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The Oregon State Hospital was in the news again recently. Hospital superintedent Roy Orr's resignation April 2 coincided with the release of a report (pdf) on the investigation into the death of a patient at the mental hospital last October. Richard Harris, head of the Addiction and Mental Health division at DHS, asked for Orr's resignation. He told the Statesman Journal, "it was time to make a change in leadership."
The State Hospital has been under scrutiny in the past and an ongoing federal investigation has resulted in harsh criticisms of the facility. The hospital has demonstrated a reduction in violent incidents and is currently expanding to create more space for patients, but advocacy organizations say they want to see more improvements on a faster timeline.
Do you have experience at the State Hospital as an employee or as a patient? What would you like to see new leadership bring to the facility? Have you experienced mental health care in another state's mental hospital? What was that experience like?
GUESTS:
- Richard Harris: Head of the Addictions and Mental Health division of the Oregon Department of Human Services
- Nena Strickland: Acting superintendent of the Oregon State Hospital
- Chris Bouneff: Executive director of NAMI Oregon
Tagged as: mental health · state hospital
Photo credit: Pete Springer/OPB News
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Hi Dave,
I wish we could have a discussion as advocate for the taxpayers. What is the cost per month per patient? I know the discussion is suppose to be about the death of a patient. When do we get to discuss the outrageous costs. The State appears to be no good at cost savings. They have no competition. The State has very little oversight. Let's look at the numbers. The taxpayers are not good at looking at the numbers and holding the State accountable to cost cutting.
In the late 90s, the cost per patient per month was 13,000 dollars at the State Hospital. The cost in the forensic program may have been a little less. The cost today might be in the range of 15,000 dollars per patient per month. You might say that is good compared with the SOCP (State Operated Community Program). The cost at the SOCP per patient per month is about 25,000 dollars per client per month. What if you had 25,000 every month to spend on you older mother or father? That would definitely cover the house payment for a pretty nice McMansion.
To digress a little further, what is the cost per month per inmate in corrections? The cost are said to be about 7,000 dollars per month per inmate. But the DOC (Department of Corrections) doesn't tell the whole picture. They don't include PERS (pension), and many, many other costs. To get the figures we need to get figure for the whole budget and divide the whole cost by the inmante days and then get inmate cost per month. I mean get the whole budget and then work the numbers.
Why doesn't the press lay out something as simple as the costs for the taxpayer? Is each taxpayer supposed to do their own research? Let's lay out a foundation for the taxpayer to let us know what we are talking about as far as cost. Lay it out as simply as possible. Sometimes I wonder who is minding the store. Taxpayers don't have the time or the focus to do this footwork. Who is the advocate for the taxpayer?
Thanks,
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Hello! I "survived" employment at OSH in Salem and Portland. I have one recommendation for the new Chief Administrator. CLEAN HOUSE! Get rid of all of the higher ups. This is the only way ANYTHING will ever change there. The mandated overtimes, unhappy employees, no support in doing your job. I was part of a team that was supposed to implement Behavior Support Planning in the hospital and we did not get any support from upper management, so of course our program is failing. Change needs to happen from the top, and until that occurs, nothing will change.
The new hospital is opening at maximum capacity, never a good thing, and it is because people are not moving around the system fast enough. Another suggestion is get rid of the PSRB, or the Psychiatric Secure Review Board. They have WAY TOO MUCH POWER! People who do not need to be at the State Hospital any more are still there due to this group.
Just some ideas. Thank you!
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I also survived employment at OSH Cornerstone Program when it was Co-Ed, and as a part of my undergrad. degree studied the PSRB when it was Sunset and brand-new. Unfortunately some very high profile events permanently affected the way they (PSRB) do business, while other events (such as the death of Francke) have been largely ignored. Particular populations were excluded (post partum women who killed their own children), and as we have seen, the current influx of domestic violence deaths which are again outside the pale, and in the hands of potential victims who must get on a plane, fly to Canada and apply for Sanctuary. The politics of programs, competition for funding (filling the beds), and overlapping jurisdictional practices of law enforcement from the Feds (DEA & ATF) to the locals at the state, county and city levels create information constipation as they all compete for some portion of the biggest wallet on the block. Deciding behavior based on past behavior (PSRB), and a program driven system unfortunately creates a default standard of one size fits all that proliferates itself throughout all decision points and affects all the individuals involved.
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Any discussion of problems at Oregon State Hospital should include the topic of mandatory overtime. It is both an indicator of funding problems and a source of deteriorating care.
Mandatory overtime occurs when the daily staffing needs exceed the number of staff scheduled plus those who volunteer to work overtime. Staff on duty are told at the end of their eight hour shift that the they are required to stay for another eight hours. There is no option. The impact of this on staff alertness, productivity, vigilance and, ultimately, patient care, morale and employment longevity is immense. Consider this common scenario: An employee has completed a 2PM to 11PM shift in one of the most dangerous workplaces in the state. Then, instead of going home and sleeping, she must stay on the job through the night fully alert and vigilant, until 6:30AM. Having been awake for a full 24 hours straight, she can then race home, try to sleep a few hours during the morning, and get up in time to be at work at 2PM for another eight hours. By the end of that shift she will have worked 24 hours out of the last 32. Any chores, tasks, relationships at home are essentially abandoned for the 2 to 3 days it takes to recover from the equivalent of severe jet lag.
