SAN FRANCISCO -- The U.S. Justice Department has issued a scathing report about alleged abuse and neglect at one of California's mental hospitals.

The report, contained in a June 27 letter to Gov. Arnold Schwarzenegger, called suicides, illegal drug use, improper use of restraints and inadequate medical care "widespread and systematic deficiencies that currently exist" at Napa State Hospital. It gives Department of Mental Health officials 49 days to implement "minimum remedial measures."

The governor's office had no immediate response to the letter Thursday and directed inquiries to the Department of Mental Health.

DOJ said it notified then-Gov. Gray Davis of its investigation in January 2004. Since then, DMH has refused to cooperate, repeatedly preventing access to the facility, said the 23-page letter from Bradley J. Schlozman, acting assistant attorney general.

According to the report, the department most recently said "access will not be provided before sometime in 2006. The state's conduct is unusual ... Most government officials cooperate ... because they recognize that protecting the rights of institutionalized citizens warrants a thorough and impartial review."

DMH spokeswoman Kirsten Macintyre said Thursday the department didn't deny access, but simply asked for a delay because an investigation is "a huge diversion of resources" and because time and money was already being spent on preparing for the hospital's reaccreditation, which takes place this fall.

She said the letter came as a surprise to the department, which has been in "constant contact" with DOJ, and it fails to give all the facts.

"I'm not saying we're perfect on patient care," she said. "But you have to present things in a fair light."

She said the department already has improved some of its problem areas.

"The goal is to resolve this," Macintyre said.

The report said Napa State Hospital, which houses and treats about 1,100 mentally ill patients who are either civilly or criminally committed, "fails to protect patients from harm and abuse."

Problems include assault; suicide; excessive and inappropriate use of physical and chemical restraints and seclusion; inadequate, ineffective and counterproductive treatment; and exposure to unnecessary environmental hazards.

Lupe Rincon, a hospital spokeswoman, said many allegations were based on inaccurate information from family members, advocates and old surveys. She said she could not respond to specific complaints.

"Releasing further information could compromise our negotiations for a settlement agreement with the U.S. DOJ," she said.

DOJ outlined a lack of basic hygiene at Napa including forcing patients to spend 12 hours in soiled diapers; taking two hours to respond to patients' call lights; and bathing patients as infrequently as every two to four weeks.

Hospital staff also punished patients who sought release, failed to provide English interpreters and refused to intervene during violent episodes among patients.

One patient strangled his roommate, another assaulted other patients at least 20 times in five months, and several patients hanged themselves, despite providing warning signs to staff, the report said.

Napa patients also have access to illegal drugs, according to the report. Three patients overdosed on methamphetamine or cocaine in the fall of 2004. One patient died, and three other patients obtained and used heroin during this time.

The DOJ also said patients allege that staffers provide patients with illegal drugs, including marijuana and cocaine, in exchange for cash or sex.

Restraints and seclusion also are overused at Napa, according to DOJ. The report cited one patient who was restrained for 369 consecutive hours and another who was "walking wrist to wrist restrained" for 50 hours.

"Multiple independent sources have alleged that staff at Napa goad patients into behaviors that are then punished with restraint or seclusion," the report said.

DOJ set forth three pages of recommendations to "remedy the deficiencies," but it was unclear what power the department has, if any, to enforce them. A DOJ spokesman did not immediately return a call seeking comment.

But Macintyre said "they could take us to court to mandate programmatic changes, but we have no reason to believe that's going to happen. ... We've been working with them all along here, and we're all after the same result."