Two other high profile patients are Brian David Mitchell and Wanda Barzee, who are accused of kidnapping Elizabeth Smart five years ago today. Both Mitchell and Barzee, however, are still receiving treatment and have not yet been restored legally to full mental competency.

Mental-health restoration "occurs in 70 to 80 percent of cases, usually within the 90-days-to-six-months interval," said psychologist Gerald Berg, who evaluates state hospital patients.

Patient-driven programs

Each day at 10 a.m., 1:30 and 3 p.m., patients in the forensics units attend art classes with approved supplies, tend a small garden or participate in recreational therapy of basketball or volleyball in the secure outdoor yard.

There are group discussions about substance-abuse issues and one-on-one counseling with a psychiatrist. Once a month, clients also meet with their treatment team, which includes a doctor, an administrator, the unit nursing director, nursing staff and social workers, to discuss their progress.

"It's a hospital-type environment," said Don Rosenbaum, the hospital's director of forensic and safety services. "That's our focus. We let them know they're in a hospital. Generally they're OK to be here. Some don't like to be confined, but most appreciate what we're trying to do for them and put in the (reciprocal) effort."

After classes and dinner, there's time to just relax, watch TV or read. Several times a week, community members visit to conduct religious services, including a Jehovah's Witness scripture study, Catholic Mass and Latter-day Saint Enrichment Night for women. After such a full day, bedtime is around 10:30 p.m.

"I'm generally impressed with our state hospital and the treatment that people receive," said 4th District Judge Donald J. Eyre Jr., who has handled many cases involving competency evaluations. "The staff there has genuine concern for the patients."

Waiting for a place

The intensive care in the hospital is far more expensive than a spot in the Utah County Jail in Spanish Fork, which is $80 a day compared with more than $400 in a forensics room.

Each month, there are five or six inmates at the jail awaiting competency evaluations or hoping for a hospital bed after being evaluated.

Some linger in jail as long as three months before they get a place in the hospital.

"We've got quite a list of people in the process of trying to determine if they're competent," said Dale Bench, health services director at the jail. "We're constantly seeing ... an increase of mentally ill people coming to the jail. It just seems every year to increase."

Social workers and psychiatrists in the jail can evaluate inmates and give medications, but they don't have the funding for the intensive therapy patients get at the hospital.

"I have a limited amount of services I can provide," Bench said. "(It's) quite frustrating on my end because I'm doing more crisis intervention and meds, but not therapies and things they really need."

Funding for the state hospital comes from the Utah Department of Health and Human Services, and right now, the forensic unit is at full capacity — 98 patients, with four on the waiting list.

"We have people waiting," Rosenbaum said, but added Utah's lists are shorter than other states. "It's uncomfortable for us to see our people waiting in jails."

---

E-mail: sisraelsen@desnews.com