This is a common event. The amount of mandatory overtime has increased dramatically over the last three years. Staffing is in a downward spiral where vacancies cannot be filled faster than they occur. Staff are, on average, less experienced and more poorly trained than they have been for many years. Consider that, in a time of very high unemployment there continue to be many vacancies. This raw fact speaks directly to the working conditions.
Here are the number of hours of mandatory overtime worked, by quarter:
2006
Qtr4 1279
2007
Qtr1 1315
Qtr2 943
Qtr3 541
Qtr4 5572008
Qtr1 1466
Qtr2 1985
Qtr3 1770
Qtr4 23722009
Qtr1 1481
Qtr2 4171
Qtr3 3290
Qtr4 3063Richard Yates (retired following 30 years of employment at OSH)
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Those numbers ARE accurate despite Mrs Strickland "believing" they "couldn't have jumped 4-fold" ---- breaking news, they HAVE jumped four fold the last several quarters, overall.
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LET'S HEAR THE VIEWS OF GROUPS THAT ARE OF, BY AND FOR OREGON MENTAL HEALTH CLIENTS!
I need to emphasize that for seven years, Oregon has had a huge problem: Zero funding for the state-wide voice of mental health consumers and psychiatric survivors.
Most US states have something... A newsletter, an office of mental health consumer affairs, an annual conference, something.
But for seven years, Oregon has had zero resources to amplify the state-wide voice of customers of the mental health system here.
In the disability movement, there's a saying "Nothing About Us, Without Us"!
I direct MindFreedom International. We regularly work with individuals who have lived in or currently live in Oregon State Hospital. Because of this, MindFreedom's state-wide alert system sent out the very first public word about suspicious circumstances in the death of Moises Perez.
On Thursday we were one of the sponsors of an all-day Peer Wellness Forum, and a number of OSH patients were there, side by side with all the others.
It takes extra effort to hear the voice of groups representing marginalized groups. Now there is a state-wide coalition uniting such groups, Oregon Consumer/Survivor Coalition (OCSC), and we're a proud part of that coalition.
I'd like to remind the producers of Think Out Loud that individual OSH workers or patients are important to hear. But it's also important to hear from the groups that represent this voice.
If media did a major story about immigrant rights.... gay/lesbian issues... or any other marginalized group, then we would hear representatives of groups of, by and for those constituencies, as we should. But what about mental health?
We've all heard of sexism and racism. But few have even heard of 'sanism," or laugh when they hear the word. Discrimination against and silencing of citizens diagnosed with serious mental health problems is extreme, persistent, and proven. I know, because this is my 34th year as a community organizer for this constituency, and I myself am a psychiatric survivor.
David W. Oaks, Director, MindFreedom International
www.mindfreedom.org/oregon
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David,
We do have a representative from the mental illness advocacy community: Chris Bouneff from NAMI Oregon.
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David, you speak well for those of us whose voices are simply ignored.
Thank you for your message!
Let us hope that we who know the mental health system from the inside, from our very lives, will finally be heard.
No one spoke for me today, and I listened and hoped to hear someone who has lived experience as a mental health consumer and psychiatric survivor.
What I heard was the system speaking for itself, about itself, with no real grasp of Moises Perez's experience.
I hope for more from Public Broadcasting, from our state and communities.
We must be heard!!
meghan caughey, MA, MFA
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I too am a psychiatric survivor. I say...the hospital was headed in a good direction with Roy Orr. It needed to be run like a business for a while...and it was! This was a good thing. If we treat it like a business and CLEAN HOUSE we will be able to take care of our staffing mandates which in turn will ultimately help the residents of the hospital.
I wish mandates was the only thing wrong with the institution, but it is not. The residents who live within the walls of Oregon State Hospital are having their rights taken away on a daily basis. Every day that goes by when a patient can successfully live on their own, but the PSRB restricts them to the "inside" is a day of unrest in the residents spirit. Not only that but it is "shady" business by the PSRB.
Roy Orr was good for the institution. There would be a time down the road when OSH could have used a different kind of leader, but not right now. In other words, OSH still needs him and they don't have him.
Rexino
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As a former patient I can speak volumes on the disgrace of Oregon's state hospital. Patients at OSH are simply over medicated and warehoused so the public can forget about them. Not only are people warehoused and forgotten but Mitche's comment about the PSRB is right on. Did you know that the PSRB is the single largest drain on Oregon's mental health budget? Not only does the PSRB prevent people from leaving the hospital when they are ready but once a person does leave the hospital the financial drain on the system continues because of the PSRB. The PSRB does nothing but perpetuate the stigma people with mental health disorders live with every day. People leaving prison for murder don't even have to live under the type of conditions a person under the supervision of the PSRB has to live under. I agree with Mitche, the PSRB has way to much power. The money the PSRB uses up should be spent on care for people with mental health disorders, not punishment. The PSRB is not theraputic in any way but is all about being punitive and should be stopped. People with mental health disorders need therapy and help, they do not need to learn to accept responsibility for crimes as the PSRB is fond of saying.
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I'm wondering why OSH continues to act as though the head should be treated separately from the body. Mr. Perez had multiple health problems - did his mental health issues take precedence over his general health issues? I read that he apparently tried to refuse psych drugs because he didn't like the way they made him feel...did OSH doctors order any lab tests to see whether he had fat in his stools (indicating malabsorption), check his Vitamin D levels, find out what his metallothionein levels were, test to see whether he had food intolerances or see if he could improve with Omega 3s? Was an immunoglobulin panel test ever ordered? What medical lab tests are ordered when a patient enters OSH? What follow-up testing is done as the patient "progresses" at OSH? I would dearly love to acquire Mr. Perez's medical records to see what drugs he was taking, what lab testing was done, and how his mental AND physical issues were addressed. OSH has a tremendous opportunity to improve the lives of its patients with a few lab tests, nutritious food, fresh air - what a waste of life.
