This article has been updated to incorporate additional reporting.
Saying state officials remain out of compliance with a 2002 ruling intended to protect the civil rights of people experiencing mental illness, a federal judge has ordered further changes to how the state’s major psychiatric facility, the Oregon State Hospital, handles admissions and discharges.
A lack of beds for those committed to the state hospital has increasingly become a major bottleneck, causing patients to be housed in jails as well as hospitals for long periods of time without adequate care, violating their civil rights.
The problem has spilled over into the courts, sparking additional filings in long-running litigation over the state hospital as well as numerous related lawsuits and filings. A particular focus are “aid and assist” patients, who are patients facing criminal charges who need treatment to restore their competency to aid and assist in their legal defense — a group that has soared in number even as the number of civilly committed patients has dwindled to a trickle.
On Monday, U.S. District Judge Michael Mosman ruled on motions the state and advocates with Disability Rights Oregon and Metropolitan Public Defenders (MPD) filed, amending a controversial order he’d issued last September.
His order last fall set a deadline for patient stays in an effort to unjam the bottleneck at the hospital. But the new rules sparked criticisms from behavioral health advocates and prosecutors who argued that the deadlines could cause people to be discharged to communities while they still posed a danger to themselves or others.
Under Mosman’s initial deadlines, aid-and-assist patients could stay at the hospital for up to 90 days if they face a misdemeanor, six months if they face a felony charge or 12 months if they face a violent felony charge.
His new order, however, makes two changes: first, that only people charged with felonies or misdemeanors involving harm to others will be ordered to the state hospital for treatment to restore them to competency. Second, that if a prosecutor is concerned about the imminent release of a person charged with a violent felony, they may petition the court to continue keeping them at the state hospital, rather than discharging them.
The change admission policies around people charged with misdemeanors will make a small but significant reduction in demand for beds, according to Emily Cooper, legal director for Disability Rights Oregon, which is among the groups that have sued the state What may be even more powerful, she said, is that it amounts to a “real recognition” by system partners that houselessness or the offense of “vagrancy” should not be considered crimes.
“This mediation and a resulting order shows how Oregonians from across the spectrum came together, key stakeholders, to craft a solution so that we're all working together. And that is not something you typically see in litigation,” she added.
The new ruling could help the state move further toward compliance with the 2002 order requiring that aid-and-assist patients be admitted within seven days.
A top state hospital administrator recently told lawmakers that the facility was already making progress. In December 2022, people coming into the hospital were waiting in jail for an average of 39.2 days, but the number decreased to 16.9 days by May. The latest numbers are even below that, according to Cooper.
A state spokesperson attributed the judge’s order to settlement conferences that Stacie Beckerman, a federal magistrate judge, assisted. David Baden, the interim director of the Oregon Health Authority, in a statement thanked the state and local agencies, as well as advocacy groups, that worked on what he characterized as a “significant compromise.”
