Here Are Some Quick Fixes for the Crisis at Oregon State Hospital

On Friday, a trio of judges laid out all the ways Oregon’s system for providing psychiatric care to criminal defendants has failed. Today, an outside expert issued a report explaining how the state can fix it—and fast.

The crux of the problem: Judges are sending more and more criminal defendants to Oregon State Hospital for treatment, and administrators can’t keep up. The result is that people are spending upwards of 25 days in jail waiting for a psychiatric hospital bed. The state is under court order to keep the wait under seven days.

The state has tried releasing people from the hospital early and investing more money in treatment services. Neither, so far, has worked.

“That record numbers of restoration orders have so greatly tipped the balance away from compliance is concerning. Recidivism of the population remains too high, and the effectiveness of community restoration remains uncertain overall,” says the University of Michigan’s Dr. Debra Pinals, the outside expert brought in to analyze the state’s progress in meeting that seven-day goal.

But, she says, the state has some quick fixes at its disposal. Her report offers a laundry list of recommendations, including several “that can be executed within current staffing, budget and statutory schemes.”

Hire more evaluators. The problem, Pinals says, boils down to “flow.” The state needs to get people into and out of treatment faster. In order to get people out, they need to be evaluated to ensure that they’re sane enough to stand trial. But right now, the state faces a backlog of nearly 300 evaluations. That, she says, could be fixed at minimal cost by simply hiring new evaluators—and tightening vague laws that make it too easy to avoid coming to definitive conclusions.

Get money out the door. The state is sitting on nearly $10 million in grants to build new secure treatment beds that are waiting to be finalized. “If partners are able to add these new beds, they should create additional placement opportunities for OSH discharges,” Pinals notes. But, as WW has reported, the problem isn’t just money but red tape.

Increase oversight. A decade ago, the state had an oversight team dedicated to improving flow through the state’s residential treatment system. Pinals says the state can and should bring it back. The Oregon Health Authority “currently has five positions that may be repurposed for this team,” she notes.