From the Portland Tribune, August 31 2008

Hooper Detox Center move could free space in housing project

When James Chasse Jr. died in police custody in 2006, Portland cops didn’t know he was schizophrenic, and didn’t have an appropriate place to bring him even if they had known.

Now county officials think they have such a place on the inner east side.

Multnomah County is working on a public-private partnership with Central City Concern to build a mental health evaluation and assessment facility in the Central City’s David P. Hooper Detoxification Center, east of the Burnside Bridge.

Central City Concern plans to break ground early next year on a $23 million low-income housing project at the former Ramada Inn at Northeast Third Avenue and Weidler, said Ed Blackburn, Central City Concern executive director. The 52-bed Hooper Detox Center will be moved into the building, he said. That would free up space for a mental health evaluation and assessment facility on the second floor of the current Hooper facility, said.

“It’s not a done deal,” said Multnomah County Chairman Ted Wheeler. “But I think we’ve made great strides forward. I’m fairly confident we’re moving forward.”

The county has lacked an appropriate place to screen potentially mentally ill people picked up on the streets since it pulled the plug on the Providence Crisis Triage Center early this decade.

The Hooper facility would continue to house the county-funded “sobering” center run by Central City Concern. That’s where inebriated people are lodged for several hours until they sober up. Some are later transferred to the detox center, where they are under round-the-clock professional care to help them on the road to recovery.
Operating funds hard to come by

Putting the mental health screening center near the sobering center makes sense for operational purposes, but it also may be an easier place to site it, Wheeler said.

“Inebriation often masks mental health symptoms,” he said.

“It’s often very difficult for law enforcement people or even medical practitioners to always tell someone who’s in a mental health crisis from someone who is intoxicated,” Blackburn said. “Some people are both having a mental health breakdown and/or intoxicated.”

The mental health evaluation center would have 16 beds, and people could stay there up to 14 days. It would cost $3 million to build and $3 million a year to operate.

Wheeler made the project one of his top priorities in the 2008-09 county budget, and set aside $1 million for construction. Portland Development Commission has allotted $2 million from its central eastside urban renewal funding, Blackburn said.

The ongoing operational funds will be harder to come by, Wheeler said. But he recently convinced seven health-related companies to chip in a total of $600,000 to operate the Hooper facility. Hospitals, health insurers and others save money when inebriated people are treated at Hooper instead of being lodged in hospital emergency rooms.

The same entities could save money if mentally ill people are properly evaluated at a new intake center, rather than dropped off at emergency rooms. Portland police would save money as well, because officers now wait hours for people receiving treatment in the emergency room.

Wheeler said he’ll go back to some of the same groups that helped pay for Hooper services, to see if they could chip into the mental health evaluation center operating costs.

“I think we have started a very strong partnership,” he said. “We all have a vested financial interest in it.”

Central City Concern isn’t proposing this in an effort to expand, Blackburn. The nonprofit would be perfectly content if another entity were contracted by the county to run it. The agency wants to help because the facility is sorely needed, he said.

OUR COMMENT – This was a very good idea two years ago, when the Mayor’s task force on Public Safety and Mental Illness proposed opening a sub-acute psychiatric facility, replacing the Crisis Triage Center, closed after community complaints about poor management and high costs. But it’s been two years -so with a reluctant vendor, we’re not holding out collective breath the County can find the continuing operating costs to open this facility.

Opinion by Debra Orman McHugh, published in the Salem Statesman Journal, August 29 2008

When I first read of the death of Andrew Hanlon, I was overcome with fear. My initial thought was, “My God! That could have been my family! That could have been my son!”

Even in those first moments of shock, I was keenly aware of how the life and death of one family member affects the whole family. That is no less true when that family member struggles with mental illness.

I have been affected by the mental illness of a family member, in one way or another, for more than 30 years. Whether dealing with the illness of a child or a spouse, a parent or a sibling, the impact on the family can be unbearable.

