Oregon Health Authority Director Pat Allen said admissions at the Oregon State Hospital are moving in the “wrong direction” following a judge’s order intended to open up beds at the psychiatric facility.
Allen on Thursday updated the House Behavioral Health Committee on the implementation of a federal court order mandating timeframes on treatment for patients sent to the state psychiatric hospital for treatment needed to defend themselves against criminal charges.
The order, issued by Judge Michael Mosman in September, is intended to free up space at the state hospital and prevent patients from languishing in local jails while awaiting treatment. The hearing highlighted the shortage of community mental health programs and resources to serve patients after their release and broad concerns on the order’s feasibility.
Allen presented figures contrasting the hospital's projected monthly numbers of discharges and admissions since the order and how they played out. He told the committee that the number of discharges was “more or less” what they should be. In November, the hospital discharged 85 patients, slightly below the projected 90.
But the hospital saw 95 new orders to admit patients unable to aid and assist in their own defense, higher than the projected 74.
“Even with this accelerated discharge plan, because of new aid and assist orders being so dramatically higher we're continuing to lose ground,” said Allen.
State Rep. Rob Nosse, a Portland Democrat who chairs the committee, asked Allen what he would do if he had a “magic wand” to improve the situation.
“More of everything,” Allen responded, adding that more community-based settings were needed. He said there are “dozens” of people ready to be released to community settings but remain in the hospital.
The Mosman order requires the state hospital to release patients based on the severity of their charges. The timeframes range from 90 days for patients facing misdemeanors to up to a year for a violent felony.
Emily Cooper, the attorney for Disability Rights Oregon who asked Mosman for the order, said some patients may be stabilized with medications long enough to understand the charges they face, but will continue to cycle in and out of the system without long-term, community behavioral health services.
Meanwhile, she said people with mental illness are being sent to local jails, which she said aren’t designed for treatment and where some have died.
“This is on our watch; this isn't our state,” she said.
Lane County Commissioner Pat Farr pointed to numbers showing that over a third of aid and assist patients are readmitted to the state hospital within a year after being discharged, which he said was evidence that the system is “broken.”
Tom Crawford, political and policy Strategist for SEIU 503, told the committee that state hospital employees represented by his union have reported that the Mosman order has exacerbated problems with understaffing. He said hospital employees have reported that the facility “has never felt more unsafe than it does at present.” Hospital workers have called the 90-day timeframe to treat some patients unrealistic and that it takes 30-days along for some to detox, said Crawford.
Kevin Barton and Paige Clarkson, the respective district attorneys for Washington and Marion counties, told the committee they remained alarmed that people charged with violent felonies were being returned to the counties where they were charged.
“Our public safety systems are, frankly, just left to piecemeal and problem-solve county by county,” said Clarkson.