PROVO — The camera-lined hallways are quiet at the Utah State Hospital.
Doctors and social workers pass each other with a smile as they slip from one unit to the other, busily teaching patients about mental illnesses, crimes they are accused of committing and the legal system in which the patients are supposed to take part.
Here, in the forensic unit of Utah State Hospital, mentally ill people charged with crimes serve their time.
But instead of bars and striped jumpsuits, the patients sleep on mattresses, wear street clothes and spend their days learning why shooting someone, robbing a store, or kidnapping a child is wrong — and how they must take responsibility for their actions.
Nestled against the mountains on Provo's east bench, the Utah State Hospital was founded in 1885 as a destination for people struggling with issues such as those known today as schizophrenia or bipolar disorder.
The four parts of the forensics unit — a women's, men's and mixed-gender and a higher-security area for men — have double-occupancy bedrooms with bookshelves and desks. The higher security area has single rooms.
These four areas are where the individuals stay who are charged with crimes.
Some patients spend their free time between classes watching television or reading while others sit in the sun in the small enclosed courtyard.
Patients in the forensics unit stay as long as it takes them to be restored to mental competency — a level at which they can understand what charges they face.
However, if a forensics-unit patient stays for several years in the hospital without significant progress, prosecutors and defense attorneys may need to consider a civil commitment and drop charges against them. However, criminal charges can be refiled if the individual is eventually deemed mentally fit to stand trial.
One patient is Eryk Drej, 33, who has been receiving treatment in the state hospital for nearly two years. He was charged with first-degree felony murder in June 2005.
Drej shot his brother 10 times in the driveway of their American Fork home. He told police he was protecting a woman from his brother's plans to sell her organs on the black market.
Therapy helped Drej to understand the charges against him, and now he can participate in his own defense. His case was heard in court Wednesday and was scheduled to be heard again June 13.
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