Oregon State Hospital Population Down, But Could Rise with Winter

The number of people sent to the state hospital pending criminal trials has declined from its alarming peak in 2016, but this population is still too high, with counties sending people who don’t belong there and limiting the hospital’s ability to serve the most critical cases, an Oregon State Hospital official told lawmakers this week.

“These are folks who are not competent to stand trial,” said Arthur Tolan, the director of hospital systems and analysis at the Oregon State Hospital.“They are sent to the state hospital when they could stay in the community.”

Tolan said the sustained high census of this group of patients  -- known as the “aid & assist” population -- has forced people with civil commitments to sit on a waiting list, even as their mental condition makes them a harm to themselves or others.

The aid & assist group, while disturbed, are often nonviolent and accused of minor crimes like trespassing and public urination. “There was one case who was there for ‘malicious littering,’” said Rep. Mitch Greenlick, D-Portland, who has been a chief critic of the overuse of the state hospital for this class of people.

People designated for the aid & assist group are placed in the state hospital in front of those who have more serious mental health problems, per a state statute that dictates that the hospital receive these patients in seven days to stabilize their mental health condition so that they can be considered sane for their criminal trial.

Once committed, the aid and assist patients stay a median of 72 days, at a cost of $86,000 per patient, as per-day costs at the hospital is $1,200 on average.

The population of this group peaked at about 240 patients last winter and has now stabilized at about 190 patients. But patient counts have been rising in winter and falling in summer, and it’s unclear whether the hospital aid and assist group will remain under 200 this winter. And five years ago, the hospital housed only about 100 such patients.

A task force continues work on this issue, helping county governments with diversion tactics, including better case management, coordination with community crisis centers and assistance with basic needs and housing.

The winter rise is a likely indication that the hospital’s troubles are related to Portland’s abject failure to address rising housing costs and homelessness. As the weather turns foul, police are more likely to take pity on mentally ill homeless people and board them in the state hospital rather than encounter them again and again committing petty crimes.

A 2016 analysis from The Lund Report showed that almost all of the growth in this population is coming from just one county -- Multnomah.

“The community sees these people over and over,” Tolan said. Arresting them “is the quickest door” into the hospital, “and so it's used most often."

Chris may be reached at [email protected]