Psychiatric patient accused of raping a fellow ward at the San Mateo Medical Center back from Napa State Hospital

However, doctors now conclude he is able to aid in his own defense and he appeared in San Mateo County Superior Court yesterday.

But defense attorney Paul DeMeester disagrees with the finding, saying his client needs to be placed in a conservatorship and given mental treatment in a secure facility.

"This is a guy who I do not believe will ever be restored to competency," DeMeester said. "Why these hospitals keep sending him back is beyond me unless it's just to free up bed space."

O'Brien's arrest for the alleged March 30, 2010 sexual assault not only left him facing criminal charges but also turned a spotlight on the county hospital's security in its psychiatric ward.

Prosecutors say sometime between 11:30 p.m. March 29, 2010 and 7 a.m. March 30, 2010, O'Brien entered the hospital room of a 23-year-old female patient, held her down on the bed with a hand over her mouth and sexually assaulted her multiple times. Minutes later, O'Brien allegedly returned with a piece of paper on which he'd drawn a pair of lips with a finger over them to essentially tell her to stay quiet. The following morning, the woman reported the alleged assault and police were contacted.

O'Brien wanted the woman to be his girlfriend and said he forcibly attacked her because she resisted him, according to authorities.

The following month, O'Brien was also charged with assaulting a jail officer who tried stopping him from mashing food into his cell floor.

After O'Brien's arrest, the San Mateo Medical Center launched an in-house investigation. The result was a list of recommended changes including the addition of a security officer and nurse to the ward, further investigation into whether staff members in the unit were culpable and improving communication and risk evaluations of patients.

In August 2010, O'Brien was committed to Napa State Hospital. He was found competent the following year but his mental health deteriorated before he could stand trial and he was returned to the hospital where he has remained until now.

District Attorney Steve Wagstaffe hopes if O'Brien stands trial the process is swift to prevent a similar mental breakdown.

"The goal when we have someone who has twice been sent up on competency is to keep that from happening again so we are determined to move quickly," Wagstaffe said.

But DeMeester said time is not the problem.

"I already have reports from medical professionals that he was already not competent as of two days ago. I don't think you can push this fast enough," DeMeester said.

O'Brien remains in custody but returns to court April 3 to set further proceedings, including a request for bail.

michelle@smdailyjournal.com

(650) 344-5200 ext. 102.