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His medical records - appropriately - are confidential. Patients receive complete physicals yearly, and diagnostic tests like blood work more often as needed. A key element that has been disclosed about Mr. Perez' case is that, although the extent of his medical problems was known, he refused treatment for them. Patients under the PSRB have not been declared incompetent. They have the right to refuse treatment. Yes, this puts treaters in a bind, but would you take away that fundamental right?
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As someone who has worked in out
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It is extremely important to keep in mind that those persons who have been hospitalized at the Oregon State Hospital have been court-committed, meaning that they have been determined to be a danger to self or others. Which means that to be at OSH means this person does not have the judgement to care for him/herself and/or may be a threat to others' safety. Despite that, this patient has the right to refuse medications and treatment, even though they may be responding to auditory and visual hallucinations, mistaking that another person may be trying to harm him because of extreme paranoia, or shoving pencils into their arm because of impulses to self-harm. My understanding is that only a judge can override the patient's refusal of medications and treatment. Although the efficacy of medications vary and the possibility of adverse s/e's exist with any medication, it is because of medications that physical measures to restrain persons from harming themselves or others can be the intervention of last resort. The issue of mandatory overtime is very much related to one staff-to-one patient and sometimes two staff-to-one patient because of patient safety issues, meaning the patient engages in either self-harming or very aggressive behaviors. It is those behaviors that have often resulted in the routine frequency of staff injuries because patients have attacked staff. Some of the forensic units may have up to 40 patients on one unit which also contributes to the frequency of 1:1 or 2:1 staffing because having that many people with such severe behavioral and mental issues on one unit is simply too many. In general society, there are expectations of behavior and consequences of not following those expectations. In contrast, at the state hospital, the "consequences" for not following expectations, e.g. reasonable civility to others can be pretty weak because of patient rights. As a tax payer, I wish that those patients who refuse treatment could be discharged to the streets, however that would create even greater problems in the community. Since that is impractical, there should be serious reconsideration about the rights of patients who are court-committed to the state hospital funded by my tax dollars.
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My brother, (who has dealt with schezophrenia most of his adult life), was a patient at the hospital in Nov 09 when he had an accident from "choking on a peanut butter sandwich". He had been there for about 2 months prior because of an altercation with my father, (he's fine) that got him arrested, in jail for several months, then off to the State Hospital for evaluation. None of which, my family believes, was necessary, but that's a whole other talk show. My father and I had gone to visit on the weekend before the accident and couldn't believe the shape he was in. The moment we saw him through the gate, (his face usually lit up when he saw us) we knew something was terribly wrong. It was if he had no idea who we were, like his spirit had been taken, it was dreadful and heartbreaking. I immediately called, from the grounds his psychiatrist there, who felt as if HER hands were tied, and she, too, was afraid for my brother's fate, THAT terrified me beyond belief! I know they have a reputation for over medicating and all I know is the very next weekend, he had this "accident". The story I got was that "he had been pacing while eating and just kind of lost conciousness and slumped to the floor", he then, was without oxygen for a number of minutes, was sent to Salem General Hospital, there for 6 weeks, (in a coma for 3 weeks) and now has a brain injury on top of everything else in his troubled life.
Shall I go on? Yeah, how much space do I have here to talk about this place...
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Hopefully someone has informed you and your family that neuroleptic psychiatric drugs (now more commonly called "antipsychotics") can suppress the gag reflex. Choking deaths have not been uncommon related to neuroleptics. In fact, if I remember correctly, on the same day years ago, Oregon State Hospital had two choking deaths on the same day (I think from pancakes). The solution has been to address treatment for choking. But there's a bigger question: What about the MASSIVE INCREDIBLE BIZARRE over-drugging of people in the mental health system. Please understand we are pro-choice on psychiatric drugs. Many of our member take prescribed psychiatric drugs (and they're the most interested in this topic, it's their lives at stake!) I myself asked for psychiatric drugs. This is not about being pro- or con- psychiatric drugs. BUT THERE IS AN ENORMOUSLY HUGE AMOUNT OF OVER-DRUGGING, off the charts!!!! This can be one reason people in public mental health system die more than 25 years earlier than the general public! Use Google search engine to look up our folder on this, use these words-- neuroleptics mortality mindfreedom
And while you're there, use the search engine to look up:
antipsychotics brain damage
That's another thing that is suppressed.... that long-term high-dose neuroleptics can cause FRONTAL LOBE SHRINKAGE. Again, we're pro-choice, many of our members make the difficult choice to take them. But don't the public, taxpayers, families and the brain owners have a right to know????
Remember, we the taxpayers were told the "newer" neuroleptics caused less twitching (tardive dyskinesia) and were more effective. But instead it turns out they cause similar rate of TD, and are not that much more effective. But they were tremendously MORE EXPENSIVE. Now we know they have their own mortality issues.
Oregon State Hospital has ash cans full of ashes of patients, many now without names.
What will it take to change this culture of extreme disempowerment?
How about listening to and amplifying the VOICE of the customer????
I sure hope Think Out Loud producers include that voice! Even though we have reached them on previous shows, they did not phone us to participate in this show.