The reality is that there are many of us who live with the pain of having a seriously mentally ill family member. Worries about the health and safety of that family member are constant and wearing. Feelings of helplessness, anger and frustration are inescapable. For people living with serious mental illness and their families, the most insidious feeling is that of isolation.

Serious mental illness strikes people of all ages, races and socioeconomic backgrounds. It is not the result of poor parenting, but of imbalanced brain chemistry. With a wide range of services tailored to their needs, and often medication, most people who live with serious mental illnesses can significantly reduce the impact of their illness and have a satisfying life and achieve independence.

While finding effective medical and psychiatric care is a first priority, most people with serious mental illness need more than medical help. They need the structure and steady support that family, friends and neighbors can provide.

As I thought about the death of Andrew Hanlon — a son, a brother, a friend — I was motivated to take action. I am speaking out about my experience with serious mental illness in the hope that it will give another parent or sister or daughter the freedom to seek help for their family member and themselves.

Loving a person with mental illness (especially one who is unstable) is emotionally and physically exhausting. Many of us feel there is no one else living our struggle. I want to reach out to other families like mine and tell them we are not alone. There is a place where we can go to get information, support and, occasionally, a shoulder to cry on.

The National Association on Mental Illness is the nation’s largest grass-roots mental-health organization dedicated to improving the lives of people living with serious mental illness and their families. Members of NAMI are families, friends and people living with serious mental illnesses such as major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder, panic disorder, post-traumatic stress disorder and borderline personality disorder.

Here in Salem, NAMI Marion-Polk provides free education and support to people living with mental illness and their family and friends. We are not alone.

Opinion from Margie Boule, published by the Oregonian, August 11 2008

Therapist and mom’s novel aimed at kids

Jenna Knudsen used to beg her mother, Marjie Knudsen, to pull her out of public school and home-school her.

Jenna hated going to school. Oh, she had friends. She participated in activities: For four years at Southridge High School, Jenna was a cheerleader. She also was in the musical.

On the outside, Jenna looked happy and successful.

On the inside, Jenna was “hurting so much,” Marjie says, “she would get stomachaches. She was tormented, and going to school was the worst.”

This is not a story about a bully making Jenna’s life miserable. “She wasn’t a target,” Marjie says. The only person beating up Jenna was Jenna herself.

For a long time, Marjie just thought Jenna was shy. “She was very clingy,” Marjie says. She thought Jenna would outgrow it. By fifth grade, Marjie realized Jenna needed help to overcome her anxieties.

“Our pediatrician suggested she see a psychologist. Boy, that was the best decision I could have made.”

Jenna and Marjie learned Jenna had something called “social anxiety.” Between 3 and 13 percent of all people have it, according to Jenne Henderson, a local clinical psychologist who treats children with anxiety.

“Social anxiety is more severe than shyness,” Jenne says. “It impacts a person’s life more dramatically, or causes them more distress.”

Parents often experience denial when their children have social anxiety. They don’t realize that techniques and therapies are available that may help the anxious child learn to feel comfortable in the outside world.

Instead, they get in the habit of protecting the child. They let the child stay home when the child pretends to be sick, or says he doesn’t want to go to a birthday party or sleepover. The parent will order the child’s meal in a restaurant, or allow a child to avoid summer camp.

Often the child doesn’t understand why he or she feels so much fear. Jenna didn’t.

“Life was just hard,” she says. “Doing things that were normal for everyone else was so hard for me, and I didn’t know why. I’d think, ‘Why do I get so nervous and other people don’t?’ ”

After she dragged herself to school, Jenna says, “it was fine. But even if it went well, next morning I’d be nervous again.”

Marjie and Jenna learned techniques from Jenne, and slowly Jenna expanded her comfort zone. Marjie chaperoned school events, so she was nearby if Jenna got anxious. Later, as Jenna became more comfortable, she would carry a cell phone and call her mother if she got scared.

