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Atascadero State Hospital (ASH) is located on the central coast of California, in San Luis Obispo County, halfway between Los Angeles and San Francisco. It is an all-male, maximum-security facility, that houses mentally ill and disordered convicts who have been committed to psychiatric facilities by California's courts.〔(【引用サイトリンク】title=Atascadero State Hospital patient killed in attack )〕 Located in Atascadero, California, it is the largest employer in that town.(needed ) ==History== ASH opened in 1954, as a state-run, self-contained public sector forensic psychiatric facility. It is enclosed within a security perimeter, and accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Patients are referred to the hospital by the Superior Court, Board of Prison Terms, or the Department of Corrections. Its treatment programs have reflected the psychiatric assumptions of the times. Initially constructed to treat mentally disordered sex offenders (MDSOs), initial programs focused on separation from society, albeit in an environment which provided freedom of movement. This was restricted after patient escapes. Initial research and treatment programs aimed at understanding and reducing the risk of reoffense in sexual offenders.〔http://heinonline.org/HOL/LandingPage?handle=hein.journals/tjeflr4&div=7&id=&page=〕〔http://journals.lww.com/psychosomaticmedicine/Abstract/1976/07000/Plasma_Testosterone_Levels_in_the_Rapist.4.aspx〕〔http://link.springer.com/article/10.1007/s11194-005-1212-x〕〔http://link.springer.com/article/10.1007/BF01579247〕〔http://www.nature.com/nature/journal/v224/n5217/abs/224369a0.html〕〔http://heinonline.org/HOL/LandingPage?handle=hein.journals/fedpro38&div=51&id=&page=〕〔http://onlinelibrary.wiley.com/doi/10.1111/j.1943-278X.1984.tb00342.x/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=false〕 In the early 1980s, the focus of the hospital's treatment programs shifted to patients found not guilty by reason of insanity (NGRI) and incompetent to stand trial; ASH was a pioneer in developing effective treatment programs for the latter.〔http://ijo.sagepub.com/content/45/3/356.short〕 In the 1990s, California passed sexually violent predator (SVP) laws, imposing civil commitment upon prisoners meeting criteria upon the expiration of their determinate prison term. SVPs were housed in ASH until the new state hospital in Coalinga opened around 2004. In the mid-1980s, a US Department of Justice investigation under CRIPA led to important and positive clinical reforms at ASH. Sidney F. Herndon was the Executive Director throughout the 1980s and brought in a strong clinical and administrative team and built up the medical staff under Gordon Gritter MD as Clinical Director. David Saunders MD led the development of a forensic psychiatry fellowship, affiliated with UCSF-Fresno and UCLA. Harold Carmel MD and Mel Hunter JD MPA established the Atascadero Clinical Safety Project (ACSP) which conducted groundbreaking research into staff injuries from patient aggression 〔http://www.jaapl.org/content/21/4/485.short〕〔http://www.jaapl.org/content/19/3/309.short〕 and, after Carmel left to become CEO of the Colorado Mental Health Institute at Pueblo in 1991, under Hunter and Colleen Love developed important programs to improve staff safety,〔http://europepmc.org/abstract/med/10486772〕〔http://ps.psychiatryonline.org/doi/abs/10.1176/ps.47.7.751?journalCode=ps〕〔http://onlinelibrary.wiley.com/doi/10.1111/j.2044-8333.1997.tb00335.x/abstract〕 which won awards from the American Psychiatric Association〔http://ps.psychiatryonline.org/doi/full/10.1176/ps.50.11.1481〕 and, in 1998, the Ernest A. Codman Award in the Hospital Category. In this era, ASH was an important center of research and teaching.〔http://ps.psychiatryonline.org/doi/abs/10.1176/ps.45.2.138〕〔http://jiv.sagepub.com/content/14/4/437.short〕〔http://mtp.oxfordjournals.org/content/20/2/98.abstract〕〔http://www.jaapl.org/content/23/3/387.short〕〔http://jpp.sagepub.com/content/9/4/222.short〕 Many clinical staff left ASH in the late 1990s with the advent of the SVPs, which was believed by many clinicians to compromise the hospital's mission of providing excellent care for persons with serious mental illness, as opposed to containment of sexually dangerous offenders. When salaries for California prison mental health staff, especially psychiatrists, increased dramatically as a result of federal litigation, ASH lost many of its psychiatrists and other clinical staff.〔http://mentalhopenews.blogspot.com/2007/04/state-is-sued-over-mental-hospital.html〕 Psychiatrist salaries have been increased to levels just under the prison psychiatrist salaries, and ASH's psychiatrist staffing is now (2014) being rebuilt. Another traumatic period came with another US DOJ CRIPA investigation in the mid-2000s. Mel Hunter, by this time ASH Executive Director, was removed from his position as a result of his refusal to compromise the clinical operations of the hospital at the behest of the DOJ consultants. He was replaced by hospital leadership whose understandable priority was to expedite the CRIPA process by obeying all diktats by the consultants. In the event, the imposition of the atypical views of consultants with no experience in forensic psychiatry led to a degradation of clinical operations and safety, with great spikes in patient violence that came to an end when the consultants left the hospital following exposes by the LA Times into apparent cronyism.〔http://articles.latimes.com/2012/jun/17/local/la-me-mental-consultant-20120617〕〔http://articles.latimes.com/2012/apr/14/local/la-me-mental-health-consultants-20120415〕〔http://articles.latimes.com/2011/jan/28/local/la-me-singh-20110128〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Atascadero State Hospital」の詳細全文を読む スポンサード リンク
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