- David Oaks, Director, MindFreedom International
board member, Oregon Consumer/Survivor Coalition
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After two years in an administrative support position, my feeling is there is widespread fear/anxiety from threats of being written up for "policy violations" which may or may not exist, or are subjectively interpreted. Fear, paranoia, and insecurity and perpetuated by management, rumors abound,management does nothing to quell or reassure. Staff, even the most dedicated, quickly become apathetic. I was told by several psychiatrist at OSH that the hospital is a revolving door facility; that the patients will be noncompliant once discharged; I think this belief transfers to a "why bother" attitude, along with the abuse of policy to keep people in fear of their job, is where the cultural atmosphere turns sour. this is mostly why good people leave.
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I am very concerned about the situation at Oregon State Hospital.
As a certified peer specialist and Vice -President of Mental Health Amercia of Oregon, I have worked with Adminitratior Roy Orr to improve condtions at OSH.
I have also testified befor the legislative Joint Committee of OSH Pateint Care on behalf onpatients at the hospital.I ask to be allowed to make comment on the program Think Outloud which is playing right now regarding Roy Orr's resignation.Thank you. I am also a mental health consumer /psychiatric survivor,
meghan Caughey MA MFA -
Meghan,
We welcome all comments. What's your take?
Thanks,
Dave
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Another issue that may be relevant is the effect of low staffing on the employees.
What are the feelings of direct care staff about their working conditions at this point in time?
Is anything being done to address effects of low staffing on direct care employees?
Thank you.
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Thank you so much, Mr. Oaks! No, my family and I were not told of this suppressent. I've always wondered, why the hell are they giving something like peanut butter to their patients? Anyone, who takes meds, knows that lots of them cause a very dry mouth, isn't this like "common sense 101"? Clearly, no. I would love to have your website address to keep in touch and tell more of this story. Do I think of legal action? Everyday. Do I want to put my family through it, particularly my brother? And my father is 88, he couldn't endure it.
Again, thanks so much for your comment and insight, it's very much appreciated!
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You are not alone. If one listens to mental health client organizations, one can learn a lot!
Last week I was in a staff meeting with an individual and her family about her concern regarding forced psychiatric drugging. During the discussion, I helped find out that the individual's mother was a survivor of brutal forced electroshock, which traumatized the whole family about mental health care.
It took me a few minutes to find out this family had experienced trauma from the care system.
And one more example: It's actually MindFreedom Oregon, our state affiliate, that blew the whistle on the death of Mr. Perez, FIRST, in our state-wide alert. This was before the Oregonian report, before coverage by Statesman Journal. It was OUR alert system that put out the word.
So please note an immediate example of the silencing of mental health clients. OPB's Think Out Loud has a persistent, ongoing pattern of excluding the voice of mental health client organizations. This problem was brought up before with OPB's Think Out Loud.
But for today's show we were told that NAMI would represent "us." There are more than a dozen mental health client organizations in Oregon. We are united through Oregon Consumer/Survivor Coalition.
There's a saying in the disability movement, "Nothing About Us, Without Us."
I would much rather have this conversation be about the perspectives of our constituency, rather than the persistent exclusion of that voice by OPB's Think Out Loud.
Without that voice, the conversation becomes about asking for "more money" for the broken mental health system, without asking what can really be done to change a culture.
How does one change a culture of the organization, without including the voice of groups representing the customers?
The problem is beyond Oregon State Hospital.... Obviously it's a cultural problem in Oregon itself, reflected in OPB's exclusion of that voice. In fact, it has a name, that hardly anyone has heard. You've heard of racism, sexism, etc. But have you heard of "sanism." Hardly anyone has. But we're seeing a clear example of it in the staff of Think Out Loud. Not just today, but for over a year, persistently and repeatedly.
OPB, you have a problem... I hope OPB members are listening.
- David
David W. Oaks, Director, MindFreedom
Board member, Oregon Consumer/Survivor Coalition
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The Oregon State Hospital suffers from the overall paradigm that Heraldo built his investigative reporting career on in the '80s that resulted in many psychiatric institutions being shut down and patients being released into the community to join the ranks of the homeless. While the standard of sedative medication and physical restraints was discontinued, and screening to identify the physically disabled from the mentally ill was re-evaluated, the use of criminal codes to mandate treatment continues unabated. Where as a particular demographic adjudicated as NGRI and under the supervision of the PSRB, and the D&A population adjudicated through criminal codes are "mandated" to treatment, treatment by definition is a volitional choice, reguardless of diagnostic categories. The one paradigm that has demonstrated effectiveness is with children, when placed as individuals in particular types of communities. When the efficacy was demonstrated, parents from all over the world rushed to place their children and were turned down. As community members pointed out, changes in behavior and mental attitude were due to the embeded effects of the larger supportive community. It was not "treatment" it was the experience of a functional loving environment. Treatment mandating results in a permanent population of the non-compliant and mentally ill. Transition back into a culture/environment in which the original diagnosis/behavior was developed makes some form of long term and/or intermittent intsitutionalization inevitable.
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Patients describe staff clustering at the front desk behind a glass barrier to chat and enjoy one another's company--for long stretches--ignoring patients. I know this from a family member who has been there recently, and also from other NAMI parents who presently have someone there. In a recent case, the family member called to ask staff to help his son, who he had been talking to on the patient phone, and staff just blew him off. That was 50-D.
I know about the back-to-back shifts, but there is no excuse for this kind of thing.