Jenna learned, she says, “if you keep putting yourself into situations, it will only make you stronger, even if you are really nervous. It’s better to expose yourself to anxious situations than to avoid them.”

When Jenna turned 17, she says, all the techniques she’d learned fell into place. Today she feels much more comfortable in social situations. In fact, she’s looking forward to going away to college next month.

Marjie could have relaxed, knowing Jenna was better. “But I kept running into parents with kids who had the same problem,” she says. Worse, the parents had tried to help their children and had given up.

Marjie knew the secret was preparing anxious children, ahead of time, for social situations. She’d learned that from her friend Jenne, who sometimes pretends to be a barista, so anxious children she works with can practice ordering treats at Starbucks.

After research, Marjie discovered there were almost no fiction books about social anxiety for grade school kids.

“I had tried to read nonfiction books to Jenna, about social anxiety,” and they weren’t compelling. “I thought if there was a memorable story, if it was entertaining, kids might actually read it.”

So, Marjie got together with Jenne, and the two wrote a novel for kids called “BRAVE: Be Ready and Victory’s Easy, A Story About Social Anxiety” (Summertime Press, $11.95, 96 pages). The acronym BRAVE is one Marjie came up with, based on the techniques that had helped Jenna. “I thought kids would remember an acronym,” Marjie says. “And kids with social anxiety need to be brave.”

The book is about a boy named Danny, who’s anxious all the time. In the book, he deals with bullies and public speaking assignments, visiting other kids’ houses and daily stomachaches. By being brave, by preparing in advance, Danny’s life gets easier.

The book was released Aug. 1 and is available at Amazon.com. Its authors hope kids, parents, pediatricians and teachers will read the book, better understand what it feels like to have social anxiety and learn new ways to overcome fear.

Jenna knows the techniques in the book work. Today she’s “so glad” her mother refused to home-school her. “If I hadn’t gone to school and forced myself to go through those situations, I wouldn’t be the same today,” she says. “This book will help a lot of kids.”

EXTRA – BRAVE: Be Ready and Victory’s Easy, A Story About Social Anxiety, @ Powells.com

From the Forest Grove News Times, August 27 2008

As Yogi Berra said, it isn’t over until it’s over, but it’s clear that the folks at Luke-Dorf are about down to their last out in their botched effort to set up a group home in Cornelius.

This isn’t cause for applause, even if you’re rooting for the home team.

We understand that the former residents of Connell House don’t evoke a lot of sympathy – criminals and people with mental illness rarely do. People who are judged guilty “except for insanity” leave the courtroom with two big strikes.

Last week’s vote by the Cornelius Planning Commission just about guarantees that such people won’t be coming back to Luke-Dorf’s secured residential facility on North 29th Avenue any time soon.

We don’t blame nearby homeowners who feel relieved by that news, but the fact is, these people need to live somewhere, and there’s ample evidence that facilities like Connell House are not only safe, but offer these people some hope of getting better.

So, what went wrong?

There’s plenty of blame to go around, but it starts with officials at Luke-Dorf, the Tigard-based mental-health agency which last year applied for a city permit to remodel the building.

At some point it became clear to city officials that what they thought Luke-Dorf was planning to do in the building was far different from what the agency intended.

It’s not clear whether this was an intended end-run by the nonprofit or just poor communication, but either way, it was the foggy start that doomed Connell House.

City officials aren’t blameless. They could have done a better job of pressing Luke-Dorf for details at the outset. But once they realized what kind of residents were coming, they began working with the agency toward some sort of a solution.

Hope for any collaborative resolution, however, was dashed when Washington County Sheriff Rob Gordon decided to take matters into his own hands on the day after Christmas. That’s when employees of his office distributed notices to 1,400 Cornelius residents that three of the men staying at Connell House were sex offenders.

Since then, heavy scrutiny from law enforcement and the media has painted an unflattering picture of Luke-Dorf’s group home, culminating in a June escape that forced the state to temporarily shut the facility down — even though the man who bolted was there for health reasons, not because of a criminal record.

