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The troubles at the Oregon State Hospital (OSH) have been well documented — on our show and elsewhere. A new superintendent has been at the helm for about six months now. What's going on with the Salem mental institution in terms of patient care and new facilities? We'll speak to Superintendent Greg Roberts for the hour and take your questions and calls.
What would you like to ask him? Have you worked or spent time at the Oregon State Hospital? Have you cared for patients who later were admitted to OSH? What do you want to know about the state of the State Hospital?
GUEST:
- Greg Roberts: Superintendent of the Oregon State Hospital
Tagged as: greg roberts · mental health · oregon state hospital
Photo credit: Pete Springer
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I just heard the show, and I'm so glad that guests and host Emily Harris brought up Bob Whitaker's book. However, I'm concerned about the replies from Greg Roberts. I did get on the show and here are my 3 main comments in brief:
1) INDIVIDUAL CONSUMER VOICES
Thank you Emily for including the voices of individual mental health consumers right at the top of the show. I think this really humanizes those of us diagnosed with psychiatric disabilities.
2) GROUP VOICE
So my question was about the priority of including representatives of GROUPS of mental health clients. I mentioned that today Oregon Consumer/Survivor Coalition unites about 14 groups (I'm on OCSC board).
I also plugged MindFreedom International, based here in Eugene. I've been director for its 25 years.
3) CONCERN ABOUT INFLUENCE ON GREG ROBERTS
Because our groups don't have as much influence with Greg, I'm concerned about whether bullying by the old fashioned, disproven medical model is unfairly impacting him.
On the show, Greg claimed that people in Oregon State Hospital are NOT over-drugged. He said there was fair due process about forced drugging. He said while he was not a clinician, he felt the majority of patients should be on psychiatric drugs, and that psychiatric problems were like diabetes.
Wait a minute! Countless people have seen massive over-drugging to this day in Oregon State Hospital, it's the main approach used. Forced drugging "override" requests are easily and routinely rubber stamped. And if the majority of people in OSH have a mental "illness" similar to diabetes, then is there a lab test for any known mental health problem?
I asked twice about the lab test, and Greg did not answer.
I ended by saying that listening to him felt like hearing an administrator for the Fukushima nuclear power plant, the day before the Tsunami. We'd be told by the administrator that he's not a nuclear engineer, but he's sure things are safe.
I especially appreciate that Sarah Smith, whose daughter has recently experienced over-drugging and forced drugging at OSH, had the last question. Sarah is a mom with a lot of courage. She asked about "Open Dialogue," but Greg thought she meant talking with family organizations. Sarah was referring to the alternative in Finland discussed at the end of Whitaker's book, that is showing far better results than the over-drugging approach.
I hope all reading this connect up! You can contact OCSC at oregon.united@gmail.com. Contact MindFreedom at office@mindfreedom.org. Thanks.
David W. Oaks, Eugene, Oregon
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I am a certified Reiki 2 practitioner and have seen the wonderful calming and healing effects Reiki can provide, especially for calming and centering the mind and body. I would like to ask Greg Roberts if patients can receive Reiki while at OSH? Would he be open to doing a pilot program on the patients the staff feel might benefit from such a treatment? I would be happy to provide services pro bono and set up a study to demonstrate the effectiveness of Reiki treatment using the PHQ-9, GAD-7, MDQ, etc.to determine baseline before each session and see if there is a change immediately following each treatment. I believe this kind of study would be easy to set up and carry out and that Reiki would help patients to be discharged sooner.
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I have spent fair time in hospitals because of my sport and I want to ask Greg Roberts what treatments they use for trauma related injuries and do they have the latest technology for finding and diagnosing ilnesses?
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Hi Cocoburra,
Do you mean trauma related injuries as they might relate to mental illness? Or how the OSH handles trauma injuries if/when they happen to people staying there?
Thanks,
Emily -
Good Point, Emily, as the Oregon State Hospital focusses on MENTAL health, rather than physiological health. (SEE: One Flew Over a Cuckoo's Nest, The Chief, McMurphy and all the 'nuts' in the boat.)