Dianne Farrell
Corvallis
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oh I saw this clustering all the time. if they did bother to slide open the window they would flat out tell them NO without even listening to the request.
about the annual physicals NOT! there were plenty of charts coming across my desk where they were not updated in YEARS even with chronic conditions present. it was the rare doc that would do regular updates. with patients under PSRB it was a requirement, so we'd send reminders, even then they were late.
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This is a common staff behavior generally enabled by antiquated design. Newer psychiatric hospital have staff area open and accessible to patients with the elimination of glass barriers.
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Lack of staff is a direct result of the defunding of government. Reveiw the lack of revenue producing law enforcement, the increase in the number of tax discounts and the general desire of many to defund government so eventually government will disappear. People are working to ensure that places like the state hospital will, someday, not exist. Until the issue of defunding of government functions is addressed, the quality of services will decline until government functions no longer exist.
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I worked at OSH as an Occupational Therapy intern last year. As has been said, treatment is a whole package. Occupational Therapy is a very holistic profession and we look at a how people interact with their environment and how they need/want to go about living their lives. There are a lot of people working there who really are trying their best and doing good work. Work has to be done supporting staff and patients together in order to really help things improve.
On the unit where I worked we had pretty stable patients most of whom had been there for years (some as many as 20).However long periods of hospitalization doesn't necessarily mean long periods of active treatment. Often people are so institutionalized that dealing with the outside world is very scary and difficult.
One of the biggest issues is that not everyone is getting active treatment. The hospital doesn't have uniform regulations on treatment or even evaluation forms across the hospital (or didn't when I was there). There has to be a whole attitude shift across the hospital or nothing will change. If people in the community don't put mental health treatment as a priority then likely things won't change.
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There is an utter lack of cohesive work being done on the whole. From management and front line staff not on the same page and refusing to show mutual respect. To legislators and DHS upper leaders refusing to listen to lower level management who work with patients daily. To consumer advocates refusing to budge on many issues nor willingly working with people in charge of patients and hospital administration.
As someone who has worked in a direct care position at OSH (both Portland and Salem) for close to 10 years, I find the situation heart breaking because the basics of getting positive, lasting, meaningful changes agreed upon will not happen at the current rate we are at. A new building will gloss this over for a few years, decades...etc but this problems we are all upset about now will only persist in the long term. The communication triangle is dysfunctional.
The biggest issue from a patient perspective - no community housing. There is basically no housing available. I've seen patients get better, stablize only to get depressed and back down again all because they cannot get them back into community housing. Patients who are stable will wait for months, even years to get discharged.Lastly, the mandate issue is a big one as is the infrastructure problem. The biggest issue from my perspective is different and has not been discussed internally to any real degree: the people in charge of caring for patients on a daily basis are generally not well trained, generally have no experience/background in mental health to speak of and are usually supported by an RN or two (who also recieve little to no mental health training) and one management person who is also an RN. We need more support on a daily, hourly basis from trained mental health clinicians. Currently these clinicians never join the patient milieu and only do 45 minute groups, no individual therapy to speak of and no support/training on a regular basis for staff who are caring for patients 24 hours a day. THAT is what MUST change!!!
A private psychiatric hospital which must get people better to stay in business would not be run this way. They have at least one or two mental health clinicans running the ward milieu at all times. RN's are not mental health clinicians. -
Hi Rain,There are various levels of RN from two year associate degree to PhD. Clinical Nurse Specialists in Psychiatric/Mental Health are mental health clinicians.
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I have a son at OSH, for almost a year, now. He had a traumatic brain injury eight years ago and has trouble relating to others, which caused a legal violation and then a choice between jail or the State Hospital. I was extremely apprehensive about his future at the Hosptial. I was worried he would be 'warehoused' and drugged, among other fears.
Since the begining staff showed great empathy for my concerns and were overall considerate to me.
My son has had the opportunity to be involved in many group therapy's, including some 'alternatives' - like yoga and sweat lodges. He has the choice of a full daily schedule. The professional staff seem to know what is happening with him and are actively supporting his progress. I can't say everyone has been 100% extrordinary all the time, but overall I have been very impressed with staff from the communication room to the security to the doctors.
One staff remarked about how overcrowed the floors are and the need for more staff.
My son has shown great progress in his recovery and I applaud the staff for their efforts. He is showing more potential for being a good community member after all their work.
A Mom
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Why won't OPB's "Think Out Loud" include representatives of the mental health consumer/psychiatric survivor organizations in Oregon?
I phoned up right at the beginning of the show to ask about including the voice of Oregon's mental health client groups in the discussions about Oregon State Hospital.
I was told the director, decided not to ask this question.
The individual answering the call told me that OPB felt that NAMI represented "our" voice.
This is not to knock NAMI. But NAMI is primarily a parent's organization, and is not an organization of, by and for mental health clients in Oregon.
We went around this problem with Think Out Loud some time ago when they did a special series about mental health. The voice of mental health consumers was being neglected, we complained, and right at the end they did a segment about mental health client organizations.
I'm profoundly disappointed with OPB. We'll definitely put in a complaint to OPB. But what will finally change the culture THERE at OPB, to include the voice of marginalized groups?
David Oaks, Director, MindFreedom
Board member of Oregon Consumer/Survivor Coalition.
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If anything I could take from the show, it seemed TOL could stand to do a follow up show on OSH in the near future. Perhaps you could advocate for that and your inclusion in a future show?
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David,
I hear your concern and will phone you to follow-up. It certainly was not our intention to leave out the voice of people affected by mental illness. I hope our conversation will shed more light on our thinking.
