Jázmin Pellegrini was just 15 years old when she died, her body discovered in a San Francisco driveway in April 2024 with little evidence of how she got there. But over the ensuing months, the Chronicle would find that years of erratic and destabilizing care in for-profit psychiatric hospitals had helped lead the teen to that point, and that Jázmin was far from the only one.
In “Failed to Death,” reporters Cynthia Dizikes and Joaquin Palomino spent more than a year investigating California’s behavioral health care system, as Gov. Gavin Newsom ushers in unprecedented changes to build more facilities while making it easier to force people in emotional crisis into treatment. In this environment, the Chronicle found that psychiatric hospitals operated by for-profit companies have become the state’s fast-growing destination for tens of thousands of people experiencing mental health emergencies every year, and particularly for children, while offering abysmal care.
Since Newsom took office in 2019, hundreds of patients in for-profits have reported being beaten and sexually assaulted while they were supposed to be receiving stabilizing treatment for illnesses like depression, bipolar disorder and schizophrenia. At least 17 have died amid deficient care.
The Chronicle’s hand-built dataset of serious safety incidents, mined from thousands of health and law enforcement records, provides the most comprehensive accounting to date of the deplorable conditions in these for-profit facilities. Yet this tally still represents just a fraction of the harm playing out behind their locked doors. Reporters found the hospitals often fail to report assaults and injuries to the state while facing virtually no consequences from the Newsom administration for routinely violating regulations and laws.
Over the course of this project, photographer Gabrielle Lurie worked diligently to gain the trust of Jázmin’s family and document the human toll of these failures through striking images. Palomino and Dizikes also spoke to dozens of patients and their families, and current and former hospital employees, who shared life-shattering accounts of how their hopes of receiving and providing high-level care had been destroyed by the dysfunction within these facilities.
The common denominator was often understaffing, which the Chronicle discovered had been propelled by a decades-old regulatory loophole.
In a first-of-its-kind analysis, the Chronicle used detailed financial data that all hospitals report to the state to compare staffing and patient spending between for-profit psychiatric hospitals and other facilities that provide similar services. The findings were revelatory: For-profits employed far fewer caregivers, who also tended to be lower-paid and less-qualified, than their counterparts. As a result, for-profits spent less than half as much on direct patient care, helping them to bank hundreds of millions of dollars in profits, with much of that coming from taxpayer-funded insurance.
This investigation could not have come at a more pivotal time. As California transforms how it delivers mental health care, “Failed to Death” has fundamentally shifted the focus beyond the quantity of facilities, to the quality of care they provide.
