OVERWHELMED: Autistic patients say they can't access coping tools at Arizona State Hospital

KJZZ’s The Show spent six months speaking to incarcerated patients inside the Arizona State Hospital, and their families and lawyers outside, in what they described as a secretive and psychologically damaging institution for patients with autism.

The Show also reviewed hundreds of pages of state audits, inspection reports, meeting minutes and medical records, watched legislative testimony and interviewed medical professionals and autism specialists from across the country.

In part one of the special report OVERWHELMED, meet Matt Solan, who has been in the Arizona State Hospital for almost five years.

HOLLY GIESZL: OK. Are we all on?

ATHENA ANKRAH: Yes, hi, I'm here.

GIESZL: Matt?

MATT SOLAN: Yes, I'm here.

GIESZL: OK, good.

AMY SILVERMAN: Hi Matt, it's Amy.

SOLAN: Hi, Amy. How are you?

SILVERMAN: I'm good. How are you doing?

SOLAN: I'm surviving, barely.

Matt Solan is overwhelmed. He's been a patient at the Arizona State Hospital since April 2020, found guilty of aggravated assault with a deadly weapon because he was found to be guilty except insane. Solan was sent to ASH, as it's often known, instead of prison.

The idea is to rehabilitate rather than punish so that patients can someday rejoin society and lead fulfilling, safe, productive lives. Instead, Solan and others say ASH is making them worse.

According to state hospital medical records Solan provided to KJZZ, the 35-year-old has been diagnosed with anti-social and narcissistic personality disorders. As a child, he was also diagnosed with autism. It's the lack of accommodations for his autism, Solan says, that is causing him distress.

"Well, if I could sum it up in one word, I would use the word torture," said Solan.

It took weeks to arrange the timing of the phone call with Solan's lawyer, and once we get on the phone, it's easy to hear what he means when he talks about sensory overload.

"Every single room and the hallway and corridor from the day room to the treatment rooms to the bedrooms to the bathrooms, they just amplify noise and the echo here is horrible. So no matter where I go in here, I can't escape the sensory overstimulation that all this noise and motion and commotion causes," Solan said.

Between patients, staff, walkie-talkies and TVs, the place is so loud, he says, that Solan has willed himself nocturnal, sleeping through the day and waking up at night when it's quiet and there’s less stimulation.

"On the average day, when my sleep schedule's not interrupted for one reason or another, I would sleep all day. I would wake up around dinner. The staff would save my lunch and dinner for me, so I'd eat them both at once, and then I would get on the computer and I would stay on the computer and do paperwork and research," Solan said. "I spend probably 12-13 hours a day studying, reading and writing computer code. I just do that all night until the sun comes up. And then usually before breakfast is served, I'll go to my room. I'll take out my little game player, watch a cartoon until I can't keep my eyes open and go to sleep and sleep the rest of the day."

In a statement provided to KJZZ, the Arizona Department of Health Services said: “Quiet rooms, weighted blankets, and noise-canceling headphones are incorporated into care plans for patients when clinically indicated.”

But Solan's medical records from August of last year show that a nurse practitioner at ASH ordered accommodations for him, including noise-canceling headphones. And a legal appeal filed by his lawyer mentions prior medical orders for soothing baths.

"There's one of the, one of the shower rooms has a bathtub in it to help with grounding and, and, and cooling off. And over the last, I don't know, 4 months, the hospital imposed a bunch of sweeping changes that haven't made much sense, but they effectively came in and said the bathtubs are permanently closed, nobody can use them and shut off the water to them," Solan said. "They seized my headphones when they raided the whole hospital after revamping their contraband policy. I'm basically down out of all of my coping tools."

Solan was also unsuccessful recently in suing the hospital to allow him access to his therapy dog. The dog died before the case could be resolved.

Last fall, Solan was charged with aggravated assault against an ASH employee. His attorney, Holly Gieszl, says this is not the first time one of her clients with autism has been punished for acting out after being denied accommodations.

She says hospital staff are undertrained and struggle to de-escalate when a patient has an outburst.

Because diagnosing mental health conditions is more of an art than a science, it's hard to know how many people across the US with serious mental illness also have autism. The study of dual diagnoses is relatively new. Researchers have only begun to break the surface in the last few years.

In this series, we'll hear from two other patients in the forensic unit at ASH who report similar experiences to Solan, as well as the sister of a former patient who says her autistic brother emerged from ASH much sicker than when he went in.

Attorneys representing patients at ASH say substandard treatment is widespread, and advocates for the autism community say the place is shrouded in secrecy, making it impossible to know what is really going on.

The Department of Health Services and Gov. Katie Hobbs's office declined to answer any specific questions for this story. Repeated requests for a tour of the state hospital were denied.