Janice Bellucci (from The Alliance for Constitutional Sex Offense Laws); and Jim Spertus, Attorney At Law.  Joining the call from the California State Assembly were: Anthony Dimartino, Legislative Director for Assemblymember Shirley Weber; Daniel Savage, Chief of Staff for Assemblymember Adrin Nazarian; and Reginald Fair, Chief of Staff for Assemblymember Anna Caballero.  Representing Disability Rights California was Leslie Morrison, Director of Investigations.  (See Fresno Bee article: "We pay millions for sex offender therapy at Coalinga Hospital".)


The theme of the conference call was: 


a.         Coalinga State Hospital is unconstitutional, and has failed to meet its burden as a mental health facility to provide patients with reasonable therapeutic opportunities, that have proven exit strategies, are rational, and not merely a facade to keep human beings perceived by society as "irredeemable," confined until they die."

 b.         ALL operations at Coalinga State Hospital are currently in a state of crisis - top to bottom - affecting both patients and staff.  The Executive Management Team, including many in middle management positions, have demonstrated that they lack the qualifications to operate effective treatment programs, assessments of patients, maintain appropriate staff levels of the hospital, provide appropriate medical care, investigate patient abuse complaints, and stem the high patient death rate.  Further, they have fostered an environment of corruption and a code of silence where CSH staff are afraid to report what they know (e.g.: patient abuse).

The following is an overview of the bullet points and/or topics that were addressing:

  • A scathing presentation was made against The Office of Patient's Rights.  Documentary evidence was also presented.  There is currently a hospital wide petition to banish this organization from Coalinga State Hospital because of their failure to adequately advocate for the patients and protect them from abuse.  The Civil Detainee Advisory Council (CDAC) at CSH has drafted a memorandum of no confidence in the PRA organization, and nine of it's members signed a separate memorandum calling for the PRA service contract to be terminated at the end of 2018.  In furtherance of this request, they are circulating a petition throughout the hospital. (Please click on button below for supporting CDAC documents as well as letters from Disability Rights California.)





  • ​$286,000/year per Patient
  • Unqualified Management
  • Widespread Corruption
  • Open Ended Treatment
  • Rampant Abuse of Patients
  • Staff Fear of Retaliation if They Complain or Report Abuse
  • Hundreds of Staff have Fled Employment at Facility
  • Toxic, Non-Therapeutic Environment
  • Patients Giving Up on Life, the Will to Live
  • Recordings of Police Staff on CSHAbuse.com reporting Operational Deficiencies at Facility
  • Disability Rights California / Patients Rights not Fulfilling Their Contractual Obligations
  • One Hundred Plus Patient Deaths Since 2005
  • Lack of Timely and Adequate Medical Care
  • Torturous Transportation to Outside Medical Appointments
  • Patients Refusing Transportation to Outside Medical Appointments (Can Amount to Passive Suicide)
  • Patients with a Stockholm type Syndrome without Receiving Any Type of Mental Evaluation Patients Doing Menial Type Job for $2.00 per Day for Life
  • Cancelled ALL Educational Programs (GED, College, Basic Literacy)
  • No Internet or Email Access Whatsoever (Even Supervised)
  • Patients Held as SVPs without a Probable Cause Finding
  • Approximately 33 Deportable Illegal Aliens Held as SVPs at Taxpayer Expense
  • Mayberg Consent Decree / Minimum Treatment Standards
  • A "Code of Silence" for Staff
  • No Skype to join families for dying patients or dying family members 


Coalinga State Hospital (CSH) is in a state of  crisis like none other in its past.  Staff for Assemblyman Joaquin Arambula informed the Director of this website that he would not intervene on behalf of any of the issues at CSH.  In response, we have sent an EMERGENCY email to every Chief of Staff in the California State Assembly (October 7 & 9, 2017),  and the California State Senate (October 10, 2017), because CSH is not a district specific issue, but rather an issue that needs the attention of the entire legislature at this point. Each member of the California legislature, along with their Chief of Staff is listed on our Entities Notified page.