But whatever the conditions were like at Connell House, no one can claim that the five residents who were sent back to the Oregon State Hospital this summer are better off in that crumbling Salem facility.

That’s why it’s important for the state to come up with a better game plan when the dust settles in Cornelius. By reaching out to city officials and residents alike with facts about a facility like Connell House before it’s built, the public can, and should, be able to root for the visitors.

Opinion by Paul Fattig, from the Medford Tribune, August 24, 2008

The news that the old Cuckoo’s Nest will be torn down this fall leaves me feeling a bit melancholy.

It’s not the physical destruction of the 125-year-old main building of the Oregon State Hospital in Salem that I find depressing. Indeed, I applaud razing the building where the award-winning flick “One Flew Over the Cuckoo’s Nest” was filmed in 1975. Plans call for replacing the circa-1883 structure with a new 620-bed hospital.

What haunts me is the thought of so many lonely lives ending there in the dark and dreary, dilapidated old yellow-brick building with rusting bars on its narrow windows.

One was Jonas Fattig, my paternal grandfather.

His cremated remains were among the roughly 3,500 “cremains” of mental patients in copper canisters discovered in a storage room during a 2004 tour by legislators. Oregon Senate President Peter Courtney, D-Salem, rightfully called it “the room of lost souls.”

Grampa’s copper container, portions covered by a green patina, was No. 3414.

In a March 2006 column, I wrote about retrieving the ashes of the man whose living descendants believed had been buried on the state hospital grounds.

Yet for nearly 60 years, his remains sat unclaimed on a dusty shelf in the state hospital. The ancient fellow had been committed by his eldest son to the state asylum in spring 1947.

The friendly hospital staff was extremely helpful in identifying the remains of the Fattig patriarch, the one who had brought our family from the Great Plains to eventually homestead in the Applegate Valley, where he was known to play fiddle at barn dances.

We buried old No. 3414 in Ashland’s Hargadine Cemetery. It seemed fitting since it was there he paid $5 for the “north half of lot 40″ in 1904 to bury his daughter, Bessie Belle, age 6. She had died of measles on June 10 of that year. We gently placed his canister near her remains.

The old farmer was born 150 years ago in Iowa on Jan. 22, 1858, three years beforee the eruption of the Civil War. He was 89 when he died on Sept. 17, 1947, some four years before I was born.

There were no friends or family members present when he died. His wife and my grandmother, Harriett Viola Fattig, had died in 1940.

The medical records accompanying his ashes listed the cause of death as “bronchopneumonia.” The folks in the white coats added his clinical diagnosis was “senile psychosis.”

They also noted that he was extremely sad, and that he did not know why he was locked up in what at that time was tantamount to a prison.

Family folklore has it that he was sent to the asylum after startling a flock of church ladies out on a Sunday picnic by parading buck naked amongst them. That allegedly occurred near his farm in Holland, a tiny hamlet in the Illinois Valley.

Given the reliability of stories handed down over the generations, that may not be the naked truth. But there is probably a basis for the legend.

What is indisputable is the content of two 1947 Western Union telegrams contained in his medical records. One was from the hospital staff to Charles Fattig, his eldest son, then living in rural Josephine County, notifying him that his father had just died. It requested that he wire back with funeral instructions.

“In regards to remains of Jonas Fattig am leaving to your disposal,” my now defunct uncle replied in the second telegram.

Obviously, there was a rift in the family. There may also have been an interest by the senior son in gaining control of the family farm. But perhaps grandpa was senile.

All who knew the gospel of it are long dead. Like those who have gone before, the answer belongs to the ages.

The legacy of the old gloomy hospital building has long been associated with the “One Flew Over the Cuckoo’s Nest” movie based on the novel by the late Ken Kesey. It was a great read with the rabble-rousing Randle McMurphy, domineering Big Nurse Ratched and the strong but silent Chief Bromden.

