Fulton State Hospital (FSH) is the oldest State Psychiatric Hospital west of the Mississippi River. The hospital underwent a dramatic change that will have a positive impact on the services it provides over the coming decades. In August 2019, our state-of-the-art facility opened, revolutionizing the treatment we provide our clients.
FSH operates three distinct treatment centers, each offering customized programs to meet the needs of our clients. Together, these centers treat up to 450 clients with two levels of security. They include: 1) Nixon Forensic Center (NFC), a high-security center that can treat up to 300 clients; 2) the Sex Offender Rehabilitation and Treatment Services (SORTS), a high-security center that can treat up to 200 civilly committed Sexually Violent Predators; and 3) Hearnes Psychiatric Center (HPC), a minimum-security center that can treat up to 24 clients with developmental disabilities and severe mental illness. HPC also includes the Hearnes Acute Rehabilitation Program (HARP), a non-forensic acute stabilization unit that can treat up to 15 clients. HARP provides short-term stabilization and skills development for individuals with developmental disabilities who are experiencing acute psychiatric symptoms, helping them prepare for a successful return to the community.
Client Demographics
FSH provides treatment to individuals with a broad array of mental health diagnoses, emphasizing services for those with serious mental illnesses using empirically-supported treatment modalities. Our clients are drawn from rural and urban areas throughout Missouri and reflect a racially, ethnically, and economically diverse population. Our current population is approximately 60% Caucasian, 37% African American, and 3% Native American, Hispanic, and other backgrounds. Almost 90% of our clients are male. We serve individuals from varying sexual identities and orientations. Over 75% of our clients range in age from 22 to 60. In addition, FSH treats clients who are deaf, hard of hearing, and speak English as a second language through the Interpreting Services Department. Services provided include on-site interpreting, remote interpreting, translation of documents, communication assessments, resources, and training.
Client Legal Status
The majority of our clients have been referred by the criminal courts, initially as incompetent to proceed to trial (IST) or as not guilty by reason of mental disease or defect (NGRI). A small percentage of those who come to FSH as IST are eventually found permanently incompetent to stand trial (PIST) and remain here receiving treatment to be safely transitioned into the community. Currently, about 19% of our clients were committed by the courts as IST. Most of those clients will be restored to competency and discharged within about 5-10 months. Approximately 28% have been found PIST. Another 15% are committed as not NGRI, and about 25% are civilly committed as Sexually Violent Predators (SVP). The remaining 12% have been admitted at the request of their guardians (voluntary by guardian, VBG). The length of stay for each client varies based on their legal status, recovery process, severity of mental illness, and motivation for discharge as well as the availability of space at receiving facilities.
Client Treatment Programming
Once their legal status has been determined as SVP, PIST, NGRI, or VBG, clients receive evidenced-based treatment on our long-term treatment and rehabilitation programs. Treatment programs include the Social Learning Program (SLP), New Outlook Program for Behavior and Mood Self-Management (NOP), Recovery and Self-Motivation (RSM), and the Sex Offender Rehabilitation and Treatment Services (SORTS). These programs treat clients with diverse clinical presentations. Clinically, individuals served at Fulton State Hospital have a wide range of diagnoses, covering virtually all the major categories of the DSM-5. The most common primary diagnoses include schizophrenia-spectrum disorders, mood disorders, intellectual disabilities, personality disorders, and paraphilic disorders. We also treat a smaller number who suffer from neurocognitive disorders.