California hospital released mentally ill woman early. She was picked up by a sex offender

Editor’s Note: This is the first in a two-part series about Ashlynn Miles, a mentally ill Paso Robles woman who was picked up by a sex offender after she was released early from a county psychiatric facility. This article discusses topics related to sexual assault, self-harm and suicide. Please read with care.

Kimberlee Booth was tending to the animals at her home tortoise rescue in Paso Robles over Labor Day weekend when she opened her phone to check on her daughter, 22-year-old Ashlynn Miles.

Miles, who suffers from chronic schizophrenia and is homeless, had just been released from San Luis Obispo County’s Psychiatric Health Facility.

But due to a mistake with her paperwork, she was discharged two days earlier than she should have been, so a worried Booth gave her a backpack loaded with clothing, shoes, toiletries and other essentials.

Lately, Booth has also been including one other item in the bags she assembles for her daughter: an Apple AirTag, so she can track Miles’ location and retrieve the backpack if Miles abandons it.

This time, however, her daughter held onto her backpack, and when Booth synced up the location at 2 p.m. on Sept. 4, she was shocked by what she saw.

Her daughter was no longer in Paso Robles and was instead traveling out Interstate 40 in an unknown vehicle to an unknown location.

“My heart stops,” Booth told The Tribune, recalling that moment. “If she goes back to Vegas. I can’t do anything. We’re done.”

Booth was terrified that her daughter was returning to the Nevada city, where delusions have left Miles believing she has a husband and children. She is not married or a mother.

Booth had good reason to be frightened.

Miles went missing in Nevada for seven months earlier this year after she was sexually assaulted in the Mojave Desert in January and hospitalized in Henderson.

Police in Nevada located Miles in North Las Vegas in early August after she was the victim of another assault.

In August, Booth got her daughter on a bus from Nevada to San Luis Obispo County and into the county-run psychiatric health facility — known as the PHF, or “the Puff” for short — where she spent 12 days before being discharged.

Miles had been out of the hospital for less than 72 hours before she went missing, again.

How SLO County woman went from homebody to homeless

According to her mother, who has a total of five children, Ashlynn Miles first started displaying symptoms of schizophrenia as a kindergartner.

Booth said her second-born child would speak with people who were not there on the playground and described visions of people hanging in her bedroom closet.

Although schizophrenia typically manifests in early adulthood, Miles had numerous genetic linkages to the often-hereditary disorder — immediate family members on her father and mother’s side have schizophrenia, Booth said.

For most of her childhood and adolescence, Miles’ schizophrenic symptoms were under control, Booth said.

Miles was an outgoing and witty animal lover who enjoyed outdoor activities, drawing and cherished her family above all else.

But after experiencing a head injury and enduring the traumatic death of her high school ex-boyfriend, Miles started displaying more severe delusions that caused her to act out violently toward herself and her family.

In one incident, Miles, who loves animals, felt the rescue reptiles on her mother’s property were speaking to her and she acted violently against them.

In another incident, when Miles’ now 5-year old brother was an infant, Booth discovered her daughter had put bleach in the baby’s bottle.

Booth said Miles also attempted to strangle her from the backseat of the car while she was driving.

Eventually, the violence escalated to the point San Luis Obispo County Child Protective Services intervened and told Booth that Miles could not live in the home while Booth had underage children in her care.

That left Booth with an impossible choice — force her sick daughter to leave or risk the safety and security of the rest of her family.

Miles has been homeless since December 2020 — staying on the Bob Jones City-to-the-Sea Bike Trail and the area near Prado Road.

Booth said her daughter constantly tells her she wants to come home, but she knows that her illness, when left untreated, poses too much risk to those who love her.

Glitch at SLO psychiatric hospital leads to early discharge

When Miles returned to Paso Robles from Nevada by bus in August, confused and delusional, law enforcement immediately placed her on a 5150 mental health hold as an adult who is “gravely disabled” by their mental illness, meaning they cannot provide for their most basic needs.

Law enforcement officers told Booth that Miles willingly walked into the police car to be transported to the hospital and didn’t ask questions.

Soon after the 72-hour hold was issued, it was upgraded to a 5250, which extends involuntary treatment to a maximum of 14 days.

She was admitted to the PHF on Aug. 18 and was scheduled to be discharged on Sept. 4, Booth said.

Instead of staying until her hold was up, however, Miles was released early due to human error, Booth said, leaving the facility on Friday, Sept. 2, ahead of the Labor Day holiday weekend.