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Thanks for encouraging public attention to this. However, I have a question for OPB, Think Out Loud and Emily: There have been a number of shows on your program about mental health, and it feels to me that the primary mental health consumer and psychiatric survivor perspective has not been adequately represented. Can you assure us you're providing adequate time to individuals diagnosed with psychiatric disabilities, and the groups that represent them? As the disability movement says, "Nothing About Us Without Us." For those interested, there is a state-wide coalition of nonprofits run by mental health clients, called Oregon Consumer Survivor Coalition. People can contact the group at oregon.united@gmail.com. Thanks,
David Oaks, Director, MindFreedom International
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Hi David - Friday's show is an hour with Greg Roberts, the still relatively new hospital superintendent. There won't be other scheduled or invited guests on this program. We're of course seeking questions from anyone interested in mental health, public spending, or other related issues. We always value input from people with direct experience with the subject at hand!
Thanks, Emily
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I appreciate Emily responding. However, I think it might help if Think Out Loud leaders would acknowledge they have had a problem with the who when it comes to mental health, over a several year period. I've lost count of the number of times I've heard a show, and there's been barely any representation from the state-wide voices of groups representing mental health consumers and psychiatric survivors.
I was a guest on a TOL show that had a couple of moms. For about 10 minutes at the end I did have an opportunity to try to respond about the many points brought up about involuntary psychiatric care, but it was certainly not equal time
Afterwards one of the moms phoned me and we had a long chat: She actually had a perspective similar to ours. She was horrified by the massive over-drugging her adult child had endured at Oregon State Hospital, day after day with injections.
My theory is that the oppression involved with the psychiatric industry is so off the charts extreme... and the voice of those on the receiving end has been so extremely suppressed... that there is an "ism." You've heard of sexism and racism, but what about "sanism"?
It's particularly challenging when the sanism involves a show that one would hope would include a diversity of views, including those who the show is ABOUT. Could you imagine TOL doing repeated shows on gay rights, immigrant issues, women's issues, labor issues... and never giving equal time to representatives from groups OF those constituents?
OPB has really taken the progressive community for granted. Now when they are being challenged by the right wing, they are counting on the grassroots. But I have to say KBOO radio has done a far better job in reaching out to our constituency, and actually including voices from the population of mental health consumers and psychiatric survivors, and our groups.
You know, ever since the Japanese nuclear catastrophe, I'm starting to get a tiny bit disappointed with "normal." Those were so-called "normal" people who designed those plants, despite the existence of tsunami's. Similarly, I'm beginning to wonder about media representatives who also consider themselves "normal." In fact, I'm beginning to feel that what is called "normal" on our planet -- a conformity that persists despite the planet shredding itself in so many ways, such as the climate crisis -- may be one of the biggest challenges humanity has ever faced.
Friday's show is not the only one by Think Out Loud to focus on industry representatives, rather than those on the "sharp end of the needle."
OPB has had about six shows on mental health in the last few years that have tended to marginalize the voice of, by and for our constituency. Is OPB standing for Oregon Psychiatric Broadcasting?
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Annet, I was just coming on to post exactly the same question! Anybody talking about hospital or mental health reform today needs to address the vital issues Whitaker raises. It's been the elephant in the room for 25 years or more, as more and more people have come to believe the oft-repeated myth that "mental illness is a disease of the brain caused by chemical imbalances, and we have amazing new drugs that rebalance your brain chemicals."
Whitaker's book solidly puts the lie to this piece of propaganda and returns our focus to where it should be: what science actually tells us about the impact of our current treatment model. And as a person who has worked in the field for many years, I can tell you that the impact is very much as Whitaker describes it. And it isn't pretty.
Please make sure that the question of how and when and why we use psychiatric drugs, as well as what alternative methods are going to be available at OSH, takes a central place in the discussion. And Emily, if you have not read the book, you must do so. I'll be happy to buy you a copy. Maybe Robert can come on your show one day soon. That would be awesome!
