Psychiatric Security Review Board Reform Moves Forward

Nevertheless, concerns about more aggressive changes to the Board persist
The Lund Report

June 1, 2011—A bill that fundamentally changes the way people are evaluated who are found “guilty except for insanity” is winding its way through the legislature, and represents the most significant changes to the Psychiatric Security Review Board (PSRB) since its inception. 

House Bill 3100 passed out of the Ways and Means Subcommittee on Public Safety yesterday, and now moves to the full Ways and Means Committee, the final step before proceeding to the House and Senate for a vote.
The bill makes four fundamental changes – among them -- certified psychiatrists or psychologists must evaluate a person who pleads “guilty except for insanity.”
“The goal is to bring some consistency and confidence to the system,” said Mary Claire Buckley, the Board’s executive director.
Those committing misdemeanor-level crimes would be removed from the PSRB’s jurisdiction, which has authority over Oregon State Hospital’s patients found “guilty except for insanity,” meaning that they committed a crime under the influence of their mental illness.
Anyone who commits a Class C felony must undergo an evaluation to determine if they can be placed in a community treatment setting and do not need hospital-level care. And those unable to assist their lawyer in their own defense trial could seek treatment in a community setting.
Currently, both of these populations are sent to the Oregon State Hospital if they need the level of care the Hospital provides.
“This bill would advance the efforts to place individuals with criminal issues and mental health issues in the most appropriate place for treatment, supervision and restorative services,” said Richard Harris, the director of the state’s Addictions and Mental Health Division.
Senate Bill 420, which advocates say would make more aggressive changes to the PSRB, failed to move out of committee
Under that bill, the Oregon Health Authority would have jurisdiction of patients at the state hospital, rather than the PSRB. The PSRB would continue to have jurisdiction of those released to communtiy settings, as well as patients at the state hospital who committed Measure 11 offenses, aggravated murder, and Arson I.
By giving such jurisdiction to the Oregon Health Authority, advocates say, clinicians and doctors working with hospital patients would have more say in determining whether someone could leave the hospital. 
“The hospital [would have] some control over who comes in and leaves,” said Chris Bouneff, the executive director of Oregon's chapter of the National Alliance on Mental Illness (NAMI). “Right now, they have no control.”
The bill came under opposition from the Oregon District Attorneys Association and the Oregon Psychiatric Association, which were not privy to a work group that drafted the legislation.
“We have, as an organization, participated in every mental health bill for the last 30 years, and we were not part of this work group,” said Dr. Joseph Blum, a psychiatrist at Oregon Health & Science University, who testified on behalf of the psychiatric association. “I don’t believe that there was one clinician [involved] with this bill.”
He criticized the bill because it didn’t clearly specifying the hearing procedure that the Oregon Health Authority and the hospital’s physicians would need to follow before releasing a patient. “It should not leave everything up to administrative rule [making],” he said.
Elizabeth Cushwa, the executive director of the district attorney’s association, objected because people could be released who posed a risk into the community.
“These are our most dangerous people,” she said.
However, Bob Joondeph, the executive director of Disability Rights Oregon, felt the legislation should move forward. 
“Why do you want to change something that has been successful for 33 years and has a two percent recidivism rate?” Sen. Joanne Verger asked him. 

“We think [the Board] has been overly restrictive, and this has been a detriment in terms of the amount of time people have to spend in the hospital,” he responded. “We are wasting resources when we do not have resources to waste.”
Since no action was taken, the bill did not move forward. It is not dead, and the Ways and Means subcommittee can still move it out of committee.
“There’s been a lot of work on this bill,” said Sen. Jackie Winters (R-Salem). “Many of us have looked forward to the day in Oregon when we actually deal with the mentally ill in a more humane way. This is just one piece of the discussion.
News source: 


--Many of us have looked forward to the day in Oregon when we actually deal with the mentally ill in a more humane way Are you deliberately being offensive? Harold A. Maio, retired Mental Health Editor

The failure of the state to involve all players such as Oregon Psychiatric Association should tell all of us that this so called new policy is all about $$(the lack of it). There will be no new magical housing in the community. I used to be on state board of NAMI and think they are making a significant mistake in supporting proposed changes. Simply shifting some tasks to Oregon Health Authority is similar to moving deck chairs on a sinking ship e.g. our failing mental health system which suffers from poor over sight,lack of enough $$ and a proper balance of all relevant parties. Michael Kaplan,M.S.(Educational Psychology)