Judge wants better state plan to solve staffing shortage at mental hospitals

SACRAMENTO —  Saying he was unimpressed with a state plan to address a crippling staff shortage in California’s mental hospitals, a U.S. district judge Monday gave the Department of Mental Health another month to submit a more comprehensive solution.

In February, Judge Lawrence K. Karlton ordered state mental health officials to produce a plan that would stem the flow of mental health clinicians to better-paying jobs with the California Department of Corrections and Rehabilitation. That exodus has left the state hospitals dangerously short of staff and jeopardized patient safety.

In response, Gov. Arnold Schwarzenegger and Department of Mental Health Director Stephen W. Mayberg last month authorized raises for existing staff through the end of June, and will seek to extend the increases through the next budget year.

But lawyers who are representing mentally ill prisoners in a class-action lawsuit before Karlton said those raises fell too short of corrections’ salaries to prevent staff from leaving the hospitals for prison jobs.

When told that the Department of Mental Health would submit a better plan, Karlton voiced fears that there may not be enough qualified clinicians in California to solve the problem.

“It’s not at all clear to me what can be done,” he said. “I’m very discouraged.”

Nevertheless, Karlton gave the state until May 21 to submit a more detailed plan, after Deputy Atty. Gen. Lisa Tillman explained that more money -- for raises for recruits as well as existing staff -- might be secured in the upcoming revisions to next year’s budget.

“I want something concrete when you show up next time,” Karlton told Tillman.

Karlton is overseeing changes in the prisons’ mental health system, where he has deemed care so poor as to be unconstitutional. He has authority over state mental health facilities only because they treat some mentally ill prisoners. He signaled Monday that he was unlikely to order broad changes for that department.

“I am not in charge of the Department of Mental Health and I don’t intend to be,” he said.

After the hearing, state officials said they were optimistic that the problem could be addressed.

“We are absolutely dedicated to resolving the staffing issues at our hospitals and ensuring patient safety, public safety and staff safety,” said Ann Boynton, undersecretary of the Health and Human Services Agency, which oversees the Department of Mental Health.

In the courtroom were employees of Atascadero, Napa and Patton state hospitals, who said they have been forced to work exhausting, mandatory overtimes. They said staff shortages also had meant that they were less able to defuse violent patient outbursts.

Paul Hannula, a psychiatric technician at Atascadero State Hospital for five years and vice president of the hospital’s chapter of the California Assn. of Psychiatric Technicians, said the proposed raises add only about $77 a month to technicians’ pay -- not enough to keep them.

“We are losing our experienced staff,” he said. “It is dwindling so fast.”

Hannula applauded the judge. “He is taking this very, very seriously,” he said.

But some workers were less impressed. Patton nurse Christina Villareal said that workers who left for more lucrative prison jobs were recruiting former colleagues. She said she wanted the judge to take more urgent action:

“I had hoped there would be more to it,” she said of Monday’s hearing.

lee.romney@latimes.com

scott.gold@latimes.com