---- Steve
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I forgot the exact quote but it goes something like this "instead of asking what's wrong with you, ask "what happened to you. The state of Oregon has had a trauma informed policy in place for years in which all entities engaged in mental health services are supposed to comply. What I have been able to find is that that it is geared towards auxillary staff, receptionists, support staff, in awareness screening for trauma. What I have been unable to determine is how it effectively alters treatment. It seems that 99% of patients entering the state hospital have experienced trauma as a precursor to becoming symptomatic or during the course of treatment by being in the system. Shouldn't that suggest extensive treatment beyond medication management? How is the hospital addressing this? How much of the medical staff resources go to protocols that are not tied to prescrbing drugs and checking on them and of course paying for them?
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I fully agree with Tom wilson's comments and want to a couple of things...Tom mentions auxiliary staff, receptionists, etc. yeah lower staff!!! You will find within the rank and file of the OSH staff a lot of compassionate people doing good things with patients in tiny ways, my daughter was the recipient of many acts of kindness by rank and file employees but these employees lack power to change the mental health paradigm at hospitals such as OSH. What they need to bring into the new 'culture' are the highest ranking employees, the psychiatrists, most of whom embrace the disease model of mental illness, comparing it falsely to diabetes, a very unscientific claim since we know the mechanism by which diabetes is diagnosed and contolled, as opposed to this theory of a chemistry imbalance in the brain which vagely has something to do with seratonin and dopamine but which has never been proven. This approach simply does not address the underlying cause of psychosis for thousands of indivdiuals like my daughter trapped in the mental health system. I believe that trauma is important to look at as well as nutrition, cognitive behavior therapy, spiritual practices such as yoga, etc. The whole soft science of psychiatry is based on experimenting with different medications and dosages until a 'match' is found, no matter that many people are devestated by the side effects while this process of trial and elimination takes place, and meanwhile, many become trapped within the mental health system while acting out symptoms that are actually worsened if not originating from withdrawal from these powerful medications.
Doctors do not own up to the the fact that longitudinal studies indicate that outcomes for patients labeled with severe psychiatric disorders have become worse since the advent of the new 'miracle' generation of neuroleptics or studies which indicate that the patients with the best outcomes are those, who, like escape from the chronic cycle of drugs/dependence/symptoms
These important studies are virtually being ignored by the highest ranking employees of OSH, the very ones who purport to be 'scientists' and it wouldn't be so scandalous if were not our children whose lives are affected. Where are the psychiatrists who are willing to think outside of the box?
If OSH wants to truly change the culture: dramatically increase the number of treatment specialists (peer counselors) at OSH, so that EVERY patient is assigned to one, be among the very first state mental hospitals in the U.S. to institute open family dialog, and in situations where families are not involved, create alternative 'families' team of community based volunteers and professionals who will help indivdiuals to successfully integrate back into the communities.
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For Centuries all societies had fortress-like insane assylums, nunneries, monasteries and crazy houses for the mentally ill. Or the attic apartment for your crazy uncle. Sometimes they were treated as fools, witches, magical sorcerers or devil possessed. Sometimes they were given the leadership crown--ie Nero, George III, Hitler, Stalin, Quaddafi, Uday Hussein, Robert Mugabe.
In the past 40 years we have had miraculous breakthroughs in psychiatric medication rivaling the age of antibiotics. Mental illness can be managed like a benign chronic illness like diabetes, HIV infection or hypertension. The mentally ill when properly medicated can live in society, in homes with their families, and even hold a job.
95% of mental illness can be managed successfully as an outpatient. It is a small minority that needs institutionalization, but they are very debilitated.
The other problem with chronic mental medication is how often patients fall off their medication regime. They are otherwise healthy. A lot of them are in denial about mental illness. They think the rest of the world is loony and they are the only sane person on the planet. And why can't they have a fun night drinking a fifth of vodka. And a small heroin injection will really cap a day. And I don't need this medication anyway. And the CIA is bugging my thoughts.
And the medication when in harmonious balance with brain chemistry, falls to subtherapeutic levels. And there is rebound psychosis. And it takes weeks to rebuild the medication effect in an expensive inpatient enviorment.
