Bed shortages at California mental health facilities leave inmates deemed incompetent in limbo

Before Jan. 1, 2019, the time frame a person had to be declared competent to stand trial was three years for a felony charge. In September 2018, California Senate Bill 1187 was passed which reduced the time to two years.

OROVILLE — Despite being found incompetent to stand trial, Samuel Eugene Johnson sits in the Butte County Jail, waiting for a bed to open at a California mental health facility.

Johnson, a homeless man, was charged with the murder of 55-year-old Linda Blacksten in 2018 near the Chico State University campus.

In March 2019, Johnson pleaded guilty by reason of insanity and was deemed incompetent to stand trial.

The courtroom

When a defendant seems unfit to stand trial due to mental health concerns, a defense attorney can declare a doubt of competency to stand trial.

Once this happens, the defendant is analyzed by a psychiatric specialist who submits a report to the judge, who has the ultimate decision on whether the process of restoring competency through behavioral health services will begin.

According to Butte County District Attorney Mike Ramsey, in about half of these cases, the defendant is declared competent and the trial continues.

Those who are found incompetent to stand trial begin the rehabilitation process. Ramsey said Butte County Behavioral Health Services checks to see if there is a local facility that will suffice, though that is often not the case.

The default, Ramsey said, is to send them to a state facility, though this presents a problem as most facilities have long wait lists and the defendants end up sitting in the local jail, waiting for beds to open up.

“It’s a well-known frustration,” Ramsey said. “They wait months and months for a bed to open up so they can get the person in the hospital. During this time, they are not getting any treatment.”‘

Ramsey said the process can sometimes take so long that the defense attorney in charge of the case will file a writ of habeas corpus to the court, spurring representatives from the state hospital to be questioned by a judge regarding the wait. These are usually in extreme circumstances.

Once the defendant begins receiving treatment, a clock starts ticking. Those in rehabilitation have a legally specified length of time to be deemed by a doctor as fit to stand trial. During this process, if the person’s competency is restored, they will return to the county to be tried.

Before Jan. 1, 2019, the time frame a person had to be declared competent to stand trial was three years for a felony charge. In September 2018, California Senate Bill 1187 was passed which reduced the time to two years.

When time runs out

After the two years in a state facility are up and the defendant is not declared competent, the case is dropped and there are two routes that can be taken based on the person’s potential threat level to the public.

According to Ramsey, if the person is not considered a threat to others, a conservatorship is granted and the person is transported to a long-term mental health facility.

Alternatively, in extreme situations of violence and risk, a variation of this process known as the Murphy Conservatorship takes place. The person is taken to a locked facility for a long-term commitment.

“(The Murphy Conservatorship) is reserved for the dangerous of the dangerous,” Ramsey said.

Insanity plea vs. incompetency

The plea of not guilty by reason of insanity refers to the defendant’s inability to know right from wrong or not understand the nature of their actions, said Phil Heithecker. Heithecker is the executive director of the Butte County Public Defender Consortium and has been a public defender since 1998.

Incompetency to stand trial, Heithecker said, can be doubted when it seems the defendant does not understand the court preceding.

“The lawyer expresses a doubt that their client is fit to stand trial,” Heithecker said. “A doctor is appointed and then evaluates the client. At that point, criminal proceedings are put on hold.”

Complications

When the state facility is full, the defendants are placed on a waiting list.

“Those beds at the state are full, and we’re having folks languish in jail waiting to be transported to the state hospital,” Heithecker said. “Sometimes the folks are just waiting in jail to begin the process of having their legal competency restored.”

While filing a writ of habeas corpus is an extreme scenario, Heithecker said more often the court order the state hospital to explain why the transfer of the inmate hasn’t happened. Because these are contempt proceedings against the state, an attorney with the hospital appears before the court to provide reasoning, sometimes in the form of showing the waitlist and how the person has moved up.

In extreme circumstances, the court can impose monetary sanctions on the state, though Heithecker said this is usually a last resort.

Some people, especially those who are homeless, with mental illness can get trapped in the cycle due to the lack of care, he added.

“The problem is we’re seeing more and more people with mental illness that are getting caught in the criminal justice system and they need mental health treatment. If you’re homeless and you’re not able to get your medications, you’ll commit more crimes and get trapped in a revolving door in the system.”

Local alternative

With a build-up of inmates waiting to be transferred, the Butte County Sheriff’s Office and the Butte County Jail opened five beds to those who have been found incompetent to stand trial.

The program acts as a way to begin the process of restoring competency in partnership with the state. A doctor from a care provider called Wellpath oversees the patients at the jail to minimize the wait time, said Sheriff Kory Honea.

All five beds are currently in use, with four people on the local jail’s waiting list.

“Historically, there has been a significant lack of bed space to accommodate all of the people throughout California,” Honea said. “It hasn’t been uncommon for inmates suffering from mental health issues to remain in jail. It ultimately delays the criminal justice process and puts all of these people in limbo.”

Though the limit remains at five beds for the county jail, Honea said the program has been beneficial and resulted in rehabilitation.

“Our initial experience with the program has been good,” Honea said. “There’s been a number of people who have been restored to competency without having to send them to the hospital.”