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NAMI Oregon argues court orders have excluded civilly committed patients

The advocacy group made the argument as it backed a federal court appeal by hospital systems who say they’re being saddled unfairly with civilly committed patients.
Oregon State Hospital in Salem. | JAKE THOMAS/THE LUND REPORT
January 9, 2024

The National Alliance on Mental Illness Oregon has aligned itself with four of the state’s hospital systems, arguing in a court filing that the Oregon Health Authority “is shirking its constitutional and statutory obligations to civilly committed patients.”

The advocacy group filed the brief last month in federal appeals court, arguing that the hospital systems — Legacy Health, Providence Health & Services, PeaceHealth and St. Charles Health System — should be allowed to revive a lawsuit alleging they’re being forced to warehouse civilly committed psychiatric patients with nowhere else to go. 

Chris Bouneff, executive director of NAMI Oregon, told The Lund Report that his group decided to get involved because civilly committed patients have been left out of a recent federal court order that reshaped access to the state’s scarce mental health resources.  

“If we’re really going to honestly look at the population in need, and a population whose liberties are being impinged upon, we need to look at that whole population,” he said. “Because decisions are being made that really impact all people living with serious mental illness.” 

U.S. Judge Michael Mosman in 2022 issued a sweeping order that set discharge deadlines for how long the Oregon State Hospital could house so-called “aid and assist” patients, who are considered unable to help and participate in their defense because of severe mental illness. 

The order is credited with opening beds for aid and assist patients at the psychiatric facility and preventing them from languishing in jail. However, detractors blame it for straining the system elsewhere and creating new access challenges for other populations. 

Last spring, Mosman threw out the hospital system’s lawsuit after concluding they didn’t have legal standing to bring it on behalf of their civilly committed patients. Mosman wrote in his order that Disability Rights Oregon, which has driven now decades-old litigation over state hospital admissions, is better suited to advocate on behalf of civilly committed patients. 

Bouneff said that Disability Rights Oregon is “making arguments that need to be made” and that people who need services shouldn’t languish in jail. But he said his organization also has a role to play as an advocate for people experiencing mental illness. He pointed out that services for aid and assist patients are intended to restore them to the point they can face charges —which are not  “long-term health goals.” 

Bouneff said the state is obligated to deliver medically necessary services to people who have been civilly committed because of a mental illness who have not been accused of crimes. 

“Without that voice at the table, decisions are being made that don’t take that into account,” he said. “And the idea of our brief is just to support the notion that civil commitment, patients need to be part of the conversation too.”

The brief argues that the interests of the hospitals and civilly committed patients are aligned because if the lawsuit succeeds it would mean “more hospital beds for individuals with severe mental illness who have short-term, acute-care needs.”

It also pushed back on an argument made by attorneys for the health authority earlier that the hospitals could refuse to take civilly committed patients. 

“It is inexplicable for OHA to contend that hospitals can prevent their injuries by releasing these individuals to the street. It would mean that many individuals subject to a civil commitment order would receive no care, because OHA is not providing any,” reads the brief. “If the (hospitals) adopted OHA’s position, then it would only exacerbate the harm caused by OHA’s failure to follow the law, and could be a death sentence for individuals for whom a court has found there to be a ‘highly probable’ threat of harm to themselves.”

Disability Rights Oregon CEO Jake Cornett responded with a brief statement that read, “We stand by our court filings in this case as an organization that represents people with mental illness.”

You can reach Jake Thomas at [email protected] or via X @jakethomas2009.