Approximately 110 patients have died at CSH since 2005, (approximately 3-4 died this past September), and at least 20+ walking around CSH are in the dying process, and many are committing what we view as passive suicide by refusing medical treatment for serious illnesses.  Hundreds of professional staff have fled the facility and current working conditions for the remaining staff are almost unbearable for many of them. Psychologists and Social Workers have double their normal caseloads, or worse.  Nurses are being pulled away from nursing duties to work as Psychiatric  Technicians.  Monthly Treatment Teams have been cancelled.  Medical doctors are responsible for 200-300 patients and many patients are not being seen in "sick call" in a timely matter, or at all.  Outside medical specialists have cancelled contracts because of patients not showing up for appointments because they refused to be transported by CDCR for fear of being abused during the transportation process.
 

VISITORS TO THIS SITE:   Please view our "Audio Recordings" page to hear recordings from patients who speak from their heart about how they believe they are going to die at CSH, how they have made the decision that want to die at CSH, or how they think of suicide every day.  There are also recordings from men who describe in explicit detail how CSH has crushed their souls, crushed their spirits, and how the treatment programs at CSH in most cases has taken 10, 15, 20 years of their lives, and any hope that they will ever be free again (at a cost to taxpayers of $200,000.00+ per year). [ NOTE!  WE ARE ADDING NEW PATIENT RECORDINGS EVERY FEW DAYS SO KEEP CHECKING BACK ON OUR SITE] .

Please DON'T MISS the STAFF/LAWENFORCEMENT recordings where they speak about the alleged crimes involving the Director of State Hospitals, Pam Ahlin, and her staff, as well as patient abuse going on at the hospital, and what happens to staff who report it.
 
FACT BLOG: Please view our Fact Blog page where we report with more detail on issues inside the hospital.  We have also identified by name all of the Psychologists, Social Workers, and Behavior Specialists, who have refused to conduct a hospital wide mental health assessment to determine exactly which patients specifically (and how many) have made the decision they want to die at CSH, believe they will die at CSH, or who have given up on life, so that this information could be reported to the Governor and the Legislature.  These same doctors, have refused to declare a "mental health emergency at CSH," in spite of that the patient recordings on this website which reveal a grave mental health crisis. 


EMERGENCY REQUEST
TO THE LEGISLATURE

In our email to the Chief's of Staff referenced above, CSHAbuse.com is requesting the following: 

1)  An IMMEDIATE conference call with a few Chiefs of Staff and our peer leadership groups at the hospital to discuss the current crisis at CSH and make the case for a mid-level staff delegation to visit the hospital within 90 days;

2)  A mid-level staff delegation (within 90 days) from at least 4 different legislative offices to meet with patients for 2 days (at the hospital) and validate what is alleged on
CSHAbuse.com;  validate the sentiments expressed in the patient audio recordings in terms of their hopelessness, the belief that they are going to die at CSH, that they want to die/retire at CSH, or they have suicidal ideations because of the treatment programs;

3)  A Legislative Analysts Report on all CSH operations and programs;

4)  Some sort of outside investigation HOTLINE where staff with information can come forward and have safe refuge to report corruption within hospital management and patient abuse;

5)  Possible hearings before the Assembly or Senate where patients would be able to testify via SKYPE.