“The PHF screwed up on the paperwork,” Booth said. “How do you screw up on that? You guys have had records for her since she was 18 years old.”

It’s unclear why Miles was released, and Anne Robin, director of San Luis Obispo County Behavioral Health Services, said the agency cannot comment on specific patients.

Robin said that patients who do not meet the criteria for medical necessity and imminent risk outlined in the California Code of Regulations, which licenses psychiatric health facilities in state, can be discharged from the facility at any time.

Patient has more than 50 hospitalizations in 4 years

Miles’ August stay was the 12th time she’s been admitted to the PHF in the past four years, according to medical records shared with The Tribune.

It’s possible she’s been to local psychiatric facilities even more than that.

When placed on a mental health hold, the patient is transferred to a local emergency room for medical clearance and then is sent to the unlocked, county-run crisis stabilization unit in San Luis Obispo for a stay of less than 24 hours, the locked psychiatric hospital for a longer stay or a psychiatric hospital out of the county.

During a meeting with the San Luis Obispo County Public Guardian’s Office last fall, Miles’ social worker through Family Care Network said they counted 18 mental health holds in SLO County from 2018 through October 2021.

The Public Guardian’s Office is appointed by the San Luis Obispo County Superior Court to act as a probate or conservator for people with who require conservatorship, such as those with severe mental disabilities.

Twice in the past year, Booth asked the Public Guardian’s Office to appoint a conservator for her gravely disabled daughter so that she could receive more intensive care. But her requests were rejected both times due to technicalities.

In August, the Public Guardian’s Office told Booth they needed all of Miles’ paperwork from her time as a missing person in Nevada to proceed with her case.

Then a social worker in charge of Miles’ case told Booth that because the Public Guardian’s Office rejected the conservatorship request, and she didn’t have enough time to process all of Miles’ paperwork on the Friday before Labor Day, Miles had to be discharged.

“You just referred her to (the) Public Guardian the same week of discharge because she’s gravely disabled, unable to care for herself. Then you discharge her early,” Booth said.

“(The PHF supervisor) literally told me, ‘She’s not ready to be released. I’m very worried about her. I’m very sorry,’” Booth said.

Booth hasn’t even been able to review her daughter’s records from her most recent PHF stay, despite having power of attorney. That allows her to view her daughter’s medical records when she is considered unable to manage her own care, such as when she is placed on a mental health hold.

Booth has thousands of documents from San Luis Obispo County Behavioral Health and the associated Psychiatric Health Facility pertaining to her daughter’s care over the years.

She said this is the first time her request to obtain her daughter’s medical records has been denied by Behavioral Health.

“I’ve gotten them from everywhere,” Booth said. “I’m still getting them from everywhere, and the PHF refuses.”

‘She’s not ready to be released’

On Friday, Sept. 2, Miles was discharged from the PHF and was transported to the converted Motel 6 off Highway 46 that now serves as ECHO’s Paso Robles shelter.

There, she was given a one-night voucher despite being banned from all homeless shelters in the area for demonstrating violence to herself and staff and for being mentally unstable, Booth said.

The state has made efforts to ensure homeless psychiatric patients are discharged to a shelter, not the streets.

A law passed in January 2019 required acute psychiatric hospitals licensed by the California Department of Public Health to offer homeless patients shelter, a meal, weather-appropriate clothing and a game plan for coordinating between agencies.

But there’s a loophole. Because the PHF is not considered an acute psychiatric hospital licensed by the California Department of Public Health, it is not subject to the same requirements for releasing homeless patients such as Miles.

“We do try to provide all of the supports we can for people leaving the PHF who were homeless upon admission; however the legislation does not apply to our level of licensure,” Robin told The Tribune via email. “As a reminder, anyone discharge from the PHF who is not on a conservatorship is considered voluntary and may accept or reject any referrals or arrangements that they want.”

Location of shelter could be dangerous

When Booth went out to see her daughter at ECHO, she was immediately alarmed.

“She was worse than when I had taken her to the PHF... and she had just been released,” Booth said. “She was worse than I had ever seen her in my life.”

She said Miles was wearing a pair of dirty men’s shoes with no laces and had no food stamps.

Booth said her daughter pointed to her body and described tattoos on her arm that were not there, depicting children who do not exist.

But Booth had another major worry. One of Miles’ delusions tells her to commit suicide by walking into traffic, according to her medical records, and the ECHO shelter is located near the busy Highway 101-Highway 46 interchange.

