At California's five state psychiatric hospitals, patients are mostly criminal defendants found not guilty by reason of insanity or incompetent to stand trial. They've been sent to these institutions for psychiatric care. But sometimes the patients can be violent.
Five years ago this week, a staff member was murdered by a patient at Napa State Hospital, in California's wine country. In the time since, the hospital has tried to improve safety. While the majority of patients are not violent, sometimes those who are target not just staff, but other patients as well.
Although it's rare for members of the media to gain access to the hospital, I was invited by Frank and Barbara Brackin to join them in visiting their 45-year-old son, Shawn, who has been a patient at Napa State for nearly 20 years. I met up with Shawn's parents in the parking lot.
“Our main concern now is for Shawn's safety,” says Frank. “He was not given the death sentence, (but) he's almost had it twice in the past three years,” he adds, in reference to assaults Shawn has suffered at the hospital.
After passing through a number of locked gates and surrendering our driver's licenses, we pass through several locked doors and then a metal detector, where we also surrender our cellphones and wallets.
At last, we're ushered into a tiny room to visit with Shawn Brackin.
“I'm glad to see you,” he says, shuffling toward us with difficulty. He's wearing a blue helmet to protect his head in case he falls — which happens somewhat frequently — or is pushed.
Shawn wasn't always in this condition, his parents had explained to me earlier. His life took a bad turn at age 6, when he was struck by a car and had a severe head injury. That accident began a slow descent that ended in tragedy.
After graduating from high school, Shawn became increasingly depressed and withdrawn. In 1995, he took a small gun and walked into a local police station.
Frank Brackin says that was an attempt at “suicide by cop.”
“He was wanting to die,” says Frank. “And so he put himself before the firing squad, and he had no idea the firing squad would turn on themselves.”
On that day, when he was 25 years old, Shawn was shot by police but survived. In the mayhem, an officer shot and killed another cop.
Shawn Brackin was charged with six felonies. As part of a plea deal, he was found “not guilty by reason of insanity.” And that plea — with its diagnosis of mental illness — is what led him to Napa State Hospital.
“We had no choice, really,” Shawn's father says. “We wanted to protect him and make sure he had a safe environment. We thought a hospital would be a safe environment.”
But over the years, Shawn Brackin has been assaulted by several patients. Last year he suffered a particularly brutal assault when a patient turned on him.
The day I visited Shawn, his hair was damp from sweat. It was a hot day in Napa, and the tiny room had no air conditioning or ventilation. I ask him if feels he's gotten well while at the hospital, if he thinks he's better off for having been sent there.
“I'm better off,” he says. “I'm pretty good right now.”
But his mother says things are not good. Before he entered the state hospital system, Shawn was able to drive and hold a job, Barbara Brackin says.
“He interacted with the family, laughed and joked, played cards. And he was the Uno champ,” she says, and laughs. “Nobody else could usually beat him.”
The latest assault on Shawn Brackin was just one of 1,800 at Napa State Hospital last year. To be fair, most of those assaults are very minor.
While the Brackins don't dismiss what their son did 20 years ago in that police station, they feel he's had to pay too high a price and have filed a lawsuit against the hospital, alleging negligence in failing to keep their son safe.
Napa has made many changes since psychiatric technician Donna Gross was murdered by a patient five years ago, but mostly those changes are intended to protect staff. While a new law took effect in July that will allow the hospital to isolate the most dangerous patients, hospital Executive Director Dolly Matteucci says more needs to be done.
“We have made tremendous progress in safety improvements and in mitigating violence at the hospital,” she tells me. “But sadly it continues to be a part of our environment and our shared experience as patients and employees. And it is unacceptable.”
Not all families are critical of Napa. Many say they enjoy the visits with their loved ones — who they say are finally getting the kind of treatment they should have gotten before the tragedy that sent them there happened.
One Family's Story
Candace and Hans — they've asked that we just use their first names to protect their privacy — say their son has been at Napa for 3½ years. At their request, we're not using his name.
Candace says that when their son was in high school, he started changing.
“He couldn't organize his homework. He couldn't turn in assignments,” she says. “And he was becoming very quiet around the house, and also talked about feeling spirits and things around him.”
It was the early signs of schizophrenia. The symptoms got worse, and his behavior escalated. Hans and Candace were so worried their son would hurt himself or someone else that they had him confined against his will.
They called the police many times, but authorities could not hold him indefinitely, so he was always released. Candace and Hans tried repeatedly to get their son psychiatric help, but as an adult he had the right to refuse treatment.
Finally, in 2012 while suffering delusions, their son killed someone in the Berkeley Hills.
He was found not guilty by reason of insanity and sent to Napa State Hospital, where his mother says he is slowly getting better.
“It has taken this long to see real results of recovery,” she says, “in little bits and pieces along the way. It was only because of the sustained treatment we had through Napa.”
Despite the complaints and problems at California's state mental hospitals, there's a long waiting list to get into them — and many of those waiting spend their time in jail.
My nine-month investigation into California's state mental hospitals began with a simple question: “What happens to people found 'not guilty by reason of insanity' or 'incompetent to stand trial'?”
Turns out the answers — and the issues raised — are complicated.
One thing emphasized to me over and over is that people sent to state mental hospitals are patients, not prisoners. That means they have certain rights and privileges, even if they're violent.
I'll never forget my visit to Napa with the Brackins. It felt like I had entered a kind of “forbidden zone” where outsiders rarely went. And meeting Shawn after hearing so much about him from his parents was very poignant.
On my visit, we were met in the parking lot by a media representative from the Department of State Hospitals. We were warned not to videotape or photograph the barbed-wired security fence, the tight security at the main gate, or people coming and going (including reporters, like me).
We passed through multiple locked gates, doors and a metal detector before we were told to surrender cell phones and wallets.
I was warned not to talk to or interview any other patients. I was asked to turn over my audio recordings of Shawn Brackin so the Department of State Hospitals could review them to make sure he didn't say anything compromising the privacy of other patients. I negotiated a much more narrow accommodation.
I was also denied any access to record audio of music therapy classes. I was told this could jeopardize patient privacy.
I found all these requests to be overly strict. I've been to numerous state prisons, including San Quentin. The Department of Corrections has allowed me to freely photograph the gate, inmates, the cell blocks — pretty much anything except Death Row. I have attended classes, religious services and therapy classes and was allowed to record, videotape and take photos.
To keep us away from other patients at Napa (who were meeting with family members nearby) the four of us were escorted to a tiny (perhaps 10 feet by 10 feet) room with no air conditioning and no apparent ventilation. (I was told this is where attorneys can meet privately with patients and their families.) At one point Shawn, who appears to have severe brain damage from assaults he suffered at Napa, asked to open the door to let some air in.
But not all families criticize Napa. Some say their loved ones are finally getting the treatment they should have gotten in the community before they committed tragic crimes.
And even strong critics acknowledge there's a role for state hospitals to play in our criminal justice system, especially for violent defendants.
But some advocates for the mentally ill say we need to make more treatment available in the community whenever possible — rather than in locked state hospitals like Napa.
Scott Shafer, a senior correspondent for KQED and host of the show's California Report, is a 2014-2015 John Jay/Langeloth Health and Justice Reporting Fellow. The above story is an abridged version of online reports posted October 23 and Oct. 24, as part of a nine-month investigation into conditions at California's mental hospitals. For the full report, access to the broadcast version, and to other stories in Shafer's investigation, please click HERE. His Twitter handle is @scottshafer. Shafer welcomes comments from readers