Four of Oregon’s largest hospital systems are suing the state over a system that “ignores” people with severe mental illness who have not committed a crime.
PORTLAND, Ore. — In Oregon, there are two ways a person with severe mental illness may be forced to receive treatment and care.
The first path is through a process called a “civil commitment,” which allows doctors and judges to order involuntary treatment if they determine that a person is an immediate danger to themselves or others.
The second path is through the criminal justice system. A person can commit a crime, be arrested, and then be examined and sent from prison to the Oregon State Hospital for mandatory treatment and possible recovery if it is determined that they are unable to assist in self-defense. will be transferred to a facility such as
Over the past five years, the “private” or preventive care route has all but disappeared in Oregon.
“The system doesn’t really treat people in the non-criminal parts of the system and it’s easy to criminalize them,” said Lisa Daly, the nonprofit’s executive director. treatment advocacy center, researching commitment laws by state. “(Oregon) is going in the wrong direction.”
And four of the state’s largest hospital systems are suing the Oregon Health Authority for “neglecting” civil commitment patients as treatment for acute mental illness is left to local agencies.
RELATED: Providence, Legacy, PeaceHealth sue Oregon over mental health care treatment
Bed reduction and court order
Nationally, the number of beds in state psychiatric hospitals has been declining for decades, and for the past 15 years, the proportion of beds occupied by criminal patients has exceeded the proportion of beds occupied by civilian patients, according to TAC.
This shift reflects a system that waits for people with severe mental illness to commit crimes before requiring treatment, and perhaps nowhere in the country is this shift more evident than in Oregon. Probably.
Oregon State Hospital reported in 2018 that it split care almost evenly between three major patient types, including civil involvement, aid and support, and psychiatric safety review boards. The last refers to people who have been convicted of crimes “other than insanity” and are in state custody, rather than those awaiting trial.
However, incarcerated patients with severe mental illness (and their rescuers) were waiting too long for care or transport, violating national standards.
In 2019, a judge ordered the Oregon Health Authority to comply with a federal order and transfer incarcerated severely mentally ill patients to a state hospital within seven days.
Forced by this court order, OHA began prioritizing criminal justice cases and drastically reduced the number of civilian patients it admitted to free up bed space.
Related: Court ruling requires Oregon State Hospital to toe the line between patient rights and public safety
By 2021, civic engagement in Oregon had all but disappeared. As a result, long-term mental health care is often only available to those who have committed serious crimes.
“It just keeps getting deeper into the hole.”
Beyond the protection of the state, people with severe mental illness often end up in and out of acute care hospitals and community-based options that are ill-equipped to provide sustained treatment, playing a dangerous waiting game. linked.
“They have been abandoned and forgotten by the state,” says Melissa Eckstein, director of the Unity Behavioral Health Center, a go-to source for mental health treatment in Portland.
Eckstein told KGW that Unity used to send about 400 people a year to state hospitals for treatment. Currently, Unity only sends in “a handful” each year, as it prioritizes admitting criminal patients.
“Our treatment teams are in a really difficult situation because what they believe will help the person live their most fulfilling life and maintain stability is not available to them. Because there isn’t,” Dr. Eckstein said.
When asked if Unity had other options outside of Oregon State Hospital to transfer these types of civilian patients, Eckstein replied: “At this point, there really isn’t.”
KGW has shared stories of people and families searching for answers within the system.
Eric Gardner’s family said he was unable to receive mandatory care and is now homeless. Unaware of his illness, Kenny Benton first sought treatment after threatening his girlfriend’s mother with a knife. Brett Meister also committed four civil charges, but each time he was released he was unable to get help resigning.
According to OHA, in 2023, Oregon State Hospitals admitted 1,209 patients on treatment and recovery orders to assist and assist in their own pending criminal cases. The hospital admitted only 15 civil commitment patients that year.
“Every month that passes, it feels like we’re falling deeper and deeper into the hole,” Eckstein said.
Eckstein said severely mentally ill patients with nowhere to go “occupy very important and limited community-based hospital beds.”
In contrast, four of Oregon’s largest hospital groups, Legacy (including Unity), Providence, PeaceHealth, and St. He is suing the OHA, accusing it of neglecting the care of a severely mentally ill person. People in acute care hospitals.”
A federal judge ruled against the hospital system, and the hospital is appealing that decision, with a hearing scheduled for May 8.
Last in the nation
When compared to other states in terms of civil commitment standards and admissions, Oregon We become increasingly isolated.
a Treatment Advocacy Center Survey Oregon was found to use 7% of the state’s available psychiatric bed space for civil cases rather than criminal cases. The state ranked last among states that allow civil participation. The national average for private patient occupancy is 48%. According to TAC.
“Essentially, you’re creating a system where people only receive care in the most expensive and least effective settings,” Daly said.
Daly told KGW that society would not tolerate this system of pre-crime care in other types of medical care, and asked why those of us with mental illness should have to.
“We’re creating a system where care is based on the idea that there has to be a victim,” Daly says. “I don’t think it makes sense, and I don’t think most people would agree that that’s what they want.”
Washington County District Attorney Kevin Barton told KGW that Oregon’s civil commitment process is “broken” and that the standards are so high that the judicial system has to intervene as a last resort. Stated.
“That’s often the only path a person has toward some level of mental health treatment, and that’s a ridiculous way to approach this problem,” Barton said.
Barton said all levels of government and health care believe there is a serious problem, but there is little incentive to make fundamental changes.
“There is a lack of political will, a lack of leadership to actually address the problem,” he said. “Instead, we’re creating workgroup after workgroup…but nothing is really happening to solve it, and we’re finding it very frustrating.”
This is the second part of a three-part KGW “Uncommitted” series that explores how Oregon has effectively criminalized severe mental illness over the past five years, often mandating treatment. Waiting for an individual to commit a serious crime. This report will air during this week’s broadcast of KGW’s The Story at 6:30 p.m.
Part 1: A Portland couple tried everything to get their son treated for his mental health.then killed her mother