                                                                       OUR RESPONSE TO
                                                 ASSEMBLYMAN JOAQUIN ARAMBULA

 
We want to acknowledge that the Director of CSHAbuse.com has been treated with the utmost respect by Mr. Arambula's Capitol Staff in efforts to advocate on behalf of Coalinga State Hospital.  However, there were only three short phone calls with Hans Hemann, Chief of Staff, and our written request for a conference call to discuss a delegation from the legislature with the peer leadership from the hospital was not even brought up during our discussions.  The last conversation with Mr. Hemann was his informing us that they found "no code violations" with Coalinga State Hospital, and it was on that basis that their office would not be offering assistance.  Mr. Hemann promised that he would provide Mr. Arambula's position in writing, however, no such document has yet been received by CSHAbuse.com.  During our last phone call with Mr. Hemann, he was not sympathetic or moved by the patient or staff/law enforcement recordings, and was resistant to the suggestion that there was anything wrong at Coalinga State Hospital worthy of an investigation or inquiry.  Though Mr. Hemann was courteous, polite, and professional as he figuratively showed us to the the door.  Needless to say, we find Mr. Arambula's position completely inconsistent with the evidence we have posted on this website in the form of audio recordings.  One also has to ask why in  a nearly 1/2 a billion dollar mental health facility, staff and law enforcement can be heard in these recordings, confiding their grievances to a "patient."  As recently as January 8, 2018, more than a dozen staff and law enforcement currently employed at the hospital continue to complain to this patient about abuse and corruption in the hospital.


The names of additional individuals and entities who have been notified of these circumstances are identified on the "Entities Notified" page.  


Governor Jerry Brown has ignored multiple requests to place the hospital into a "State of Emergency".  Every member of the California State Senate has similarly disregarded the need for the State of Emergency.  Coalinga State Hospital needs a Crisis Management Team to immediately take control of all hospital operations.  This team must include agents from the FBI, representatives from the Legislature and, most importantly, independent mental health experts to assess the patients.  


Hospital operations are so out of control, they represent a crisis of epic proportion in areas that matter the most.  The mission of this mental health facility to maintain a dynamic therapeutic environment which measures itself by the number of men it returns to society as law abiding citizens... does not exist. Coalinga State Hospital in its current state represents a tragedy for the citizens of California who suffer from debilitating mental illnesses which impede their ability to navigate their lives, wandering the streets or confined in jails without treatment. These unfortunate individuals need and deserve a hospital where excellence is the required standard in all areas of its operations and staff/patient interactions. They also deserve a hospital administration which utilizes systems and protocols to monitor its performance, as well as requiring accountability equally from all its staff. 


The hospital has always been an environment where hostility, anger, despair, conflict and hopelessness permeates the overall milieu. The first couple of years after opening in 2005, hospital administrators at the time were somewhat proactive about problem solving and trying to set a more positive tone. Since 2008/2009, the hospital tone is consistently negative, almost completely anti-therapeutic, and for many patients it has literally crushed their souls, their self- esteem, and their view of themselves as valuable human beings who have a place in this world. Patient complaints about these conditions are generally treated as a low priority nuisance by administrators, are barely given a cursory response, and always include standardized catch phrase responses cut and pasted from prior complaints. 

There is no question whatsoever that hundreds of patients are afflicted with something resembling Stockholm Syndrome. At least 300-400 patients, or more, feel so powerless and hopeless, they have decided to spend the remainder of their lives at the hospital until they die. For over 3 years the Chief of Psychology, the Executive management team, and the Director of State Hospitals have been admonished that they have a responsibility to conduct a survey and try to identify who these patients are. Next, they have a responsibility to reach out to those patients and vet them about the certainty of their decision. If those patients are found to be firmly committed to their decision that they wish to die at Coalinga State Hospital, administrators would then be legally and morally required to consider how to deploy the resources taxpayers have provided for those patients care & treatment in a manner that brings meaning and stimulation to their lives. 


Coalinga State Hospital is a very grim place for a large segment of its population who find that it devours their soul and spirits, breaking them down as human beings to the point where they live in a persistent state of emotional despair. Those patients exist in a state of hopelessness and are completely disconnected from the outside world. The hospital strives to keep patients disconnected from the outside world with policies such as not even allowing dying patients the opportunity to say goodbye to family or friends through a Skype or Facetime visit. If a patient's mother is dying and can't visit the hospital, a patient is similarly forbidden from saying goodbye to her via Skype or Facetime.

As several audio recordings reveal, staff who show compassion for the patients in their charge are viewed negatively by fellow staff. They discover that CSH is a place where large numbers of their fellow staff secretly harbor the view that the patient population is detestable, irredeemable, and unforgivable. These senior staff set a tone for patients to generally be treated in an overall manner which is anti-therapeutic, abusive, neglectful, and completely at odds with the mission of a mental health treatment facility.

