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Finding a Home for the Criminally Insane

AIR DATE: Wednesday, February 13th 2008
Download the mp3 for this show.
What should we do with Oregon's criminally insane?

If someone who was judged criminally insane moved in next door to you how would you react? This is an issue many people across the state -- and especially in Salem -- are wrestling with today.

The Oregon State Insane Asylum opened there in 1883. The building still stands today -- in great disrepair -- and is now known as the Oregon State Hospital. It is home to approximately 740 people, all of whom have serious mental illness. Seventy-five percent of the patients have committed crimes and have been judged "guilty except for insanity." These are people whose criminal histories range from shoplifting to sex offenses and murder.

The U.S. Justice Department recently investigated the hospital and reported that "care and conditions at the Oregon State Hospital threaten mental patients' safety and their constitutional rights." The problems include mice in patients' rooms, scabies outbreaks, and the failure of staff to clean up "messes" in seclusion rooms.

The reported care horrifies many, but the building in which the care takes place can be seen as almost as bad -- or worse. It's so bad, in fact, that state lawmakers decided it was time to build new facilities in two locations: a 620 bed psychiatric hospital on the current hospital campus, and a second 360 bed facility in Junction City.

The State claims they have had many conversations with local stakeholders about their suggested plans. But now the mayor of Salem and other community officials say they don't want the large psychiatric hospital in their neighborhood. They say it brings crime, social problems, and a bad reputation to their hometowns.

They want smaller facilities scattered around the state to care for these people. But meanwhile in Cornelius, Milwaukie, and Albany community members are fighting the placement of group homes for the criminally insane in their neighborhood.

So in whose backyard should these mentally fragile people be housed? Should one city take all of them? Or does each community hold a certain responsibility to care for these people? Is a large institution the way to care for them? Or are small group homes in community centers a better way to go?

Note: If calling in to a radio show or commenting online isn't enough, the Department of Human Services is looking for public input on the State Hospital Replacement Project. They're holding a community forum (pdf) in Salem on Wednesday night from 5 to 8 p.m. at the Salem Conference Center.

Photo credit: Pete Springer/OPB

GUESTS:

SPOKANE, Wash. (AP) - Authorities have put out a statewide alert for a mentally ill killer who escaped during a hospital field trip to a county fair, leading to fears that he'll become more unstable and potentially dangerous the longer he is on the loose with no medication.Sgt. Dave Reagan of the Spokane County sheriff's office says Phillip Arnold Paul remained at large Friday and officials believe he's headed to Sunnyside, the town where his parents live. Anyone spotting him should call 911 and not try to confront him.Paul was committed after he was acquitted by reason of insanity in the 1987 slaying of an elderly woman in Sunnyside. He soaked the woman's body in gasoline to throw off search dogs and buried the remains in her flower garden. He reportedly said voices in his head told him she was a witch.He was caught trying to escape four years later, only to knock a deputy unconscious in the booking area following his arrest.The 57-year-old Paul escaped Thursday during a supervised outing to the Spokane County Interstate Fair for patients from Eastern State Hospital. Thirty-one patients from the mental hospital were on the trip with 11 staff members.Local officials and fairgoers said they were stunned that mental patients, including at least one with a criminal past, would be taken to the fair."I think it's wrong, it's totally wrong," said Jennifer Craig, who was visiting the fair with her husband and grandchildren. "You're putting too many kids and old disabled people like me at risk."Patients must be cleared by a treatment team of six to 12 clinicians according to an extensive checklist before they can go on field trips to stores, parks, ball games, fairs and other sites, said hospital spokesman Jim Stevenson said. They wear street clothing and need not all stay together, but staff members are required to keep each patient within eyesight at all times."They have gone to the county fair in past years," said hospital spokesman Jim Stevenson.Hospital CEO Harold E. Wilson told The Spokesman-Review Paul had been "a fairly model patient."The escape led state Department of Social and Health Services Secretary Susan Dreyfus to order an indefinite halt to all outings involving criminally committed patients at the state's three mental institutions.
dat5racer —

  I guess the people who support the placement of these "people"..have never talked to a victim(if their alive)or a 3 yr old little girl raped by the guy who was placed in a "group home" in  Corneilus Ore.

  The same people refuse even the smallest suggestion on how to make it safer...my question...who then are the real nuts?

dat5racer —
I am psychologist at Oregon State Hospital. There is no question in my mind that most of the staff at OSH are doing the best job they can with the appallingly inadequate resources they are given. In addition to the decaying buildings, the hospital is seriously understaffed, principally because low pay scales make recruiting difficult. Information technology (including computers for most staff) is a recent innovation, and far from state of the art.