That is why the schizophrenics live in alleys, streets, and under bridges and bounce backto insane assylum in Salem and back to the streets and back to Salem like a loony, red, rubber ball.
The solution is long term, fail proof medication. We will know our mental illness treatments are successful when the homeless no longer populate the streets. We all need to know about mental illness because it affects us EVERYDAY.
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Medication is not the only answer. It is like the bassist in a rock band. You HAVE to have it, but you also need the drummer, guitar player and singer.
Or maybe a keyboard.
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the analogy between psychotropics and antibiotics is moronic. it reminds me of 1971 when i was told that i had a lithium deficiency and would need to take a toxic salt that causes renal failure. the miracle drug thorazine that i was assauited and battered with (a legal construct for forcible medication) nearly killed me.
i appreciate and support the refere]nces to whitakers book but it is not new or esoteric information that major tranqulilizers -- USED AS DIRECTED -- cause permanent BRAIN DAMAGE in a minimum of 15% of those who take them. that number is from NAMI but the consumer/survivor/EXINMATES ie me can show evidence that the proper number is closer to 50%.
i think the proper analogy is between psych 'meds' and cigarettes. both were pimped by doctors -- in the case of cigs i guess most of the docs were actors dressed as doctors -- and if used as directed horrible things happen
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Well, you certainly have painted a pretty picture based entirely on the psychiatric propaganda you appear to have swallowed whole without even chewing, let alone digesting it.
Otherwise healthy? Diagnosed mentally ill people die 25 YEARS EARLIER on the average than those who don't receive this helpful "treatment." Certainly, there are other factors, but death by medication side effects, including induced suicidality, is a big part of this figure. Even if that were not the case, dying 25 years earlier does NOT reflect a healthy population. But I am sure you can find a way to blame this on their "mental illness."
As to the "properly medicated" being able to live productive lives in society, you need to read Whitaker's book. A schizophrenic-diagnosed person in 1950 had about a 12 times greater chance of living a producitve life in society, as in work, education, family, etc., than does one so diagnosed today. The drugs are not only not the cure to people living under bridges, they may in many cases be a big part of the cause.
Medications don't create "harmonious brain chemistry." If you bothered to read ANY research on the subject, you will find this has been known for many, many years. Medications cause extreme DISTURBANCES in brain chemistry, which the brain battles to adjust to in various ways, some of which appear to be therapeutic (at least in the short term), and some of which are clearly incrediby destructive (such as diabetes and Tardive Dyskinesia).
So believe the propaganda if you want. But don't expect any intelligent and informed person to go along with you. Most psychiatrists would even disagree with your rosy picture of mental health treatment. I would strongly suggest you at least read "Anatomy of an Epidemic" before you post on this subject again.
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I have worked at OSH for more than 6 years in a professional position. It is undeniable the hardships that have been faced by many patients. It is also undeaniable how much money has been spent to "make it right". Were my family interred at the Hospital, I would do everything in my power to advocate for them and I am certain that I would run into a byzantine, monolithic wall of beuracracy, lawsuits, fearful staff, angry staff and frightening environments. I would pull my hair out screaming for someone to fix it.
However, we must accept that the challenges we face at the hospital are so complex, that no one really feels they can change things. It is as though all of us have stumbled upon a watch that was built in the 1800's. The watch does not work, so we become determined to fix it. We spend millions trying to understand this antiquated thing and it's inner workings. We hire consultants from around the world costing further millions. We demand endless data because the public is now watch us in our every move to fix the watch. People are even suing us because we found the watch and still have not fixed it.
The tradgedy is that, while some know how to fix some parts of the watch, no one knows how to make it all work. In truth, it never really worked. It was made broken.
We have the vision that we can fix this thing because we are short sighted. If it was never a thing meant to work, why try to make it so?
The best we can do is invest in the best training for the best staff and make sure that the parts of the watch do not continue to fail. We must also be reminded that, even though it was broken when it was made, it still ticks from time to time. We have, somehow, made it work for a few minutes every hour. Patients do go into OSH sick and come out better.