Booth said two Transitions Mental Health Association workers were monitoring Miles to keep her away from the freeway.

When she saw where Miles was staying, Booth called a supervisor at the PHF and told him, “She’s gonna die. You put her right by the freeway.”

He reportedly told her there was nothing the PHF could do until she was placed on a new hold and readmitted to the hospital. The PHF supervisor said Miles would probably be back within 48 hours and told Booth not to worry.

At the end of her visit, Booth left her daughter with the backpack with the AirTag, so she could track Miles’ movements and ensure she didn’t commit suicide by walking on the highway.

The following afternoon, on Saturday, Booth once again checked the tracker on her phone. It showed that Miles was hanging out under the bridge where she sometimes goes to buy illegal drugs.

And least she wasn’t on the highway, and she was still in town — but not for long.

How Ashlynn Miles got from Paso Robles to Arizona

The Sunday after Miles was discharged, Booth was tending to her rescue animals when she checked the tracker again around 2 p.m.

Her daughter was in Bakersfield — and she was moving.

As Booth watched the tracker, it continued to travel along Interstate 40, heading east through Barstow, then to Needles and then across the state line to Yucca, Arizona.

Although Booth had given Miles a burner phone in her backpack, she said her daughter rarely uses phones and has thrown away or buried them in the past.

So instead, Booth twice called the California Highway Patrol, who told her to call the Paso Robles Police Department to confirm that Miles was not still at the ECHO shelter and someone just stole her backpack.

She followed their instructions and confirmed that Miles was no longer at the shelter in Paso Robles or under the Highway 46 bridge where she was seen the day before.

Eventually, after about five hours, the tracker stopped at what looked like a grocery store loading dock in Kingman, Arizona, at 7:15 p.m.

Mom tells police: ‘You have to find her’

With night falling Booth again took to her phone, calling 911, which connected her to Officer Francisco Alonso with the Kingman Police Department.

On a hunch, she told Alonso to look for a truck driver.

“I go, ‘You have to find her. She’s mentally ill. She would not go there. Something’s wrong,’ ” Booth said.

According to the police report, Alonso responded to the location and found a group of truckers. He asked if any of them had an extra female passenger fitting Miles’ description, but all the drivers denied having seen Miles.

So Alonso ran the license plates of the semi-trailer trucks, and one of them came back with a frightening detail.

“I was advised by dispatch that the semi was associated with a registered sex offender,” the officer wrote in his report. “The semi was parked in the area the AirTag was pinging off of. The driver was contacted and identified as Robert Borders.

“At the same time, (Booth) was advised to use the audible sound on the AirTag.”

Booth said she clicked it, and it went off three times.

The Kingman police found Miles in the sleeping compartment of the truck, disoriented and confused but otherwise OK, Booth said.

What trucker told police

Alonso reportedly told Booth that Miles didn’t know her birthday, thought she was in Las Vegas or California and “(didn’t) know why or how she (was) in this truck.”

“Ashlynn believed that it was the year 1998 and was attempting to locate her husband and child,” Alonso said in his report. “However, Ashlynn was born in the year 2000 and had never been married or had children.”

Borders, the truck driver, was convicted in 2004 of molesting a child under 18 years of age, according to the Megan’s Law website.

In 2014, Borders was arrested on suspicion of allegedly raping an unconscious woman at a truck stop in Bakersfield, according to the Bakersfield Californian.

Also, Booth said, Borders lied to police, telling Alonso he picked Miles up in Pismo Beach — when he really he picked her up in Paso Robles.

According to the police report, Miles told Borders she was homeless and looking for a ride to Las Vegas.

Borders told the officer he thought it was strange Miles was barefoot — she does not wear shoes, her mother said — but otherwise said she was acting normal.

At some point during the ride, Borders said, Miles started acting irate and delusional, talking about demons and “other strange things,” according to the police report.

Borders told Alonso that Miles stayed in the sleeping compartment of the truck and he planned to drop her off in the desert in Needles, but instead opted to take her with him to Kingman, where he was resting for the day.

Booth is not convinced.

“What was that trucker going to do? We all know he wasn’t going to turn her in. What was he going to do with my kid?” she asked. “This guy ... took this little girl that was homeless and mentally ill.”

“She could have been murdered,” Booth said.

After locating Miles, police released Borders and no further law enforcement action was taken, according to the report.