Sincerely,
Sarah Jane Rothenfluch
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I'm an employee at OSH. I'm also a psychiatric survivor and ex-mental patient. I'm willing to bet that I'm not alone here.
Most of those working here are good, dependable people. Some are outright fantastic. Still, everyday, I see and hear things from other staff that make my skin crawl. Well, it's just a reflection of a community that has rejected and stigmatized people with mental health challenges.
Removing Roy won't help a thing. The same people are in charge. If anything, Orr was just getting up to speed about where the real problems lie- in the managers and department chiefs he relied on to run things. A clean house should start with the people who are running things now.
Mandated overtime is making an already bad situation much worse. Patients don't get to activities because of lack of staff. Patients don't get to go on passes to buy clothing or personal items for the same reason. Staff who are tired, irritated and who don't get to recharge their batteries do not promote a safe environment for patients or workers (let alone "treatment"- I won't even go there).
OSH is great at putting a lid on scandal and trying to make things look better. When one patient escapes we lock down everybody until the community forgets. We aren't good at fixing real problems. Bruce Goldberg and Richard Harris have shown that they are good at the same things.
I read in the paper that Richard and Bruce say they "have known about the problems on 50F and have been taking action". News to me.
Yes, the taxpayers are taking a bath. Give me the $180,000 to 250, 000 per year spent per patient and I could buy each one a house, a butler, a chef, real treatment and enough security to keep them safe. Their quality of life would go up 1000% and I'd still make out like a bandit. Don't even try to tell me you can't provide secure treatment in the community for a lot less.
Unfortunately, we are building a big new hospital. All the folks at the top say, "When the new hospital is here, everything will be better". It's magic. Or maybe I should say delusion.
The PSRB is a dysfunctional system built on the public perception of the "dangerous mentally ill". Add a host of illogical rules that are anti-recovery, anti-therapeutic and which reinforce the sad stereotypes that have been promoted by the movies, TV and Stephen King.
I expected better from OPB.
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I am a person who has lived with schizophrenia for the past 34 years. I have been hospitalized over 100 times, with electroshock and insulin shock treatments.
I tried to call in this morning, because I felt that I, as a psychiatric survivor and mental health consumer, have an insight into the situation at the Oregon State Hospital that neither the general public would easily understand, nor would the guests that featured in today's discussion.
I am the Vice President of a mental health advocacy organization that works with NAMI on certain issues. However, I do not feel that NAMI, in general, speaks for me. I appreciated the comments of their executive director in this program, but what I kept wondering was " where are the voices of those of us who have been hospitalized, who are on medications now, with all their side-effects (we only heard a sister speak about what this was like for her unfortunate brother).
I have worked directly with Ex-superintendent, Roy Orr, and I have been involved in legislative committees, testifying on behalf of my peers who are incarcerated in the Oregon State Hospital. They were not able to speak for themselves on this program. I wanted to hear their voices, and to add my own, from my own experience of our mental health system. Instead of sharing my insights that are germane to this discussion and relevant to the ending of discrimination towards persons with mental health challenges, my phone call to the program was placed on hold, for 25 minutes, and I waited, without success, to be heard.
If our society really has the will to ameliorate the conditions of places like the Oregon State Hospital, we must be willing to hear the voices of the persons who have been directly affected by the mental health system.
To do less, is a form of prejudice, discrimination, and narrow vision.
We must insist on listening to the voices of those of us who are the recipients of mental health services, and who live knowing that they, by the grace of god, live one more day outside the walls of confinement.
We, the mental health participants, consumers, survivors, or whatever we may be called, ask you, the media, and the society that you serve, to please stop disregarding our words and stories.
Our very lives depend on this!
Meghan Caughey MA, MFA
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Stigma is subtle and insidious. It permeates our environment. It can be seen by a good radio business not including the very individuals who are at the center of the issue of our mental health system (ever go to a physician and have them tell you that your very real pain is all in your head, and you just need to listen to them? something like that). It can be seen by the lack of funding of housing, education, and work training since "those poor people" probably just need a place to sit, smoke, and watch tv. It can be seen by the state measures of "successful" treatment being routinely focused on reduced spending, reduced hospitalization days, and reduced returns to the hospital (while the lives of those treated result in "living" in a place where they are relegated to just sitting, smoking, and watching tv). It can be seen by the assumption, when you talk with past or current recipients about their dehumanizing treatment in the "mental health system" (and you feel their quickly rising pain and frustration about being treated with negative assumptions about their potential and with disrespect), that their anguished complaints are just the evidence of their mental health symptoms. It can be seen when legislators don't prioritize sufficient funds for adequate treatment because "shouldn't a five-person group home be enough?" Or when providers don't push on insurers or payors to pay for non-medication therapies that are well-documented to be equally or more effective than medications, and believe that just symptom reduction through medication therapy that can produce disabling and life-shortening side effects should be "good enough." It is, worst of all, seen when a person experiencing mental health problems comes to believe that they shouldn't speak up on their own behalf because,"look at all of the trouble I have caused," and therefore, "I don't deserve it." Shame on us.
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Well said!
Oregon needs more varied and appropriate supportive housing options, supportive employment, seeing strengths of people instead of labels, more peer support and family/natural support system education.
Trauma exacerbates illness when the system is not preventive. Symptoms are worsened by events that are secondary to illness symptoms (losing housing, jobs, self-esteem, possessions, relationships, medical treatment) and by trauma.
Bottlenecks and gaps lead to traumatic crisis management outside of helpful mental health care, all much more expensive in dollars and emotional cost to the individual than preventive care might be.