We are no watch makers. We are no watch repairmen. We are trying to leran the craft that has eluded many thousands for decades.
For all those who have come to be angry with us, please look, because it is about to tick again. Any moment. Write about and remember that. And then have patience as we try to make it tick another time.
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I've read the human brain described as the most complex thing in the universe and I am not surprised that the scientists and therapists do not completely understand it and how to make it operate "correctly" when the human in charge of it goes off in some non-normal direction.
Each new scientific discovery gets tried and sometimes works and the media and business folks jump on the current fad-bandwagon; electroshock, gene therapy, drugs, frontal lobotomies, talk therapy, FMRI, on and on. I have huge respect for the people who are compassionate and try to do whatever they can to help the human in need.
I hope that some day the causes become well understood and effective steps are taken to prevent problems if possible, cured if possible, and/or adjusted for if possible.
Humans seem to be the best challenge for anyone who wants to work at a challenge, to do good in this world.
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i would like to ask the new superindent how he feels about the iatrogenic illness that he supervises--his pts. are labeled with diseases such as schizopherenia and bipolar and the given 'medicine' which commonly cause brain damage.
i saw a griffito 40 years ago that said 'a liberal is someone who listens to both sides of the argument and then cuts the baby in half.'
is a reformer psych hospital administrator someone who listens to both sides of the medication issue and the cuts the dosage in half -- but possibly fails to lower the brain damage rate???
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I'm wondering what Greg can say about the future of the civil commitment program and more specifically OSH having a presence in the Portland metro area. Also, what steps are being taken to curb violence at the hospital? Thanks for the program opb!!
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I would like to know what the $13,000 a month goes to for each patient staying at POSH. I'm also interested in how open the hospital is in offering "alternative treatment" plans to help those that have been traumatized in their life. Putting them in a "locked facility" only brings on more trauma and doesn't get to the root cause of why they are there. The push to put someone on Social Security and Medicare is alarming to me and gives the message "there is no cure or hope for you." My son did not commit any crime and really needs help other than medication treatment. Thank you for allowing us to ask questions on this important matter for our family members who are currently located in these hospitals. Sally Fabre
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David Oaks makes a very good point. I am a provider of services as well as a survivor of treatment. It is as if we are not even adequate to speak to issues that, upon close examination, have been articulated and spoken to in numerous research, educational, and most importantly experiential forums. This is fundamentally discriminatory as well as ignoring a valuable resource that has led the movement for recovery, improved interventions for trauma, and the improvement of health outcomes for peers [studies show that persons with mental health labels die much sooner than the "normal" population].
See http://www.dsamh.utah.gov/docs/mortality-morbidity_nasmhpd.pdf
Mr. Roberts to many of us seems to be a progressive and inclusive leader, and has suggested the addition of peer workers on each of his ward teams [22] and on the larger department administrator's tribunal. However, he faces the same professional barriers that have made the hospital an expensive and dangerous nightmare.
One of the aspects of this is the failure to look at those receiving the care as fully human and fully able to articulate their circumstances that could lead to their recovery and seeing them as relevant to their own lives and desires, which contrary to the practice [not the rhetoric] of the hospital, is possible.
Hopefully someone will change the outcomes along with the new facilities, though thus far, words have -not- resulted in action or the inclusion in the discussion of those that have the lived experience of the "mental health system." This usually means passing through the terrors of becoming part of the system and acquiring derogatory clinical labels that will stalk them for life, which of itself is enough to traumatize someone.
Drake Ewbank - Springfield OR
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Was wondering if Superintendent Roberts could explain the Hospital's investigation policy in re: to patient's complaints of abuse. In light of the article that came out in the Statesman Journal this week. The first half, an excerpt from a letter, read some very serious allegations of abuse and intimidation. Yet, the interview comments seemed entirely unrelated to the details of the letter. The letter involved fear and abuse, the comments seemed to come from a child with entitlement issues wanting his "passes"? How does an article like this make it to the Statesman Journal?
