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State hospital embroiled in contempt proceedings for not admitting mentally ill people court-ordered to get treatment

Oregon State Hospital on Friday, May 28, 2021. (Amanda Loman/Salem Reporter)

Attorneys have brought nearly a dozen contempt of court proceedings against Oregon State Hospital in the last three years, arguing hospital officials didn’t admit people with mental illnesses to get treatment ordered by judges.

In four instances, judges found the hospital and Oregon Health Authority, its parent agency, in contempt for not complying with their orders.

The contempt findings indicate the state hospital, which cares for around 500 Oregonians with mental illnesses and disabilities who are court-ordered to receive treatment, failed to follow judges’ orders in Washington County to admit people to the hospital.

The hospital has faced four contempt proceedings in Marion County Circuit Court. They developed when attorneys representing the county initiated proceedings to require the state hospital to show why they shouldn’t be found in contempt.

Contempt proceedings are a way for judges to enforce court orders that weren’t being obeyed. Contempt is not considered a crime under Oregon law but still can result in fines and jail time.

Court documents showed several people who should otherwise have been under treatment at the state hospital instead continued to be housed in county jails, waiting their turn at the Salem hospital. 

Most awaiting treatment at the state hospital are “aid and assist” patients – people facing criminal charges who were unable to aid and assist in their own defense due to a mental illness or disability – those awaiting 30-day evaluations to determine whether they can stand trial, and patients found guilty except for insanity.

As of Monday morning, two were still in the Washington County Jail in Hillsboro past the deadline set in court orders for their transfer to the Salem hospital.

The state hospital continues to endure contempt proceedings, arguing it doesn’t have the resources to take in everyone that judges order be admitted.

Tom Stenson, deputy legal director for Disability Rights Oregon, said keeping people who need treatment for severe mental illness in jails, where they are often isolated, worsens their symptoms and increases the risk of self-harm or suicide. The Portland organization has previously turned to federal court to address conditions at the Salem hospital.

“Somebody will lift the grate in their cell and hand them a meal three times a day, and that’s about the extent of the social contact that they have,” he said. “If you were trying to design a worse way to house people with serious mental illness, you’d be hard-pressed to make something that’s worse than an isolation cell in a jail.”

Stenson said jail officials are not trained to deal with people experiencing severe mental illness, often erring on the side of treating symptoms of illness with disciplinary action.

The state hospital, he said, has been largely out of compliance with court orders to admit people since November 2018, with one period of compliance from September 2019 to February 2020.

“This is a long process that has a lot to do with the state’s overall failure to manage its own populations,” he said.

Stenson cited two reasons for the state hospital not admitting people for court-ordered treatment. He said the state is not managing resources to ensure treatment for people in their communities instead of in Salem.

“It’s so easy for a county prosecutor or a police officer or a judge to say, ‘We just don’t want this person around. Let’s send them to the state hospital.’ That’s what happens,” he said.

He said police too often arrest those with mental illness for minor offenses such as trespassing or misuse of the 911 system.

“They’ll spend months in jail. Eventually somebody will send them to the state hospital, they’ll spend months at the state hospital,” he said. “They’ll be discharged not to a care facility or to a house, they’ll be discharged back to the jail. They’ll kick around the jail for a while, they’ll be released from the jail without a plan and they’ll be released back into homelessness, and the whole cycle starts over again.”

Stenson said people with mental illness are far more likely to be victims of crimes than perpetrators, but those facing serious charges who aren’t in a condition to face a criminal trial should have the opportunity for restoration.

“We’re seeing that instead, this is a dumping ground. This is a garbage bin for counties to put people with mental illness in, and it doesn’t serve anybody well in the long term,” he said of the state hospital. “We’re taking the most valuable mental health resources and we’re wasting them.”

Four contempt proceedings initiated over the past month – two in Marion County Circuit Court – remain open and stem from the hospital not following court orders to admit people with mental illnesses.

The most recent contempt proceedings come at a time when the state hospital was already under scrutiny for its administrators’ response to the Covid pandemic, which included moving some of its least stable patients to units not equipped to care for them.

A Salem Reporter investigation found the hospital is seeing more violence between patients and more staff quitting, prompting administrators to twice bring in the National Guard, most recently in September.

Hospital spokesperson Aria Seligmann wrote in an email on Nov. 5 that the hospital has not admitted any patients who were found guilty except for insanity through court proceedings that took place in 2021. She said they couldn’t be admitted because of lack of bed space, and because the hospital has to prioritize patients under orders for mental health treatment to help them aid and assist in their defense.

“They keep saying that they are required to do this, but they’ve never said why they’re required to do this or who’s telling them that other than themselves,” Stenson said of the state hospital admitting patients in a particular order. “That’s a self-imposed restriction that the health authority has imposed on themselves.”

In light of the Covid pandemic, he said U.S. District Judge Michael Mosman effectively suspended the required seven-day timeline for the state hospital to admit people found unfit to aid in their own defense. “I think we’re all anticipating it will be restored in December,” Stenson said.

Seligmann said the state hospital continues to admit several patients each week, and the Oregon Legislature approved the opening of two units on the hospital’s Junction City campus. That will allow the hospital to admit patients within seven days of a court finding they are unfit to proceed to trial.

