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When Mathew Beck returns to Sonoma County after spending nearly a dozen years locked up in the state mental hospital, he'll enter a conditional release program for the criminally insane that counts two other killers among its members.

In his transition from asylum to the street, Beck will be under close watch of doctors and social workers, living first in a residential care facility near Santa Rosa and later transferring to a group home or his own apartment.

Along the way, the man who stabbed to death two Rohnert Park women in a psychotic frenzy will attend regular outpatient therapy sessions and submit to random drug testing. He'll also be able to get a job, go to school or start a romantic relationship.

In an average of four to five years, Beck can ask for complete freedom by seeking a court finding that he is no longer insane. If he misbehaves, he will be sent back.

"There's a myth that these folks kind of faked it by pleading not guilty by reason of insanity," said Michael Kennedy, the county's mental health director. "But the folks we see were very sick. We get them on meds and bring them back so they can live some sort of normal life."

The path to an everyday existence in Sonoma County begins with the transitional program created by the Legislature in 1986 to help people returning to society from places like Napa State Hospital.

Those who enter were found to be insane at the time they committed violent felonies, including murder, assault and sex offenses. Others were deemed incompetent to stand trial or were deemed mentally ill after completing prison sentences.

They are admitted to the program if they can prove to a judge that they've had a major turnaround in their condition and are no longer a danger.

Under the law, they don't face prosecution or prison at a later date because they didn't know what they were doing at the time of the crime.

"It's a hard concept for people to accept," said Christina Barasch, the county's conditional release manager. "We understand that."

The program, which has three full-time employees and runs on a budget of about $700,000, has admitted 175 patients in its 26-year history. Fifty-three were found to have been restored to sanity and 26 are in the program now.

On average, patients have been in a mental hospital for five years before they are accepted and may remain in the program for more than a decade. Two of the current Sonoma County patients were involved in homicides.

Patients who fail must return to the state hospital. At least one person was sent back after committing an assault. Kennedy wouldn't release his name. Also, he would not identify people currently in the program, citing confidentiality concerns.

But for the most part, Kennedy said it's been successful.

Locally and statewide, only about 6 percent of those admitted commit another crime. That's a major improvement over the days when the criminally insane were released without supervision, Kennedy said.

All leave the state hospital and go for a brief stay in an unlocked facility outside the county -- in Beck's case, Northstar center in Manteca. After about three months, they come to live in one of two Sonoma County residential homes with about a half-dozen other patients.

Beck is expected to go to Home for New Beginnings on Ozone Drive between Santa Rosa and Sebastopol. An employee who answered the phone Tuesday declined to comment.

The staff at the 24-hour facility is responsible for making sure that patients take medication, abide by a curfew and report to the county mental health facility on Chanate Road for testing and therapy. Contact with victims is forbidden.

"They get caught drinking a beer or seeing someone they are not supposed to, they wrap them up and send them back," said interim Public Defender Kathleen Pozzi, who represented Beck in court. "They don't play around. It's very strict."

If patients prove themselves in the residential setting, they graduate to a group home. After that they can live with family or on their own. About a half-dozen people in the program are under the lowest level of supervision.

Eventually, the person can petition the court to be deemed sane and be released from the program.

"If all goes well ... we restore them to sanity," Kennedy said. "We make the recommendation."

The treatment in a public setting instead of being confined behind tall fences topped with razor wire at the Napa State Hospital is a topic of controversy.

Many argue in online comments and Internet chat rooms that people like Beck — who killed his uncle's fianc? and her mother in a momentary snap — should go to prison.

"My aunt and cousin were only trying to help Mathew Beck get his life together when he made the decision to pick up a carving knife and stab them to death," family member Rita Holder wrote in an email. "Our family is outraged over this news."

But the program has the support of mental health advocates and criminal justice officials.

Judge Gary Medvigy, who approved Beck's release earlier this month, said it's the appropriate way to care for people suffering debilitating conditions like schizophrenia.

"I think it's the right thing to do in a society that has decided to provide treatment instead of punishment for people with mental illness," Medvigy said. "You can't just throw away the key."

You can reach Staff Writer Paul Payne at 568-5312 or paul.payne@pressdemocrat.com.