There is no real debate among mental health professionals about the broad outlines of what an effective mental health system would look like. It would probably consist of several smaller hospitals around the state--perhaps a 300-bed facility in Portland, one of similar size in the Eugene area, 200-bed hospitals in Salem and Roseburg, and a 150 bed facility east of the Cascades, in Bend or Klamath Falls. It would also include secure residential treatment units with 10 to 20 beds in most towns of any size, group homes in every community for patients needing less supervision, and comprehensive outpatient care throughout the state, including supported semi-independent housing. While this might be more expensive in the short term than warehousing all the severely mentally ill in a mega-hospital in Salem, it would be less expensive than relying on the criminal justice system to serve as a surrogate mental health system, and would in the long run reduce the expense of long-term hospital care for hundreds of patients by preventing relapse and recidivism.

The loaded phrase "criminally mentally ill" is misleading, and conjures up an image of violent psychotics. A large number of patients at OSH are charged only with misdemeanors, and are dangerous to no one but themselves. Their crimes may include disorderly conduct (such as wandering around on freeways because they are disoriented), vagrancy, trespassing (such as sleeping in vacant buildings because they are homeless), urinating in public (because they have nowhere else to go), stealing small food items because they are hungry and have no money, and so on. Local jurisdictions charge them with as many crimes as they can and send them to OSH because then the state, rather than the county, pays for their care. Many of them never become lucid enough to stand trial, and serve a maximum sentence on exaggerated charges, after which they are discharged back to a community that still refuses to provide care and treatment.

The responsibility for this situation does not lie with OSH as an institution, much less those who work there. It lies with the Oregon legislature and the voters who elect them, Oregonians who deny adequate care to their most vulnerable fellow citizens on the grounds that it is too expensive. This is penny wise and pound foolish--taxpayers pay far more in the long run by denying care and paying for the consequences of mental illness than they would by supporting good mental health systems.

I also wonder how Mayor Taylor would feel about losing the 600 jobs that would depart from Salem along with half the patients, but that's another letter.

Tim Connor, Psy.D.
TAConnor —
Tim, thank you so much for sharing your experience and opinion. I produced this show and have been agonizing over what term to use -- if "criminally mentally ill" or "criminally insane" is not correct, in your mind, what is?
Sarah Jane Rothenfluch —
Jane, consider using the term, "person with mental illness" as you would "person with leukemia." When you say, "mentally ill person," you make the illness singular the quality of the person. A parallel would be, "cancer person" or "leukemia person."

The same is true of people with mental illness who have committed a crime.

The word "insane" is obsolete and pejorative. Using this term creates stigma which acts as a barrier - especially for young people - to accepting and receiving treatment. If you support treatment for this illness, recognize language matters - especially if you're a person with a microphone or a press.

For more information about advocacy at the Oregon State Hospital, see http://www.mentalhealthportland.org/patient-remains.html
Jason Renaud —
Thank you so very much for your work and right on the money comments....our family experiences with the system have been a nightmare....and our son has the benefit of a family who will intervene and work as case managers if necessary...how many other families have this experience? Benton County cut funding and we became case managers.....every step of the process, for ten years, has been incredibly difficult....from the ACLU, old facilities, continually changing staff, old medications used to save money, Social Security, Pendleton, Salem, Klamath Falls.....all of it...is broken. As a State we made the decision to close Dammasch and integrate (to save money)....and the State is full of NIMBYS...until one points out to other locals that released criminals are all over the City....

the first thing one sees when one enters EOPC in Pendleton....the restraint room.

What about a single system? How about the same doctor for maybe, six months?
How about the same support staff for a year?

I do believe in the end we will be judged by how we treat weaker members of our society....and thank you for your work Tim.
JAMISON LEE —
The current State Hospital harms neighborhoods as well as patients. Relocation should go hand in hand with reform>

Bill Dixon
Salem
Bill Dixon —
I think Salem's officials should be ashamed of themselves for "jumping" at the chance to be rid of this responsibility. Where do they suppose we place this faction of our society? They should cry for more resources rather than to be rid of this "pesky" problem.
CasandraMShannon —
My family owns a home adjacent to the Oregon State Hospital. In the time we have lived here, we have not experienced any problems whatsoever. My concern is not that the Hospital is here (obviously we would not have purchased our home if it was), but that the redevelopment plan respect the existing integrity of the neighborhood. On the west side of the OSH campus there is a beautiful park that is used by many people in the neighborhood. In fact, it is one of the few green spaces in the area.

My primary concern is the prospect of having a multi-story barracks errected on that site. If there is to be a 600 bed facility on the current OSH land, I hope the OSH develops a plan that integrates the facility into the landscape and makes it as unobtrusive as possible.

