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State Needs Both A New Hospital And A New System Of Care

Some of Oregon’s most vulnerable residents are at risk. That’s the conclusion of a scathing federal report on the Oregon State Hospital for the mentally ill.

Some problems are being fixed. But officials say many issues won’t be resolved until the state’s two new mental hospitals open.

Salem correspondent Chris Lehman reports on the future of the Oregon State Hospital.

 State Hospital

 Oregon State Hospital in Salem

 Take an audio slideshow tour of the hospital grounds.

The Oregon State Hospital is old. Parts date from 1883.  Even the newest building on the sprawling Salem campus was built more than a half-century ago.

Linda Hammond:   “I don’t think that we’re going to be doing this again anytime soon.”

Linda Hammond is the administrator of the Hospital Replacement Project.

Linda Hammond:  “This truly is a once in a lifetime opportunity and we need to leave Oregonians with something that they will be able to manage in years to come.”

It’s Hammond’s job to figure out what that looks like.

Last year the Oregon legislature approved a $458 million plan to build two new state hospital buildings:  A 620-bed facility in Salem and a 360-bed facility in Junction City, about an hour south of Salem.

Both projects are still in the design phase.  But Hammond says they represent a shift in philosophy for caring for the mentally-ill.

Linda Hammond:  “What we’re seeing nationally and internationally is the move to creating almost like a community environment, where you would live on your ward, so you would sleep there and that would be your home base.  Then you would go downtown for such things as food and some other functions that you could do during the day.”

Of course, they wouldn’t literally be going downtown.  In fact, they won’t be leaving the premises.

On Our Minds

OPB's series on mental health care in Oregon

The health system in Oregon, as in the rest of the United States is in crisis.

Costs are skyrocketing, millions of children and adults remain uninsured and even working people are going without health care. Presidential candidates are promising plans that will come to the rescue.

Here at OPB, we’re focusing on one aspect of the health care system in Oregon: mental health.

Our new series, "On Our Minds," examines who's getting and giving mental health care.

About two-thirds of the patients at the Oregon State Hospital are there because they’ve committed crimes and were judged guilty but insane.  Most of the other patients are there because they’ve been determined to be a danger to themselves or others.  So Hammond says the hospital has to be secure — much like a prison.

Linda Hammond:  “That doesn’t have to mean fences. You can create an environment where the building itself, the outside walls of the building, are the perimeter, part of the campus, and there’s green space inside that area.”

It may be a shift in philosophy, as Hammond says, but some mental health advocates say it’s not nearly big enough.

Robin Henderson is head of the psychiatric unit at St. Charles Medical Center in Bend. She says replacing the decrepit state hospital building is of course a good thing.

Robin Henderson:  “That being said, we need a fully funded community system of care that can provide all of those types of things that help someone not go to the State Hospital.” 

The state does provide funding for several hundred mental health patients in group homes.  But mental health advocates say there’s a lengthy waiting list to get into those facilities. Henderson says the money for community-based care pales in comparison to the $458 million hospital replacement project.

Robin Henderson:  “I can show you a picture of the new Oregon State Hospital and you can go ‘Wow, I can fund that because I can touch it and I can see it.’ A community system of care is a nebulous concept and that’s a little more difficult for our legislators to grasp at times.”

State officials say they do see the value in community based care.  The 2007 legislature put $10 million towards those kinds of programs.  But they say the new state hospital facilities are desperately needed, especially to house those found guilty but insane.

The plans to build a new hospital on the grounds of the current one have drawn mixed reactions in the Salem community.  At a recent public forum, some people said they think the city takes care of more than its fair share of the state’s mentally ill.

Patrick Carter lives near the hospital.

Patrick Carter:  “Personally, I think they should consider putting it someplace else.  It just doesn’t make a lot of sense to have that kind of institution in the middle of town, in a residential neighborhood.”

 State Hospital
 Take an audio slideshow tour of the hospital grounds.

Back at the hospital, replacement project administrator Linda Hammond’s office is just around the corner from a shuttered section of the historic “J” Building.

The building gets its name because when viewed from the air, it’s shaped like a “J”.  Most of it is shuttered.  Abandoned tables and chairs line the hallways.  The bathrooms especially are from a bygone era.

Linda Hammond:  “As you can see, there’s no privacy here.  The toilets are all open to each other.  The sinks are a shared sink.”

Parts of the J Building are still used to house patients, but Hammond says those areas have been updated.  Still, it all looks familiar to anyone who’s seen the movie that was filmed here:  “One Flew Over the Cuckoo’s Nest.”

Linda Hammond shakes her head when asked about the film.

Linda Hammond:  “The hospital is more than a movie.  It’s peoples’ lives now. It’s peoples’ futures.  I always want to respect the past and never forget it and learn from it.  But it’s also very important that we focus on the future because this is what this needs to be:  A respect for the past but a vision for the future.”

Construction on the new State Hospital’s Salem campus is expected to start next year, and be complete by 2011.

The smaller Junction City facility is due to come on line in 2013.


Oregon State Hospital Replacement Project

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