There are many opportunities to join in advocacy efforts and peer support that can help identify specific policies that create the bottlenecks and gaps, and opportunities to lesson trauma.
If we can identify the policies and budget decisions that create the bottlenecks and gaps, we can advocate for better preventive care and promote recovery.
One very serious gap is the lack of appropriate housing available for State Hospital patients ready for discharge.
Lack of beds in less restrictive or appropriate housing for patients who are forced to stay in the state hospital creates a bottleneck preventing those entering crisis from accessing treatment. This lack of beds in the community seems to contribute to 'criminalization of mental illness' for some. And, this in turn leads to difficulty for these individuals in finding employment and housing, which only adds to their troubles.
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This is in response to both David Miller and Sahara Jane Rotherfluch. Considering that there are several consumer mental illness advocacy groups in Oregon I do not know why NAMI was the only one represented on you recent show. I do not know much about NAMI other than most of their funding is from companies invested in maintaining the pathological apprroach to mental health. I do know that Mind Freedom was THE watch dog group that first brought to light the tragic death of the State Hopsital patient that seemed to be the genesis to your story. Why leave Mind Freedom out? I do think that you were lacking in due dilegence. I am considering making a complaint with OPB. This is most unfortuate because I am a long time supporter of OPB, including financial support.
johnmars5
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I am so disappointed in OPB. Once again they have had a program on mental health and not a single person with a mental health diagnosis was heard from. Shame on you OPB for allowing this to happen.
There are many well educated, articulate, mindful people with mental illness diagnosis' that have a story to tell but you continue to keep them silent. I am asking to know why. I think people who listen to your program today should also be asking why. I'm a tax payer and I want to hear from the people this system is suppose to be serving, not the bureocrats and administrators who tell people something smooth. I think a formal complaint needs to go out to your donors PBS.
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OPB people - check out www.imhco.org to see an organization composed of a handful of docs, psychs and dieticians who are offering alternatives to traditional methods of treating mental illness (Integrative Mental Health Care of Oregon). Last week imhco sponsored a joint presentation by an RN and an RD (registered dietician) on how gluten can cause/trigger mental illness. I'm sure the imhco people would be thrilled by any interest you may show in what they are trying to do!
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Several years ago I was employed as a psychiatric mental health nurse at OSH. There are many highly qualified staff and physicians who have dedicated their time and efforts, and lives, to provide a healing invironment for the patients at OSH. Many patients were indeed dangerous and required a highly structured setting while they were recovering from acute phases of their illness, but the majority of patients were cooperative and doing the best they could to participate in their treatment. This is not very different from the majority of patients I've worked with in other state hospitals. The specific difference between OSH and the other state hospitals that I'm familiar with was a highly inculcated adherance to punitative responses to negative patient behaviors. Underlying this was a staff attitude that patients do not deserve to be treated compassionately. Yet, if you asked staff individually they would agree that patients, in the ideal, should be treated compassionately. Any overt efforts by individual staff to change the status quo by advocating for positive change would be met with derision, harassment or violence by other staff. I, myself, not aware of this dysfunctional culture, and attempting to initiate humane treatment change, was injected with a syringe that had just been used only moments before to administer medication to a patient with HIV and hepatitis. When I subsequently reported this to administration I was placed on the defensive by having to prove the assault happened with the added comment from administration "Oh, that person doesn't even work here anymore." Other staff have had their lives threatened and in one case was frightened enough not to go onto the unit where they worked, not out of fear from the patients but out of fear of retaliation from specific staff. I only mention these examples because it illustrates, and I'm confident there have been changes at OSH since I was there, that if retribution could be exacted on coworkers with impunity then what chance have patients, who have the least amount of power in a state hospital system, to avoid retribution.
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Simply. There is more than enough money. The union is making it impossible to change abusive and unresponsive personnel and is absolutely culpable in a culture of inertia.
Public unions produce nothing except job security through political influence, there is no competition, there is no performance standard, they can do bad or negligent work and keep their job forever as long as they elect the Governor.
All these people should be ashamed, and nothing will change, just as no one who is critical or knows what is like was even included in this... of course because the public is mislead to believe this is help rather than a prison.
OPB should be ashamed of itself too, as they have asked those responsible to explain what happened and we are stupid enough as a society to believe them. NAMI is a joke... that is still trying to justify the abuse of their own kids by themselves - frustrated enough to live vicariously in the oppression and control that the system provides to their failed efforts at it.
ITS A PRISON. And until the society has some real understanding of those that are incarcerated there, they will keep paying through the nose to have someone else sit on these people so that everyone can feel safe.
It is the most colossal waste of money in the State. It is a disgrace that kills people and their souls.... often, and does it behind locked doors. And even this tragedy will just get the same promises, the same firing of the wrong people, and NOTHING WILL CHANGE... the lives of the people there are worthless even in sacrifice... people die all the time in the mental health system just from the drugs... and no one DOES ANYTHING! And the doctors are around just to tell us that they must take them.
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Hi- I've read many good comments presented here, from the need to include voices of people with mental illness treated at OSH to the staff who have worked there. I can say that I have referred a number of people to the geriatric units of OSH. On several occasions family have thanked me after the fact because they were greatful that there was a resource to help deal with their geriatric relatives and friends. Some of the complaints I heard were "It was too grey (meaning the walls I believe)." I have also heard from one family that they were concerned that the OSH staff may not be able to keep their loved one from hurting others, which their loved one would be upset about if he had been his former self before dementia with aggression set in.
