The Oregon Health Authority released a proposal Friday for how it will deal with the backlog of jail inmates trying to get mental health treatment at the Oregon State Hospital.
Right now, there are 44 people who judges around the state have deemed in need of mental health treatment before they can aid in their own criminal defense. They're waiting inside jails until they can get admitted to the state's psychiatric hospital.
In a two-page memo to staff, OHA Director Patrick Allen said they're taking steps to reduce the time people are waiting to be admitted and speed up the discharge process for those who no longer need hospital level care. He also stressed the need for funding from state lawmakers for community based mental health services.
The plan comes days before the state is due in federal court in Portland over the issue.
Disability Rights Oregon and Metropolitan Public Defender have sued the state, arguing it's violating a 2002 federal court ruling that said inmates found unable to aid in their own defense must be transferred to the state hospital within seven days.
The plaintiffs argue that's not happening and point to the dozens in jails waiting to be transferred.
In an interview with OPB on Friday, Allen acknowledged the state is operating outside the seven day window outlined in the federal court case.
"We've driven that number down to 21 days and that waiting list down from about 60 people to closer to 30-40 people," he said. "So we're making progress."
Allen said he can't admit everyone because it would jeopardize the safety of his staff and possibly the other patients.
Research has shown the longer people with mental illnesses stay in jail, the sicker they become.
"There are a lot of studies out there that show that people with say schizophrenia that's untreated for a prolonged period of time, it may permanently reduce their baseline functioning," said Emily Cooper, legal director of Disability Rights Oregon.
Mental health advocates say people in jail often don't get proper treatment. Many jail and law enforcement officials agree.
In a declaration filed Friday in the federal lawsuit, Washington County Sheriff Pat Garrett said inmates ordered to the state hospital routinely stay in his jail past the seven day window.
"Some of these mentally ill inmates decompensate to the point where they refuse to shower or maintain basic hygiene, they smear human feces on the walls of their cell, they engage in more or less constant yelling or mumbling, they engage in self-harm or they simply withdraw to the point where they don't eat, speak or respond," Garrett said in federal court documents.
Garrett said people with mental illnesses shouldn't be in jail, but should be "humanely housed in a therapeutic environment where they can be appropriately treated by medical professionals."
House Majority Leader Jennifer Williamson, D-Portland, said lawmakers are looking at ways to prevent defendants with misdemeanors from going to the state hospital, saving the room for those with felonies.
“It saves the state hospital beds for people who are truly dangerous,” Williamson said. “It solves the problem only if we fund community mental health providers who can address the needs of people who are accused of violations and misdemeanors.”
Allen noted in his memo that OHA has asked the Legislature for $7.6 million to fund community health programs, so people could get treatment locally rather than having to go to the state hospital. Many counties in Oregon don't have adequate mental health services, making the state hospital a court's only option should they find someone unable to aid in their own criminal case.
Long term, the state and mental health advocates said they'd like to see more options so fewer people with mental illness end up in jail.
Cooper, with Disability Rights Oregon, said that's in part what the federal lawsuit is about.
"What we're trying to do in this litigation is say, 'No, we don't even want someone to show up at the jailhouse door, we want them to be diverted from the correctional health system,'" she said.
As for those who are languishing in jails right now, Allen said: "My heart goes out to them and I am doing everything that I can to get them into the hospital as quickly as I can."
That's an argument a federal judge in Portland will weigh in on Tuesday.