California law allows persons designated as sexually violent predators to be committed to the facility indefinitely (under
Jessica's Law) while they are receiving treatment. Thus, treatment is offered, but is not required. The state's position is that they are offering CSH's inhabitants adequate treatment; namely, what the state refers to as its Sex Offender Treatment Program (SOTP). Approximately 1/3 of inhabitants take part in the Sex Offender Treatment Program (SOTP). Since 2006, 179 patients have been "unconditionally released"; they have been deemed no longer to meet the criteria identifying them as sexually violent predators and can live freely, although registered as sex offenders. As of April 2009, the facility had released 13 inhabitants into the “out-patient” portion of its program. The inhabitants detained in this facility have stated that they are faced with a system they believe is one wherein the state has no interest in their being treated, being deemed to have benefited from such treatment, or being subsequently released (as would be the case in a hospital operating under different regulations, standards, or laws). Rather, the inhabitants indicate their experiences suggest the state's intent is to use Coalinga State Hospital as an internment camp by refusing to provide
any rational treatment program whatsoever to the committed individuals (i.e., treatment that conforms to that which the Federal Courts deemed to amount to the "minimum standards of treatment" after the State of California had been sued by the
U.S. Department of Justice for defrauding mental health patients [under the state's care] of adequate treatment). The patients stated that the facility refuses to monitor patients' current symptoms of the mandated disorders, to offer a minimum of 20 hours per week of treatment designed to target their alleged disorders, and otherwise to conform to the
Mayberg consent decree that resulted from the above-noted U.S. DOJ action. The patients made the claim that staff working at the facility often stare unsympathetically at them while they repeatedly beg staff to provide them with the adequate treatment the facility's administrators are purported to prohibit (i.e., scientifically approved assessments of their assigned volitional impairment disorder, daily sex offender treatment, timely assessments necessary to progress toward release, and documentation of any relevant symptoms of their disorder). The inhabitants contend that but for these failures, the majority of them would participate in the treatment program. However, choosing not to participate in SOTP and/or other treatment programs does not logically guarantee that the actual and legitimate perceived needs of committed persons would be met either. Three-quarters of CSH's 850-plus detainees refuse to participate in a core treatment program, undermining a central piece of Coalinga State Hospital's purported mission. The vast majority refuse to participate beyond the first phase of a five-phase therapy regimen. Only 25 to 30 percent of sexually violent predators consent to participate in the active phases of California's sex offender treatment program. A federal judge ruled a similar program in Minnesota to be unconstitutional. The U.S. District Court for the District of Minnesota held that Minnesota's civil commitment scheme was a punitive system that segregates and indefinitely detains a class of potentially dangerous individuals without the safeguards of the criminal justice system. However, the Eighth Circuit Court of the United States subsequently reversed. ==Notable patients==