We pay millions for sex offender therapy at Coalinga hospital. Most patients aren't in it

Patients leave the cafeteria at Coalinga State Hospital.  The hospital was built in 2005 for sexually violent predators who have served jail time, but have mental disorders that keep them from being released back into society until they complete a therapy program.
Patients leave the cafeteria at Coalinga State Hospital. The hospital was built in 2005 for sexually violent predators who have served jail time, but have mental disorders that keep them from being released back into society until they complete a therapy program. FRESNO BEE FILE

Thirteen years after Coalinga State Hospital was built to treat the state’s sexually violent predators, some of the men there say they’re more like prisoners than patients, and that the multimillion-dollar facility once criticized for its amenities is a sort of purgatory failing to rehabilitate offenders — and therefore failing the public.

The mental health hospital's goal is to provide sex offenders who have already served prison sentences with social skills "to prevent recurrence of sexual offending," but only about a third of the hospital's near 1,300 patients are actually taking the therapy that is offered, according to state officials.

In a first-ever phone call with state representatives in February, several patients alleged that hospital administrators “foster an environment of corruption” and that many patients have given up on therapy because they don't believe there's a chance they will ever be allowed to re-enter society.

"We have taken men and made them believe that if you go to these classes, that you can have your life back. But that’s a lie,” said patient Jeff Gambord, 57, who has been at the hospital since 2006 and was convicted of rape and sexual battery in the 1980s. “It would be one thing to take these men and tell them we’re going to keep you locked up for the rest of your life. People can come to terms with that. But I want you to understand what it’s like to really come to terms with what you did to hurt women or children and to become a better person ... and in spite of these changes, you can’t get out.”

'Stuck in a never-ending cycle'

Most of the civil detainees at Coalinga State Hospital are sexually violent predators, rapists or child molesters who have been diagnosed with a mental disorder that makes them "a danger to the health and safety of others" and likely to re-offend.

The hospital has an annual budget of more than $250 million, which comes out of the state's general fund, and offers psychiatric treatment to patients. Therapy includes polygraphs and penile arousal tests, and some patients have opted for chemical castration in hopes of making their case to live outside the hospital. But patients on the conference call said treatment often leads to nowhere, and that the hospital is merely an overpriced holding cell.

"We are stuck in a never-ending cycle of shame and guilt for our crimes, no matter how hard we work issues out in our therapy, with no relief," patient Billy Redding, 64, said on the Feb. 27 call.

Redding served 16 years in prison for multiple rapes he committed more than 20 years ago. He’s had about 90 different therapists since he was admitted to the hospital in 2006, and continues therapy in hopes of some day leaving. Redding said he understands why people don't want patients like him to re-enter society, but that in his case, therapy has worked.

“I don’t blame them. It’s a risk for them, and I get that. But they’re also skipping over the fact that for the last 24 years, I’ve been doing nothing but therapy,” Redding told The Bee. “Frankly, I just don’t think the way I did 30 years ago.”

According to an email from the Department of State Hospitals, only 36 percent of patients are in treatment at Coalinga State Hospital, a maximum security facility that offers a state-of-the-art gym, 16 sports yards and vocational workshops, and was designed "to lessen the clinical edge," according to its website.

Michael St. Martin, 61, is one of the patients not participating in treatment. He says he believes in treatment, but that the system at the hospital, where he has been since 2006 after serving 10 years in prison for child molestation charges, is flawed.

“The bottom line is, there is no consistency with treatment,” St. Martin said. “All of public safety is an important factor, don’t get me wrong. But the state has taken the community’s money and they’re not producing that. It’s unconscionable what they’ve done. The Supreme Court ruled that the state has to provide treatment — they didn’t say it had to work.”

Since 2006, there have been 179 patients "unconditionally released," meaning they no longer meet the criteria that marks them as a sexually violent predator and can live freely as registered sex offenders.

