Judge signs agreement to get more civil commitment patients through Oregon State Hospital

A federal judge has signed off on an agreement intended to get more patients through the Oregon State Hospital and give mental health providers more advance notice of when patients will return to the county from where they were referred to the hospital.

U.S. federal Judge Michael Mosman signed the agreement Wednesday, amending his September order that imposed strict deadlines on how long the psychiatric hospital can treat patients to restore their ability to defend themselves against criminal charges.

The amendment allows for an expedited and expanded process for admitting civil commitment patients, those with no criminal charges but who pose a danger to themselves or others. Civil commitments, often initiated by a doctor or mental health professional, were restricted by Mosman's initial order in September.

That ruling required the hospital to release aid and assist patients, those unable to aid in their legal defense, with misdemeanor charges within 90 days, felony charges within six months and “violent felony” or “person-centered” charges within a year. Patients were to be discharged to counties with 30 days' notice to create a plan for care after their release.

County courts have struggled to find placement and adequate treatment for discharged defendants still unable to aid in their own defense.

Disability Rights Oregon requested the initial Mosman ruling, arguing that leaving patients with untreated behavioral health conditions in jails is a violation of their civil rights and could cause their conditions to worsen while they wait.

But county district attorneys and judges criticized the order, as did several hospitals who had sued the state of Oregon saying the order prioritized aid and assist patients over civil commitment patients. Providence Health, Legacy Health and PeaceHealth argued the ruling resulted in long stays at their hospitals without resources to treat psychiatric patients. A request to change Mosman’s initial ruling was denied in January.

Mosman’s amendment also allows Dr. Debra Pinals, a neutral mental health expert appointed by the court to help OSH comply with patient admission requirements, to grant extensions for deadlines in her recommendations for patient stay times and discharge. It allows Pinals to extend the hospitals 30-day discharge notice to counties to 60 days.

The state hospital has struggled to meet admittance wait time and patient stay time requirements made by Pinals to help the hospital comply with a 2002 order. This has left defendants waiting in jails for state hospital admission for weeks or months at a time.

The agreement signed by Mosman is the result of a compromise reached Tuesday by parties who wanted county behavioral health and courts to have more time to prepare for the discharge of patients and others who want to move patients through the hospital more quickly.

Marion County District Attorney Paige Clarkson, who has been involved in the five months of negotiations, said the amendment is a positive development, but work remains to be done to help defendants get the treatment they need while also prioritizing public safety.

“Having extended notification of these people coming out doesn’t solve the problem of these people coming out untreated,” said Clarkson.

Marion County Circuit Court Judge Audrey Broyles agreed there is a “huge growing concern” for public safety as defendants come out of the hospital without being able to aid in their own defense.

Broyles said some patients are now unwilling to engage with treatment while at the hospital because they know they will be getting out quicker than they would prior to Mosman’s September order.

“When we don’t have secure residential treatment facilities to send them to, then all the notice in the world isn’t going to make a difference,” said Broyles.

An OSH spokesperson said in an email that the hospital appreciates the opportunity to work with others to find potential solutions that will benefit all patients.

Sydney Wyatt covers healthcare inequities in the Mid-Willamette Valley for the Statesman Journal. Send comments, questions, and tips to her at SWyatt@gannett.com, (503) 399-6613, or on Twitter @sydney_elise44

The Statesman Journal’s coverage of healthcare inequities is funded in part by the M.J. Murdock Charitable Trust, which seeks to strengthen the cultural, social, educational, and spiritual base of the Pacific Northwest through capacity-building investments in the nonprofit sector.  

This article originally appeared on Salem Statesman Journal: More patients to get through Oregon State Hospital after agreement