A 24-bed unit will open on Monday, Nov. 15, and a second 24-bed unit is planned to open early next year “depending upon workforce availability,” she said. She said that more state funding has been allocated to expand local treatment and arrests have been dropping since possession of minor amounts of drugs was decriminalized. “The number of people under aid and assist orders coming to the hospital will hopefully decrease,” she said.

The first three contempt proceedings brought against the state hospital were related to court orders between May and July 2019 in Washington County Circuit Court requiring the state hospital to admit defendants within seven days. They remained in custody at the county jail past that deadline for up to 40 days, and each defendant sought a contempt finding against the hospital and the health authority.

The state hospital presented evidence that the demand for beds by defendants with issues related their competency to stand trial has been steadily increasing and spiked in the latter part of 2018, according to the judge’s order. They argued the hospital had inadequate resources to meet that demand.

But Washington Circuit Court Judge Danielle Forrest said in her ruling that the hospital didn’t alert the court that it couldn’t admit people by the ordered dates or seek to modify her orders.

“Some of OSH’s own evidence suggests that failure to communicate effectively with the judiciary has unnecessarily strained OSH’s resources,” Forrest wrote, adding that the hospital said some beds were being used for people who no longer needed hospital care.

“This is remarkable given that OSH relies on strained resources as the explanation for why it did not comply with the court’s orders,” Forrest wrote.

She found that the hospital’s failure to admit the three people by the court’s deadline was contemptuous. She didn’t impose sanctions, however, because they were subsequently admitted.

Since then, the state hospital faced eight other contempt proceedings for not complying with court orders.

One case involved a Salem man who was found guilty except for insanity in 2020 and placed under the jurisdiction of the state Psychiatric Security Review Board. The same day as that court finding, state hospital officials were asked to set the date to admit him.

According to a declaration from Tad Larson, commander of the Marion County Sheriff’s Office Institutions Division, such defendants are usually transferred to the hospital within a day. Larson wrote that his office contacted the state hospital’s admissions director, Brandy Eurto, four times over the next 11 days to try to get him admitted into the hospital. Eurto said the patient didn’t meet the criteria for a quick admission.

The contempt proceeding was dismissed 45 days later after the hospital agreed to admit him.

Marion County again asked a judge on Jan. 21 to hold the state hospital in contempt. A man was civilly committed on Dec. 23, 2020 to OHA’s custody for 180 days because other community resources for treatment hadn’t been successful. The director of Salem Hospital’s Psychiatric Medical Center where he was treated said on Jan. 20 that he intended to discharge him within six days, and no community-based placement was available, according to a declaration.

“Oregon Health Authority and Oregon State Hospital has a pattern of failing to take individuals into the custody and (care), as ordered by the court, and leaving them to remain in jail facilities or in situations where community-based treatment options are not feasible,” Marion County said in a declaration filed Jan. 21.

The contempt proceeding was dismissed April 1. The reason for its dismissal is unclear.

Another man found guilty except for insanity was committed on March 18 to the jurisdiction of the Psychiatric Security Review Board and to the state hospital’s custody immediately. On Oct. 7, Washington County Circuit Court Judge Ricardo Menchaca wrote in an opinion that the man had been in the Washington County Jail for over 200 days after the judge ordered him to be admitted to the state hospital.

He found the state hospital and OHA in contempt and ordered a $100 fine for every day he was not admitted after Oct. 18. The man remained in custody as of Friday morning, according to the jail’s roster.

In another Washington County case, the state hospital was ordered on Aug. 10 to admit a man for a 30-day evaluation. By Sept. 30, the man still hadn’t been admitted and the judge ordered the state hospital to admit him for a 30-day observation period within two weeks. He was admitted on Oct. 12 to the state hospital for evaluation, but according to an affidavit, the hospital couldn’t determine whether he could participate in his trial despite trying for over an hour to interview him.

Two days later, he was back at the Washington County Jail, appearing for a court hearing through the chow hole in his cell door. His attorney brought a contempt proceeding, which remains open, against the state hospital and OHA on Oct. 20.

Stenson said he expects the state hospital will face more contempt proceedings in the coming months, and dozens of people statewide are awaiting court-ordered admissions to the state hospital.

“The people who want to get mental health treatment cannot get it in Oregon. They can’t get it at the community level, they can’t get the simplest, cheapest services,” he said. “We’re doing a massive disservice not just to people with mental illnesses, to the general public, to the taxpayer. We’re doing a disservice to the police and jail staff who interact with them. We’re doing a disservice to the people who work at the state hospital by running a system that is fundamentally ineffectual at what it’s supposed to be doing.”

PRIOR COVERAGE

Staffers at Oregon State Hospital endure violence, long hours despite promises of improvements

State hospital superintendent defends pandemic record in response to outside complaints

Amid staffing shortage, National Guard member assaulted by Oregon State Hospital patient

Oregon State Hospital Advisory Board says it was left out of loop on hospital staffing crisis

Contact reporter Ardeshir Tabrizian: [email protected] or 503-929-3053.

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