5+ Year Member
Jul 9, 2009
Attending Physician
Napa State Hospital is once again in the news.
I was wondering if any one has worked there and what people think of police forces in mental health environments. I Believe, although I could be wrong, that Napa State has 3 categories of patient:
1) People right out of prison (MDOs they are called in the California system)
2) Sent by the court: NGRI and waiting for restoration to competency.
3) 5150 or SMI from the community.
They may also have other categories such as dementia, intellectual disability etc that I am not aware of and even the above 3 may not be accurate.

It is also my understanding that they have a HUGE police force, albeit not on the wards at all times, for just about 1000 beds. Still people are getting, literally, their heads beaten in as well as killed. Apparently this is not new either.

So my question is if you have such a police force, why not put them on the wards? Why not have a method of identifying dangerous patients and placing them on units that are very secure. I understand the need for a therapeutic environment but when the patients know they can be assaultive and "get away with it" it is not therapeutic but the exact opposite. Not to mention the safety of the staff.

Also, I wonder how much of this is not really being done by the mentally ill but by malingerers who are using the system. Napa has a huge team of psychologists. Do they have behavioral therapy and psych testing there?