But I will be forever haunted by the thought of a bewildered old man sitting alone on his bed in that gloomy brick building, wondering why he was there.

From the Oregonian, August 22 2008

Cornelius – A commission backs the city’s revocation of a conditional-use permit

The Cornelius Planning Commission has voted to uphold the city’s revocation of a conditional-use permit for Connell House.

The commission’s unanimous vote Wednesday is the second door to slam on the home since the state temporarily shut it down two months ago after a resident climbed over the back fence and escaped.

The secure residential treatment facility caused a stir in December when neighbors found out it was housing former Oregon State Hospital patients who were “guilty except for insanity” of serious crimes.

Richard Meyer, Cornelius development and operations director, revoked the Connell House permit in January on the grounds that Luke-Dorf, the nonprofit owner-operator, did not accurately portray the kind of home it would be when it received the permit in 2007.

Meyer also contended that the home was violating city parking codes because it was drawing far more cars than originally projected and some were parking illegally.

Luke-Dorf appealed the revocation, and at a May meeting to consider the appeal, the planning commission suggested Luke-Dorf apply for a permit modification that would address the parking issues.

In the meantime, the state closed the home while investigating the escape incident, which involved a resident who had been civilly committed, not one who committed a crime.

Instead of applying for a permit modification, Luke-Dorf asked Cornelius officials to suspend proceedings until the state investigation was completed. The attorney general’s office supported that request.

But Meyer said he did not have the authority to do so.

Luke-Dorf now has 10 business days to appeal the planning commission’s decision to the City Council.

Luke-Dorf attorney Ed Sullivan said the nonprofit hasn’t decided whether to appeal and would consult with the state, which wants to resolve concerns before reopening the home.

State officials have said they’d like Connell House to reopen, Sullivan said, but Luke-Dorf had to lay off workers when it closed and would have to overcome some economic hurdles.

From OPB.com, August 20 2008

Oregon’s growing number of cases of autism, and unreliable treatment options have a group of lawmakers and state officials searching for answers this week.

Oregon has at least the third highest incidence of Autism Spectrum Disorder, or ASD, nationally.

Frustration. That’s probably the best word to describe the overwhelming feeling from parents and advocates who showed up to an autism town hall in North Portland Tuesday night.

Ellen Dutch is the mother of a 17-year-old boy with autism. She says lately, she doesn’t feel comfortable leaving him alone with other people.

Dutch mentioned that to her insurance company, and was told that her son could be admitted to a facility, only if he was suicidal.

Ellen Dutch: “If he is not suicidal, but he’s a dangerous to others, you can call the police. Those are my two options. Given what has happened in Portland, with the Portland Police, I certainly did not want to depend on that option. And when I called Multnomah County services, I got the same answer.”

Dutch’s frustration came as no surprise to Eugene-area representative, Chris Edwards. He’s the chair of the Autism Spectrum Disorder Workgroup, and the father of a six-year-old autistic boy.

Chris Edwards: “As a parent of a son with autism, I know how frustrated I’ve been at the lack of a coordinated state response to this epidemic.”

One in 89 children in Oregon is diagnosed with autism. That number is even higher around Eugene.

Edwards opened the town hall by recounting his family’s struggles and eventual successes, in finding services for his son in Eugene.

The upbeat ending to Edwards’ story, though, rubbed some parents like Lyn Osburn the wrong way . She says a court case more than a decade ago forced the state to improve care. But Osburn says efforts since then haven’t done the job.

Lyn Osburn: “The same vague ideas, the same vague measurements, the same vague recommendations as 1996. I’m really disgusted, because to me, these people are part of the problem here.”

Republican state representative and work group member, Linda Flores says she intends to introduce a bill to state lawmakers next year.

Linda Flores: “Whatever we’re doing now is preparation for work that we come into the legislative session prepared to do. Rather than doing a study, for the sake of doing a study, and setting it on a shelf and not paying attention to it.”