Many patients, who are suffering from something similar to Stockholm Syndrome, languish 5, 10, 15 years in front of shared communal televisions with staff barely noticing their existence, their apathy, their despair, and their hopeless state of mind. One patient was observed pacing in front of pay telephones for more than 6 years - 3 feet from staff offices and nobody trying to help this man. Several hundred other men who have similarly lost hope lay in bed for years, sleeping 12-18 hours per day. These behaviors are symptoms of decomposition of the human spirit - a mental condition - which most staff members ignore or don't even notice (Psychiatrists, Psychologists, Social Workers, and Psychiatric Technicians.) On licensed treatment units, staff simply observe these patients during rounds; On 9 unlicensed units, rounds are conducted by police officers who are not trained to notice or report such behavior.

An extremely confidential source within the hospital administration revealed that someone went on the internet and consulted strategies to subdue and control the CSH population of men in ways that are insidious and evil. Comprehensive investigations are needed by state licensing agencies, the U.S. Department of Justice, as well as hearings in the California State legislature. When the facts become known, there will likely be a study done of CSH and how what is occurring was ever allowed to take place. 

Hospital administrators have utilized techniques and adopted procedures which are intended, and designed, to isolate patients from their families, as well as the real world which lays beyond the fences topped with razor wire encircling the facility. The hospital environment has been stripped of cues or reminders which would stimulate patients to think about or long for a life outside of the facility. Approximately 5 years ago, a policy directive came down which forbade pictures from being displayed in any common areas of the hospital based on the premise such pictures posed a fire hazard. On one unit in particular, beautiful jigsaw puzzles which patients assembled and then displayed proudly in the unit entry hallway were torn down so viciously that most were destroyed. One staff member was told to remove nature and animal photos which she hung on the wall above her desk. Every other state hospital in California has pictures hanging throughout the facility behind Plexiglas, or those which have been treated with a chemical fire retardant.

A majority of the patients at CSH served many years in prison and have never seen the internet. As a mental health facility which is purportedly treating these patients so they can return to society as functioning members, it forbids them to access the internet, even on a closely supervised and monitored system where the service provider tracks keystrokes and blocks access to designated web sites. Federal prisoners have been allowed to send/receive email on a restricted and monitored server for many years, yet most patients at CSH don't even know what email is.

When one looks in depth at the purported treatment at CSH that costs taxpayers approximately $250,000.00 per year per patient, what is most striking is what's missing.

The harm to these patients caused by these deficiencies in psychiatric care takes many forms. Among them, inadequate, ineffective, and counterproductive treatment, excessively long hospitalizations which compound psychiatric distress and an overall lower quality of life. The Department of State Hospitals has failed miserably to provide a credible treatment program for this population.

Equally egregious is the fact that on a daily basis there are serious incidents at CSH which are driven by the underlying sense of hopelessness and frustration a majority of the men feel. Patients and staff screaming at each other, patients stealing from each other - turning on each other with their frustrations. Staff regularly activate wireless personal alarms eliciting at least 30 other staff to run to a crisis in progress, risking their safety by tripping and falling.

What is profoundly outrageous is the complete lack of resources or treatment being deployed toward the anger and hostility patients are directing toward each other. Staff immediately disperse the moment incidents deescalate and leave the patients to their own devices. Other than a cursory appearance before a Treatment Team meeting the next day, there is almost never any effort at conflict resolution or mediation of conflict between patients.

Many staff and patient peer-leadership within the hospital are calling on the Governor, as well as Senator Anthony Canella and Assemblyman Joaquin Arambula, to declare that the hospital is in a "State of Emergency," and send in a crisis management team without delay.

Staff who carry out daily abuse or neglect toward patients have been influenced by policy directives and many other mechanisms we will never fully understand. Perhaps after scholars do a study, future generations will look back on CSH in the same way we look back on segregation or slavery. 


Coalinga Conference Call - 2/27/2018