In 2010, Rodney Bock was arrested for carrying a loaded gun into a restaurant in Yuba City, north of Sacramento. Bock had severe mental illness and was later found incompetent to stand trial. He was released on bail, but was rearrested after he failed to appear at a court hearing.

Bock, 56, was placed in the Sutter County jail, awaiting transfer to a state hospital. While there, he began suffering hallucinations. After more than two weeks in jail, Bock hanged himself.

Mentally ill defendants declared incompetent to stand trial, as Bock was, are supposed to be transferred to state mental hospitals for treatment within two or three months. But more than 300 of them statewide are languishing in county jails because there’s simply no bed space.

Bock’s daughters are now plaintiffs in a lawsuit filed by the American Civil Liberties Union, charging two state agencies, including the Department of State Hospitals, with denying mentally ill inmates their right to due process — and the treatment they need.

“Jail is simply too dangerous a place for these most vulnerable defendants,” said Micaela Davis, lead attorney in the lawsuit. “We have inmates that are waiting eight, nine months and sometimes over a year before being transferred to a facility for treatment.”

California’s new state budget includes more than $17 million to add beds for defendants declared incompetent to stand trial. But not everyone agrees that’s the best approach.

Stephen Manley is a mental health court judge in Santa Clara County. His court helps defendants struggling with severe mental illnesses, including bipolar disorder or schizophrenia, find alternatives to incarceration.

Manley doesn’t want more psychiatric hospital beds; he wants to reserve state hospitals for the most violent defendants.

We send far too many people to state hospitals who do not pose a risk to public safety,” he says. “Because we don’t work with them to figure out if there isn’t a local alternative.”

Manley believes the psychiatric hospitals are already overcrowded — and understaffed. “As long as we keep overcrowding the hospitals, all we do is feed the fire,” he says, referring to violence within the hospitals.

There were more than 1,800 physical assaults at Napa State Hospital last year alone. Hospital officials say patients who are there to have their sanity restored for trial inflict the most serious injuries.

Ryan Navarre, with the organization representing Napa Hospital police, says that even officers are at risk. He recalled one patient specifically who put rocks into his socks and then spun them around “violently,” he said.

State psychiatric hospitals continue working to find a balance between treatment and security for patients and staff.

Meanwhile, Manley thinks the best solution for nonviolent offenders is to create more community-based treatment facilities.

“If we add another 500 beds people to a state hospital, all we do is make the problem worse,” he says.

But funding is already inadequate for mental health treatment. And creating more community-based programs raises new challenges — including resistance from neighbors who don’t really want to live near facilities whose clients are mentally ill criminal defendants.

Long, Dangerous Wait for Hospital Beds for Those Incompetent to Stand Trial 20 October,2015Scott Shafer

  • mozartlady

    I listened with great interest your story about the ICST defendants. I work in a state hospital and I can tell you there are a number of factors that contribute to the current wait list for these people.
    Prior to referral to the state hospital defendants are evaluated by 1 to 3 psychiatrists/psychologists. When we review many of these reports they are cookie cutter in nature and provide little information and/or erroneous information based upon the symptoms presented. Many defendants are post drug use, yet are deemed ICST (and by the way, there is drug use in the jails). Between the time they are evaluated and they arrive to the state hospital they have cleared of symptoms, yet we are tasked with getting them competent even though they may have been so at the time of admission. All substance abusers should be evaluated later in their jail stay.
    Another issue that is rampant has to do with those who malinger mental illness for secondary gain. When they are evaluated in the jail the proper malingering testing is not done or done poorly. Someone exhibiting “anxiety” or “depression” is not necessarily ICST. Many inmates have these symptoms because they don’t want to face their charges. We have had defendants returned to us 2 to 3 times after we have returned them to the counties as malingering. Also, just because someone disagrees with their public defender does not mean they are ICST. It just means they are being difficult. We can’t medicate difficult clients.
    Finally is the issue of involuntary medication. I found it laughable that you interviewed a judge from Santa Clara County Mental Health court. Perhaps he should have a discussion with the criminal court judges who send us defendants who are clearly mentally ill and potentially dangerous with no involuntary medication orders. Often these defendants have been evaluated by the court alienist who strongly recommended medications so that the person can be restored to competency. Yet, they arrive with no orders. Additionally, when we finally do attain the involuntary medications orders and establish competency the jails do not follow up with ensuring inmates take the medications (Fresno is one of the worst). We have had defendants returned to us 3 and 4 times merely because they stopped taking the medications in jail.
    The conditions in the jails are such that marginally stable mentally ill defendants actually get worse in jail. They tell us often of being in their cell 23 hours/day, no treatment, never seeing sunlight. In Fresno they are woken up at 3 AM and given a sack that contains breakfast and lunch and then essentially wait until dinner some 14 hours later. When a person is mentally unstable they sometimes don’t tend to eating regularly. I recall one defendant who would stop taking his medications in jail and returned to us 4 times, each time showing a weight loss of about 30-50 pounds in a 4-6 month period of time.
    As you can see their are many confounding factors that contribute to the backlog of ICST defendants. I hope this information has been helpful.


Scott Shafer

Scott Shafer migrated to KQED in 1998 after extended stints in politics and government to host The California  Report. Now he covers those things and more as senior editor for KQED’s Politics and Government Desk. When he’s not asking questions you’ll often find him in a pool playing water polo. Find him on Twitter @scottshafer

State of Health Sponsored by

Become a KQED sponsor