Monday, February 14, 2011

Oregon's Insane Psychiatric Security Review Board

In 1978, Oregon became the first state to create a Psychiatric Security Review Board with its primary responsibility being to protect the public, according to the Oregonian.

Oregon taxpayers are pouring hundreds of millions of dollars into treating a few hundred criminally insane patients in the state hospital, thousands more sit in prison with limited mental health treatment, and thousands more live on the street with no treatment at all.

According to the Oregonian,of the 503 patients who were at the Oregon State Hospital in Salem last week, 344 have been found guilty except for insanity. Some of them are dangerous offenders, convicted of murder and rape; others are not violent. Nearly 100 have committed low-level felonies or misdemeanors, such as theft or criminal mischief, that might have gotten them probation. But because they pleaded insanity, all will stay in secure wards -- often longer than the sentences they would have served in prison.

Judges, prosecutors and attorneys have found Oregon's guilty except for insanity law a useful tool. Courts placed 63 people under the psychiatric security board's jurisdiction last year, 82 in 2009. By comparison, Connecticut, with a population slightly smaller than Oregon's, placed six people under its psychiatric board's jurisdiction in the last year, reported the Oregonian.

Why is Oregon committing at least 10 times more?

One clear difference is that Oregon courts put people who have committed misdemeanors in the state mental hospital.

Case in point, the Oregonian reported about Wayne Richards who landed in the state mental hospital in Salem after he stole a scooter from a Fred Meyer store and abandoned it in a parking lot across the street. Oregon taxpayers will spend $17,661 every month he stays there, in one of the most expensive and most secure treatment settings the state has to offer. Of course, this is not Richards first offense, he has a long rap sheet.

The tab so far? Close to $300,000, for one guy who stole a scooter.

Richards agreed to plead guilty except for insanity in August 2009 because he thought he'd get the mental health attention he couldn't find on the outside. He also admits he took the plea because he knew he'd have warm meals and a roof over his head. It is a sad state of affairs when a guy thinks he is better off in an institution than on the street.

It becomes even worse when the government pays outrageous amounts of money, $17,661 per month, to care for someone that could function on the street for a fraction of the cost. Let's say instead that Oregon gave Richards an apartment for $1,000 a month, $1,000 spending money a month, $500 for a car, $750 for food and $100 a day for psych meds and treatment, the state would still save about $11,500 a month.

Taxpayers would be outraged that an offender could be living such an opulent lifestyle in the community on the public's dime, yet it would be about a third of what the state is paying to house a mentally ill offender in a "secured" facility.

After his plea, Richards learned he would be under the jurisdiction of the Psychiatric Security Review Board for five years -- likely twice as long as he would have been in prison. If he stays there the entire time he's under the board, the bill will top $1 million, according to the Oregonian.

Richards wonders if there could have been a better option for him and for taxpayers. "It's not worth it," he told the Oregonian, "not worth it at all."

Can you imagine what Oregon's mental health system could do for people in the community with mental illness if they had the $1 million the state could spend on Richards. The real insanity in Oregon is spending all this money on the back-end after a crime has been committed rather than for treatment on the front-end before a "person" with mental illness becomes an "offender" with mental illness.

During these difficult economic times, it is hard to imagine that any government body can continue to condone such gross mismanagement of scares resources.

To read more:;jsessionid=DC5D1B90DCD190DCDEAA96FF296A2C67?contentguid=FeQnzpRZ&full=true#display


Anonymous said...

As the father of a schizoprenic adult child who is currently in the Oregon State Mental Hospital I can speak with some knowledge about this matter.

First of all, if properly managed, the treatment and housing of these patients should not cost the amounts per patient that it is currently costing. The Oregon State Mental Hospital is a nice facility but so is a Ramada Inn that you can get for $100. a night. The point being that, all of our hospitals, mental or otherwise are out of control costwise and we should be covering many more patients for the tax dollars given. Where is all of this money going?

My child would have been semi functional in society with day to day supervision, coupled with the threat of detention. This would be much, much cheaper and probably more effective. As it is though, she had to get into enough trouble with the law to get any supervision at all. She was left to wander the streets all the way from Vegas, LA and beyond.

America has it's own type of holocaust and it's the neglect and mismanagement of our mentally ill. They are simply being left on the streets to be victimized or to commit their own crimes.

How do we pay for all of this? Make less expensive facilities that house more patients. We make too much for too few. Better treatments so the patients can actually get better and have a chance to function in the outside world. Better outpatient treatment and monitering so that a person with a history of mental illness doesn't need to be committed in the first place. Day to day supervision and treatment could be done if a patient was required to do certain things.

We need to make the commitment process easier in some cases but because of a lack of bed space or whatever the doctors, police and others will not detain someone with obvious mental problems unless the are an "immediate threat to themselves or someone else".What a copout. Even then they are usually released within three days, then the cycle continues until they commit a big enough crime to be arrested, which many mentally ill persons do.

Severely mentally ill people need supervision. If they can't get it on the outside world they will eventually die prematurely, commit a crime and end up in prison or the mental hospital, be victimized and the list goes on.

The most cost effective means of treatment would be outpatient but that is currently very ineffective in forcing a person to follow any type of treatment plan. Also, safer more effective drugs, healthy diet, adequate sleep, all of the things that don't happen on the streets. This usually requires some type of force on the patient, who, for whatever reasons does not want comply or simply cannot comply. A court order is currently required to force treatment on anyone. This needs to be easier to do. Not a return to the dark ages of throwing people in asylums and just forgetting them, but actual treatment where they have a chance in society again.

In closing, we do need to spend our tax dollars in the most effective way but our current tax rates on the wealthy are totally inadequate for helping cure some of societies ills. Call it class warfare if you like but I'm much more concerned with the people on the bottom of the heap than the fat cats who would rather spend millions on tax lobbyists, than to help there fellow man. How many mansions does a rich man need before he can share a little for the poorest?

Anonymous said...

My son is currently in the OSH, he is no longer on medication and there is no therapy there that is useful to him. In the past we have seen treatment plans built, then discarded without comment. He is given something to feel hopeful about, then something changes and the hope is taken away. There are no productive activities there for him to participate in. He needs to be sent home where he can attend school, work a job, interact with his family, attend church. All at no cost to the taxpayers.

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