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With regards to food, and feeding patients nutrient dense meals, what is being done to improve the quality of the food? Are steps being taken to assess how things like dairy, sugar and gluten might affect an individual's mental and physical health? Can local farms and CSA's form partnerships with the state mental health care system, so that high quality whole foods can reach the people who need good nutrition so badly?
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I went through the Oregon State Hospital New Employee Orientation two weeks ago. During the orientation, the following comments were made by two different presenters:
"There's a reason that 'John' is here. Don't forget that! They are not nice people. This is a correctional facility. Can they be rehabilitated? Treated? I don't know. That's for others to decide."
"We are not a jail, not a prison, we're a hospital. The people here are patients, not prisoners."
Which of these two statements most closely resembles Mr. Roberts' position?
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A common reply as to what causes mental illness is that it's a result of chemical imballance. I would ask, so, what causes a chemical imballance? Is it a lack of Prozack, or other drugs? Or could it possibly be a lack of the proper nutrients from a healthy diet that feed the brain and other body cells. There is much evidence that dietary nutrition helps with emotional and mental function. We are a SICK society. What is the diet in these institutions like? Does it make a difference what these people eat or not? Why not emphasize healthy diet and lifestyle? Too expensive? We pay the price one way or the other...
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My comment is directed to the parent who called in, frustrated that she did not have communication with her family member's hospital treatment team due to confidentialty issues. There is a process that may help with any future care, I'd direct her to the following website www.nrc-pad.org Best wishes...
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Emily, I am curious... I posted my question at 9:15 am... My question was short and precise, yet it didn't get asked. Is there something I should do in the future if I want my question asked? Is there a way to get my question answered by Greg, still? Thanks, Sabrina Louise - Portland, OR
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Great conversation on the air and online, I've really enjoyed listening to everyone's reponses.
As a student nurse I did my clincial rotation for my Mental health class at the Oregon state hospital last fall. I was on an all male, forensic (370) unit. Intimidating to say the least to walk in and see textbook examples of people who are currently symptomatic with mental illness. I had an invaluable experience and learned an incredible amount from the patients and the staff.
A few things that I will share: I was awestruck by the care the patients are receiving. They are treated like patients NOT prisoners. Each patient has a multidisciplinary team assigned to them to help them thrive and heal. I am talking Psychiatrists, social workers, mental health techs (cna/cma like role), Nurses, case managers, music therapists, pet therapists, just to name a few. They all want them to get better and get back to their familes and communities. I spoke with some patients that said the OSH was like Disneyland for a person with mental illness while prison (where they had come from as 370 patients) was the worst hell imaginable.
Shout out to all the *amazing* nurses at the OSH. They are doing great work and I thought many a time, what if my family member with mental illness had been placed there? Maybe he would still be alive? However, there is work to be done and they know that. Hopefully at the new campus they will continue to improve and really help the patients THRIVE!
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This link is to the trailer of the movie "Open Dialogue" that was mentioned.
http://www.youtube.com/watch?v=aBjIvnRFja4&feature=player_embedded
Here are the words of the film maker about his interviews with consumers there:
"They liked the openness and frankness of the therapists. They liked it that above all else their own voices were heard and valued. They liked it that they had a key say in the decision about whether or not psychiatric drugs might be of benefit to them or not. They liked it that they had alternative options to drugs presented to them. They liked it that when they were in crisis they could invite their family and friends and other important people from their lives into therapy meetings — if they wished.
They also liked it that the therapists worked in teams, right in session — because they liked listening to what the therapists had to say to each other, in the middle of session. They told me that they felt they deserved to know what the therapists were thinking! And doesn’t it make logical sense?"
What would it take to get this kind of system here in Oregon?
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Comments are now closed.
Thank you for continuing the discussion about OSH.
I would ask Greg Roberts if he has read "Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America". The book by Robert Whitaker describes a mental health system that relies on pharmaceuticals over other treatments and asserts that psychotropic drugs actually cause more harm than good. It also describes successful models for care that are based in small community-based mental health care. Does Mr. Roberts agree with Whitaker's analysis? What is being done at OSH about medication use? Are alternative treatment options being expanded?