PORTLAND, Ore. (AP) — A federal judge has ruled that the Oregon State Hospital must limit the amount of time it can hold patients charged with crimes, in a bid to create space at the overcrowded hospital for criminal defendants who need mental health treatment but are housed in jails.
The psychiatric hospital in the state capital Salem doesn't have enough personnel or enough space to add more beds but 73 defendants are currently in jail awaiting court-mandated mental health treatment before they can stand trial, according to court filings.
The historic hospital — the setting for Ken Kesey’s acclaimed novel “One Flew Over the Cuckoo’s Nest” and the location where the award-winning movie adaptation was filmed — has struggled for years with staffing and patient backlogs.
Monday's ruling by Senior U.S. District Judge Michael W. Mosman caps hospital stays at three months for people charged with a misdemeanor, six months for felony charges and a year for violent felonies including murder and rape. It seeks to speed up hospital discharges to make more beds available for incoming defendants who need treatment, but some prosecutors worry it will prematurely release patients who have yet to stand trial into communities not equipped to treat them.
The situation in Oregon is emblematic of a nationwide crisis facing mental health hospitals.
Staffing shortages in states from Arizona to Missouri to Michigan have forced providers to close psychiatric beds or entire mental health wards, diminishing the country's capacity to treat patients in need of care.
Aiming to address the issue, Michigan lawmakers in July approved a budget including $325 million for a new state psychiatric facility and about $58 million to create more beds at the state's sole psychiatric hospital for children.
In Oregon, this week's decision came in response to a complaint filed in U.S. District Court in Portland by Disability Rights Oregon, an advocacy group, and Metropolitan Public Defender, a nonprofit criminal defense law firm. The two groups, citing a “constitutional crisis,” asked the court to take steps to enforce a previous federal court order requiring the hospital to admit defendants in a timely manner.
The 2002 order, resulting from a lawsuit also filed by Disability Rights Oregon, mandated the state hospital admit defendants within seven days of being referred by a court.
But the hospital in recent years has struggled to adhere to that admission period, and staffing shortages stemming from the coronavirus pandemic have made the situation worse. Defendants “suffering from acute mental illness” have spent months in jail in violation of that order, plaintiffs said in court filings last week.
Average wait times from early to mid-August stretched as long as 38 days, among the longest they have ever been.
“Their experience waiting in jail can be horrific,” said Jesse Merrithew, the attorney representing Metropolitan Public Defender. “As a result of their mental illnesses, they’re exhibiting behaviors that the jails will punish.”
Emily Cooper, legal director for Disability Rights Oregon, said this week's ruling recognized “the value of individual patients’ lives and and a court’s authority to enforce the constitution.”
The new limits on defendant hospital stays mean approximately 100 patients are now eligible for release, Oregon State Hospital spokesperson Amber Shoebridge said in an emailed statement.
Patients will be discharged gradually over the next six months and sent back to their home counties, where a court or community health provider will determine placement. Some may be transferred to local treatment centers while others may return to county jail, Shoebridge said.
The state hospital will give counties 30 days’ notice before a patient is discharged.
The hospital, which is overseen by the Oregon Health Authority, didn’t oppose the motion.
But three district attorneys from counties in the Portland suburbs and Salem say the decision threatens public safety and hurts victims.
Mosman granted their request to intervene in the case and gave them until January to monitor the release of defendants and the hospital's admissions data.
Washington County District Attorney Kevin Barton told The Associated Press the ruling could spark a “cascade of unintended consequences.”
“When these people who are at the hospital hit those expiration dates of 90, 180 and 365 days, they just get released back to the counties with no real plan for what happens next,” said Barton, whose county includes affluent suburbs to the west of Portland.
Smaller, rural counties often lack the mental health resources that larger, urban counties can provide and might not be able adequately treat the patients being released into their communities, Barton said.
The plaintiffs' request to cap defendant hospital stays at three, six or twelve months depending on the charges against them was based on a court-ordered review of the state hospital’s admissions.
The court last year appointed an independent expert to study the hospital's capacity issues and recommend solutions. The expert report published in June estimated the caps could bring the hospital back into compliance with admissions wait times by February.
Claire Rush is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues. Follow Claire on Twitter at http://www.twitter.com/ClaireARush.
Claire Rush, The Associated Press