There are currently 13 patients living in California communities and participating in the hospital’s outpatient program, meaning a court has approved their release contingent on certain conditions. In the history of the hospital, 37 people have been approved for conditional release "and monitored while continuing treatment," according to Department of State Hospitals spokesman Ken August. Ten of them were found in violation of the terms and conditions and were sent back to the hospital.

Jeffrey Snyder, of Fresno, was arrested in March for violating the terms of his release after successfully making his case in court last year to leave the hospital. A court hearing revealed Snyder had consensual sex with a male adult at the Fresno motel where they lived, thus violating a condition of his program. A Fresno judge ordered Snyder, a convicted child molester, back to Coalinga State Hospital for at least a year.

In response to questions about the patients' allegations on the February call, August said the hospital is audited regularly by the state auditor's office and by California Health and Human Services.

"As with all state hospitals, Coalinga State Hospital is closely monitored," August said in an email. "All allegations of abuse, neglect or exploitation received by the Department of State Hospitals are reported to the California Department of Public Health and the California Health and Human Services Agency Office of Law Enforcement Support."

Representatives for state Assembly members Shirley Weber, D-San Diego, Anna Caballero, D-Salinas, and Adrin Nazarian, D-North Hollywood, were on the call with Coalinga patients. None of the elected representatives' staff returned requests for comment. Assemblyman Joaquin Arambula also declined to comment, though patients have reached out to his office. The hospital is in Arambula's Assembly district.

In the past year, patients have filed complaints with the Department of State Hospitals, Disability Rights California, Gov. Jerry Brown's office and more, calling for an outside investigation of hospital practices. Many of the complaints have been chronicled on cshabuse.com, a website ran by Gambord with the help of someone outside of the hospital, since patients are not allowed internet access.

What's the solution?

Dr. Fred Berlin, a psychiatrist who has specialized in sexual disorders for more than 30 years and is based at Johns Hopkins University, also was on the call with Coalinga patients. He said he has heard similar complaints at other such facilities, and that there still isn't a clear solution for what to do with offenders diagnosed with these mental disorders.

"I think there's good evidence that therapy can work. What's not clear is whether keeping people in an institutional setting for long periods of time does," Berlin said. "Either it's money well spent, and we're helping people be salvaged and re-enter communities to be safe and productive members of society, or we're just throwing money away. If it's just a ruse and there's not effective treatment happening, then we should at least have a conversation about it and not have treatment that seems to go on forever."

But even that conversation can be a sensitive subject because of the violent crimes committed, Berlin said.

"These are men who have paid their debt to society. They've all finished their prison sentences. But they're not going to have a lot of folks necessarily looking to advocate for them," he said. "They’re fighting an uphill battle just to get past the branding."

Rick Thomas, senior deputy district attorney for Fresno County, who specializes in sexually violent predator cases, has seen success stories from people who receive treatment like that at Coalinga State Hospital. He also has seen offenders who don't believe what they did was wrong — "that honestly believe that the 7-year-old came on to them."

"A disorder like pedophilia isn’t like being diagnosed with schizophrenia or something like that, where you can give someone medication. It's more like alcoholism. Everyone responds differently, and the first step is admitting that you're an alcoholic," Thomas said. "Many doctors have testified that there's a statistically significant impact of sex offender treatment, that it does help, and if they complete that treatment and get out, that’s the whole point of the system — to have them not be dangerous anymore."

Thomas admits there still isn't a clear public solution to how to handle this class of sex offenders, and says he believes programs like that at Coalinga State Hospital will eventually cease to exist because of stronger jail sentences. Fresno County hasn't had a new sexually violent predator case in three years, according to Thomas.

"It's not easy to figure out. My role is to protect the public, and I do that. But the ironic thing is that, in my opinion, the SVP program will die out. Most of these guys, if they did today what they did 30 years ago, they would get 15 to life. They could be getting out of prison at 75-80, and at an age that the doctors say they are no longer a risk to society.

"In another sense, from their perspective, if they have this mental disorder, they're wired this way and the doctors don't know why," Thomas said. "That's got to be difficult to live with."

Mackenzie Mays: 559-441-6412, @MackenzieMays