Psychiatric illness and the functioning of the brain in general is so complex. The symptom of anosognosia, lack of insight into and appreciation for the reality of one's illness, one's symptoms and the effects of it must be accounted for when looking at making progress in enabling people with certain illnesses to be as functional as possible. This symptom interferes with a person's ability to make rational decisions when one is ill with certain types of schizophrenia, bipolar disored and other psychotic illnesses. There are no easy solutions. One thing I have noticed in Oregon is more stigma about treatment for mental illness then I have seen elsewhere. I wish the people in power would tour some of the acute inpatient psychiatric units in the state and speak to staff and patients who have worked/lived at OSH and other state hospitals. There is much expertise here in Oregon and we may have better insights then expensive "expert" consultants from elsewhere who have not had first hand experience before, during and after OSH treatment.
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NAMI is "National Alliance on Mental Illness" Several organizations known as NAMI, are separate nonprofits, though related.
NAMI, grassroots began in 1979. NAMI Multnomah affiliate, with grassroots across the US, formed NAMI National, a separate entity with its own funding sources.
State organizations, like NAMI Oregon, were formed for organizing statewide teacher and facilitator trainings and to organize state advocacy of county affiliate members.
County affiliates connect directly with individuals, provide classes and support groups, and advocate locally.
NAMI Multnomah provides system navigators, classes, support groups and advocate, heavily subsidized by volunteer hours.
NAMI Multnomah has many wonderful peer mentors and peer advocates. (Some choose to identify as 'peers' rather than 'consumer.')
NAMI Multnomah brought Peer-to-Peer Recovery classes to Oregon, provides peer-led support groups and goes into hospitals to help individuals who are inpatient connect with recovery support after discharge.
NAMI Multnomah peers, including some who have been in the state hospital and through PSRB, educate the community through "In Our Own Voice" presentations at universities, corporations, and hospitals.
NAMI Multnomah was not contacted to speak on this OPB program about the state hospital either.
It seems appropriate to have NAMI Oregon speak about the state hospital, and still, I think it would be important to have several peers with their own personal experience at the state hospital.
Not any one of us could speak for everyone's experience, peer or family member. Sometimes, the 'family members' live with a mental illness themselves. We learn to erase the “us vs. them.”
Recovery takes many forms. The most successful give us hope and this helps erase stigma and stereotype. Some are chronically, severely ill or very young or in serious crisis, which teaches compassion and informs us of the need to advocate. We must not leave these peers out. That’s the voice of "natural support," often the family.
Some who live with mental illness have not had support of their families, or have been treated unjustly. Others express their hope to have relatives or friends advocating and find appropriate care. Or all of the above.
Several peers, with different experiences, must be heard from. One size does not fit all.
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I spent the better part of my high school years at OSH, back when the now defunct 40 Building was still taking in children/adolescents. Having little more than an eating disorder and some residual depression from the sudden loss of freedom, I spent over 2 and 1/2 years total there. I "developed" more issues as time wore on, and had more medication added to a grocery list I was already taking. My main issue--the eating disorder--was never "treated". There was no treatment at all. I had group therapy and individual therapy once a week. I was with some very sick people that required intense monitoring, which inevitably led to a lack of staff available for people who were doing well. In facing that situation day after day, it become impossible to be WELL. Eventually, I regressed enough to gain that coveted staff attention.
I don't think there is one person to blame. I was failed by multiple systems. Treatment for eating disorders in Oregon didn't exist at that time and because I was a ward of the state in SCF custody, I couldn't get help anywhere else. There was little "treatment" at OSH and even less "professionals" to give it. The mental health staff were often clueless and some probably suffered with mental health issues themselves. I found that less than half of them went to college--and sometimes that didn't matter, but there were some that shouldn't have been working with children at all.
I mean, talk about people not being able to speak for themselves? Psychiatric patients in general often can't get advocacy, but imagine being a minor in those conditions. I often heard, "write a greivance" to my many qualms. Do you think I ever got a response??
I don't think being locked up for that length of time without proper treatment helped. I can't blame the hospital, but I can blame the system that uses a state hospital as a dumping ground for people falling through the cracks.
Luckily, I left a few months after turning 18 and went to college. After I graduated I worked in a similar setting with children and learned that little has changed in the way "professionals" deal with sick kids.
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Comments are now closed.
I work in maximum secutity in the forensic unit. Someone needs to let the public know what the staff at OSH are gong thru. Right now the inner hospital e-mails are suggesting a class action law suit against the hospital for years long understaffing and forcing staff to work 2 and sometimes 3 16 hour days straight. (This equates to maybe 4 hours sleep for several days for staff that are on the most dangerous ward in the hospital). Right now , on my unit, one female patient is sending staff to the hospital on almost a weekly basis, and no one knows about it, (except administration).
Was anyone aware of the protest the staff participated in last month concering the impossible parking situation there? The staff are forced to park in muddy fields where when you step out of your car you are up to mud to your calves. So for one week staff parked in all 88 parking spaces of the administration building so administration could experience what they get to go thru on a daily basis.
Two or three months ago a staffs car (Geo Metro) was towed, without her knowledge because she had parked at the end of a line of cars in the parking lot (There was no space designation). BUT when Nina Strickland parked in an illegal parking spot last month, AND WAS CALLED AND ASKED TO MOVE HER VEHICLE, she said no and remained in the parking spot for the rest of the day, No ticket, no towing. People helping people?? RIGHT!