Following a competitive bidding war between California state mental hospitals and state prisons, both seeking psychiatrists to treat their mentally ill patients, the prison system has emerged as the winner – largely due to a federal court order to improve prisoner mental health care. However, the term “winner” is misleading because it is both patients at understaffed state mental hospitals and California taxpayers who turned out to be the losers.
The federal district court in the long-running Coleman case [Coleman v. Schwarzenegger, U.S.D.C. (E.D. Cal.), Case No. CIV S-90-0520 LKK JFM P] found that a major cause of understaffing at California prison mental health facilities – understaffing that was tied to excessive and preventable prisoner deaths – was the inadequate wages offered under then-existent state pay schedules, which made it hard to attract qualified psychiatrists.
There was not a long line at the unemployment office in California for out-of-work psychiatrists, however, so the California Department of Corrections and Rehabilitation (CDCR) had to try to entice such gainfully employed professionals away from their comfortable city offices where clients were able to walk in, to stark prison environments where their patients were violent criminals. In December 2006 the district court ordered the state to boost the wages for prison psychiatrists, which jumped from a monthly base pay of $13,311 to $24,267 for chief psychiatrists – an 82% increase. State mental hospitals were not included in the order.
Consequently, the CDCR wound up offering prison psychiatrists higher wages than psychiatrists employed in state mental hospitals – causing the latter to jump ship from hospitals to prisons to partake of the increased salaries. Predictably, this had a devastating effect on staffing levels in state mental hospitals. In fact, at least two patient suicides were linked to the vastly increased patient-to-staff ratios at the hospitals; one of those deaths resulted in a lawsuit and a $975,000 settlement with the state.