Studies show that the people are more and more interested in living in downtown environments that are walkable. The neighborhood adjacent to the OSH is within walking distance of downtown, with older homes. The character of this area should be preserved. If it is destroyed by irresponsible development, that would be a grave loss for the City of Salem.
rachelb —
Much of the current overcrowding in mental health facilities could be eased with better programs for transitioning patients. I have repeatedly watched my brother get pushed out of programs and housing as he reached a level of competency, only to fail without that support and end up back on the bottom rung of the system. If we funded more support, programs, and housing to help the mentally ill transition or sustain themselves in society we'd have less recurring patients.
Laura in PDX —
I am a person who lives with mental illness and has spent almost nine years in the mental health system in Oregon. The firt ten-months after my breakdown, I spent in Washington County Jail. From the jail I was transported to the State Hospital where I was incarcerated for two years. There is nothing theraputic about our state hospital and after being discharged from the hospital, I spent several years in therapy trying to recover from the ordeal.
I am pleased to hear a professional express the same opinions I have about ways we can "fix" the system. The thousands of dollars it costs the state to house one person at the Oregon State Hospital for one month, would go a long, long way in supporting a group home out in the community.
I'm now the Executive Director of a large drop-in center that is one hundred percent operated by the people with mental illness that use the drop-in center. The majority of people with mental illness just need a chance to build solid lives for themselves and to feel hopeful that they can become members of the community.
I'd like to see another show on mental illness that actually talks with people who live with mental illness. You aren't going to learn about mental illness by talking to the politicians and bureacrats.
NonaClarke —
I am very concerned that yesterday's show on OPB about mental health did not include the voice of mental health consumers, psychiatric survivors, or any of their groups. I understand the producers did try to get the great Dave Romprey on the show, but he was out of town.

But I know of dozens of mental health consumers and psychiatric survivors who would have been good on that show as a guest. Plus, during the call-in, I was on hold for half an hour, and a decision was made to put other newer callers on, even though I called with a perspective from the mental health consumer/psychiatric survivor community.

Could this have happened on any other issue? Could you see an OPB show on immigrants, gays, women, labor, with no guest -- OR CALLER -- from the immigrant, gay, women, or union communities? None? Zero? Nothing? I talked with the folks at OPB, and I realize they care. But what a perfect symbol of how incredibly disempowerred this community is! And ironically, half an hour later, I was on KBOO-FM for a half hour interview about these topics.

I so much appreciate alternative media. This is my 32nd year working in mental health and human rights, and I'd say mainstream media have been one of the main OBSTACLES in this field. Over and over again, mainstream media runs stories on mental health that amount to eight words:

The system is broke, give it more money!

This has been the theme of the mental health system since the 1800's, actually. Scandal after scandal plagues the mental health system... and the answer is always more and more and more and more money.

It's time to STOP. Yes, more money can be important. But LISTEN to those who have been on the receiving end of mental health care abot what REALLY needs to change. We need more than reform in mental health care, we need a nonviolent revolution.

Those interested can see our web site http://www.mindfreedom.org. We are one of the few totally independent groups in mental health. See in our calendar of events in lower left hand corner that tomorrow (Fri., 15 Feb.) we have an event in Multnomah County Public Library on this topic at 3:00 pm. Also use the internal search engine to search for OCSC, and you'll see a state wide coalition is forming of about 14 mental health consumer and psychiatric survivor groups.

May the show yesterday be the last time OPB silences the voice of consumer/survivors. I know another part of OPB is doing a series on mental health, and including that voice. But please everyone, let's learn from yesterday. What other constituency would be talked ABOUT without hearing FROM them? The disability motto is NOTHING ABOUT US WITHOUT US, let's all rally behind that. I know everyone was well meaning here, but what an incredible disaster, and what a perfect and frustrating illustration of the disempowerment in this field.

Folks can contact me if they would like more info at the below.

Thanks,

David



David W. Oaks, Executive Director
MindFreedom International
454 Willamette, Suite 216 - POB 11284
Eugene, OR 97440-3484 USA

web: http://www.mindfreedom.org
email: oaks@mindfreedom.org
office phone: (541) 345-9106
fax: (541) 345-3737
member services toll free in USA: 1-877-MAD-PRID[e] or 1-877-623-7743

United Independent Activism for Human Rights in Mental Health!

MindFreedom International is a non-profit coalition with a vision of a non-violent revolution in mental health. Accredited by the United Nations as a Non-Governmental Organization (NGO) with Consultative Roster Status.

Join now! http://www.mindfreedom.org/join-donate

"Human salvation lies in the hands of the creatively maladjusted." - Martin Luther King, Jr.



davidwoaks —
Why do we stigmatize these unfortunates as "criminally insane?"

Dianne Farrell
Corvallis
diannefarrell —

Click here: Police: Man tried to kill everyone in church - Crime & courts- msnbc.com   OH DIANE..... HERE IS ONE REASON. 

dat5racer —

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