I don't know about Pueblo, but I worked at a California State Hospital for the Criminally Insane (Atascadero) and it was as secure as any prison and more secure than some places. People could only enter to visit after a search and metal detector. In the first lobby past the first security doors (there were two), there was a little exhibit of weapons made by inmates using ordinary objects. To work there, we had to submit to random searches and also sign a legal document noting that we knew we were not to bring pens, plastic silverware, barrettes, toothbrushes. and a bunch of other things into the facility.
Each ward was locked. Some prisoners were in padded cells. A few were in 4 point restraints (not indefinitely, but until meds kicked in). Since it was a hospital, inmates were treated as patients, with thorazine and haldol topping the charts of commonly prescribed medicines. Heavily medicated patients were kept in a separate area from prisoners who managed to "make progress.' The goal, of course, was to return them to sanity so they could stand trial.
To fail the mental status exam and remain in the hospital was a goal for many prisoners. They preferred the meds and the hospital setting to prison. Many would be facing life in prison, but they would be at Atascadero for life, as well, if they couldn't pass the mental status exam.
Once they managed to convince a team of treating psychiatrists that they were mentally competent, they went before a board of psychiatrists, former judges and community members to assess whether they were mentally competent. Some really wanted to get their day in court, as they regarded themselves as innocent. It wasn't hard to learn the expected answers to the mental status questions, it was a bit harder to answer the Board's questions and while I wasn't there very long (3 months), I don't recall the Board letting more than 1 person move on to trial (and his parents were very active in finding an attorney to help with that).
As prisoners/patients moved up through levels toward more freedom and more open ward experience, treating psychiatrists would eventually refer them to the Board and sometimes, the Board would listen to a couple of hours of tedious testimony about how said prisoner was in fact fit to stand trial. While I didn't witness it, that's what several of the prisoner/patients I worked with wanted to have happen. They wanted out.
I worked in the open ward (locked into cells at night) with serial rapists, taking life history and family history data to correlate with other medical studies that were ongoing. The actual point of my work was to see if the patient's story (as told to me or to one of the other researchers in my group) lined up with what they'd told various doctors over time, and with their criminal records. So, if their criminal record stated that their semen/DNA had been found in a victim, their treating psychiatrist treated that as fact. The rapists were supposed to acknowledge the facts of their case, not lie, not dissemble and not act like antisocial personalities.
While the man I worked with the most did not, to me, seem to be lying, apparently what he told me had significant variations from what LE and treating psychiatrists said (he was lying, trying to appear more innocent and in general, convince me that he was a charming man who simply had a high libido). The psychiatrist told me that his willingness to describe his crimes truthfully to me meant he was moving toward trial.
He did not, when I asked him, deny that he raped women, though. He knew better. If he had denied it, his psychiatrist would not have considered him "mentally competent." The details he gave me of his crimes matched what was in the police records. I've always assumed that he eventually faced trial. Sadly, his time at Atascadero would count as "time served" and reduce his sentence - and he for sure preferred Atascadero to prison.
This was in the 1980's, so things have probably changed (although my friends at Atascadero say it has changed very very little).
CANADA Canada - Ying (Anita) Mui, 56, Markham Ontario, 9 Aug 2024