Hospitalized in Arizona, Miles begins to stabilize

After police found her in the back of the trucker’s vehicle, Miles was sent to Kingman Regional Medical Center by ambulance to be evaluated, according to her medical records.

The records describe her as “a calm female with tachycardia (heart beat over 100 beats per minute) and dilated pupils likely due to drug use. She confirms above story that she has a house and family in Las Vegas and got here with a trucker. She has poor insight and denies history of schizophrenia.”

Booth said that Miles could have obtained drugs while at ECHO in Paso Robles but that she is often heavily medicated with lithium when admitted to hospitals, which presents physical symptoms similar to illegal drug use.

Miles didn’t actually have drugs in her system, Booth explained.

After being medically stabilized in Kingman, Miles was transferred to Southwest Behavioral and Health Services in Phoenix.

Booth told The Tribune that the social worker at Southwest Behavioral assured her they would never release Miles when she is so obviously disabled.

The physician at the hospital in Kingman told Booth that it was “gross negligence” that her daughter was discharged in such a severely disabled condition.

When Booth first tried to contact her at Southwest Behavioral hospital, Miles didn’t recognize her mother’s voice. Booth finally was able to speak with Miles by phone about five days after her ordeal.

Miles was administered antipsychotic and anti-anxiety medications at Southwest Behavioral. Booth said she sounded delusional but clear.

In an interview with the Tribune, Miles confirmed she wound up in Arizona because she hitchhiked with a trucker.

She said she wasn’t scared but wanted to sleep inside.

“I want to stay in buildings because it’s f--king scary,” Miles said.

In the interview, Miles described incidents of sexual assault she witnessed or experienced herself. It is unclear whether the incidents she was referring to were real — as she has been sexually assaulted numerous times since becoming homeless — or part of her delusions.

How to get patient from Arizona to SLO County

At Southwest Behavioral in Phoenix, Miles was safe, but only for the time being.

Her mother again was confronted with the same fear she’s been living with for years: What happens next?

Booth emailed the SLO County PHF every day of her daughter’s hospitalization, asking the PHF to contact her social worker at the Arizona hospital. Booth wanted the PHF to discuss next steps for Miles and to transfer her medical record from her most recent stay at the facility.

“We’re not gonna lose her on the streets of Arizona,” Booth said with conviction.

After about two weeks at Southwest Behavioral in Arizona, Miles saw a judge on Sept. 19 and was set to be discharged from the hospital.

The judge ordered two years of court-ordered, outpatient treatment.

But an Arizona psychiatrist who assessed Miles said she needs to be placed in a locked psychiatric facility for up to a year.

Had she been a resident of Arizona, the psychiatrist would have sent her to Arizona State Hospital, but since she is a California resident, she needs to be sent back to the state.

The psychiatrist said she cannot travel by plane, train, bus or even private car, because she poses a risk to public safety.

The state of Arizona said it would transport her as far as the border between Arizona and California, but after that, a certified mental health worker needs to take her the rest of the way back to SLO County.

Booth tried to get the SLO County PHF to arrange transportation for Miles, but due to bureaucracy between the two facilities, she couldn’t get a commitment from the facility to pick her up or even share her records with the Arizona hospital.

“If the PHF would have done their damn job years ago or even this damn month, everyone, including Ashlynn, could be safe, but once again we are all in the face of danger and for her, even death,” Booth told The Tribune via text message.

Desperate for someone to do something, Booth spoke with Robin on Sept. 27.

Booth said Robin told her that her hands are tied and state laws prevent her from sharing medical records with the Arizona hospital or picking her up without Miles’ consent.

If the PHF is unwilling to help transport Miles from the Arizona border back to the county, she’s afraid her daughter will be discharged from the Arizona hospital in a vulnerable state.

That could put her right back into the same dangerous situation once again.

Booth’s greatest fear is her daughter will be trafficked, or hitchhike with another truck driver to try to reach Las Vegas and see the children and husband she erroneously believes are waiting for her.

It’s a nightmare scenario for a mother trying to care for her child.

“You know how I end up following her? I have to wait for the next f--king hospital to call me,” Booth said. ”And now she’s going to go missing again.”

How to get help

If you are experiencing a mental health crisis or need help finding mental health resources, call the Central Coast Hotline at 800-783-0607. You may also call the National Suicide Prevention Lifeline at 800-273-8255 or text HELLO to 741-741.

Coming tomorrow: In just four years, Ashlynn Miles has been hospitalized more than 50 times. Part two of this story explores her life and how the lack of care for her mental illness has impacted her family.