This article has been updated with additional reporting.
A second mental health advocacy group is seeking a foothold in a lawsuit that accuses the Oregon Health Authority of foisting civilly committed patients on hospitals that are unable to properly care for them.
The Mental Health Association of Portland on Friday asked for formal status in the suit, arguing they are better suited to advocate for these patients after hospitals and the health authority failed to meet their needs. If a judge grants the association’s request, it would mean a new player in ongoing litigation over Oregon’s scarce mental health resources and a new source of pressure on state officials.
The issue is expected to again be a priority for lawmakers as they gather in Salem next month for a session that will last until June.
Jason Renaud, a board member for the mental health association, told The Lund Report that he does not expect the litigation nor the underlying problem to be resolved by the end of the session. In the meantime, he wants his group to have a say in court proceedings.
“Oregon has a long history of talking about the problem and not solving it,” he said.
In civil commitment cases, a court determines whether a person’s mental health makes them a danger to themselves or others before authorizing the state to confine them for treatment.
In its filing, the mental health association indicated that it would use its formal status in the litigation to advocate for establishing additional “step-down” treatment settings. That would reduce the need for civil commitment, an exacting legal process.
“The private hospitals shouldn’t have to keep people long-term, and the state hospital doesn't have room,”
Those alternative options would include respite homes, acute detoxification, secure residential treatment facilities and transitional housing, according to the group.
Oregon currently faces a shortage of those services, which lawmakers have tried to overcome with record spending in recent years. Meanwhile, the Oregon State Hospital, as the result of a court order, admits predominantly patients who have been accused of crimes and need treatment to face prosecution.
That has left private hospitals to care for civil commitment patients. Two years ago, Legacy Health, PeaceHealth and Providence Health & Services sued the state for failing to provide adequate treatment options. St. Charles Health System later joined the litigation that a judge struck down and is now back after a successful appeal. The health authority is contesting the lawsuit as baseless.
The mental health association’s filing claims that patients languish in “a purgatorial state” because neither the hospitals nor the state officials “adequately address the needs of people with mental illness within the confines of this case.”
The hospitals “lack sufficient equipment, staff, and procedures to meet their obligations to civilly committed patients,” according to the association’s filing to intervene in the case. Specifically, they lack education vocational opportunities, outdoor facilities, cafes and other amenities present at the state hospital to help patients recover, the filing states.
Both the hospitals and the state have made valid points in previous filings that the court needs to sort out, Renaud said.
“The private hospitals shouldn’t have to keep people long-term, and the state hospital doesn't have room,” he said.
The mental health association’s filing describes what this has meant for patients confined to restrictive settings for, at times, over five months.
One patient was only allowed to walk outside his room for 10 to 15 minutes a day, could not go outside for fresh air and had to wear scrubs every day. Another patient cried in a small room because he wanted to leave. A pregnant patient was put in the most restrictive setting possible for more than four months. Another patient was confined to 96 hours in seclusion.
Those concerns echo an earlier filing from the National Alliance on Mental Illness Oregon that similarly asked the court to grant the group a formal role in the hospitals’ suit.
Authored by Juan Chavez, an attorney with the civil rights nonprofit Oregon Justice Resources Center as well as Michael Fuller and Nate Haberman of the Underdog Law Office, the filing appears to take a more assertive stance than NAMI Oregon.
Specifically, the filing claims that the hospitals’ interest is primarily financial and names them as “cross-defendants” along with the health authority in a complaint the association intends to bring.
The group’s proposed complaint accuses the health authority of violating civil commitment patients’ right to due process, as well as the U.S. Supreme Court’s Olmstead decision that requires people with mental illness to receive care in community settings. It asks for an order directing the health authority to immediately create “step-up and step-down facilities” for people experiencing a mental health crisis.
A spokesperson for the hospitals declined to comment on the mental health association’s filing. Chris Bouneff, executive director of NAMI Oregon, also declined to comment further.
Federal Judge Adrienne Nelson, who is overseeing related litigation concerning the state hospital, will decide whether to grant formal status to the mental health association. Nelson has yet to schedule a hearing on the filing.