Flores admits she doesn’t have much direct experience with autism. Unfamiliarity like that fueled criticism from advocates like Dora Raymaker. She’s an adult with autism, who spoke to the work group through a voice program on her laptop computer.

Dora Raymaker: “It is absolutely critical both in maintaining quality and from a human ethics’ standpoint for any organization that claims to serve a particular segment of the population, to have members of that segment of the population at the policy level of that organization. You must include actual autistic individuals on your committee moving forward.”

Others insisted that not only should adults with autism be on the committee, but they should be emphasized in the recommendations, as well.

People testified that the current draft prioritizes services in schools, for instance. But overall, parents like Myrsa Montoya-Brown called for stronger recommendations. In particular, she disagreed with a proposal to “explore” health insurance mandates.

Myrsa Montoya-Brown: “All it says is ‘explore specific health insurance coverage’ – I think it needs to say ‘develop and pass insurance legislation that covers physician-directed intensive treatments for ASD.”

Representative Edwards says he supports tough insurance laws, but says they’re complicated, and hard to create without loopholes. As these recommendations head toward bill form over the next few months, the question of insurance may prove controversial.

On one side, you’ve got the powerful insurance lobby. On the other, parents like Ellen Dutch, whose insurance company directed her to the police for help with her son.

Ellen Dutch: “And I said ‘what would you do if you had a child with this disability?’ Their response was ‘I would move. I would leave the state’.”

Dutch says she has had friends with autistic children leave the state – and she intends to do the same, if conditions don’t improve.

The series of public meetings on autism continues Wednesday night, in Eugene.

From KGW.com, August 19 2008

Three Oregon university presidents want to see the legal drinking age lowered from 21 to 18 because they believe the current law encourages dangerous binge-drinking on their respective campuses.

Dr. Thomas J. Hochstettler of Lewis and Clark College in Portland, Dr. Phil Creighton from Pacific University in Forest Grove and Dr. M. Lee Pelton from Willamette University in Salem joined about 100 college presidents from across the country in pushing for the change.

Others included the presidents of Duke, Dartmouth and Ohio State. They believe that the legal drinking age simply doesn’t work and that college students will drink no matter what. They said they’ll do so more dangerously when it’s illegal.

“This is not a simple question. But the current answer is also not an effective solution to the problem,” said Richard H. Brodhead, of Duke University.

The presidents signed a statement noting that while adults under the age of 21 can vote, serve on juries and enlist in the military, they are told they’re not mature enough to have a beer.

The group pushing the so-called “Amethyst Initiative” will start publishing newspaper ads in the coming weeks, hoping for serious debate among the public and among lawmakers.

Launched in July 2008, the Amethyst Initiative is made up of chancellors and presidents of universities and colleges across the United States.

“These higher education leaders have signed their names to a public statement that the 21-year-old drinking age is not working and specifically, that it has created a culture of dangerous binge drinking on their campuses,” said the website www.amethystinitiative.org.

Mothers Against Drunk Driving said the initiative is a bad move and lowering the drinking age would lead to even more fatal car crashes.

Oregon Partnership,” a statewide non-profit organization which provides alcohol and drug prevention education is adamantly opposed” to the initiative.

“This is not only a bad idea, this is a horrendous idea. Lowering the drinking age makes the underage drinking problem even worse,” said Pete Schulberg, communications director with Oregon Partnership. “When the drinking age went up to 21, there were fewer alcohol related health problems and fewer fatal car crashes,” he said.

EXTRA – Join Together.org – Advancing Effective Alcohol and Drug Policy
EXTRA – 3 Oregon college heads join the call to lower drinking age, the Oregonian, August 19 2008

OUR COMMENT – College presidents have in locus parentis responsibility to protect underage students from alcohol. This idiotic and embarrassing proposal is about dodging lawsuits, not fostering good decisions around drinking alcohol. Diligent journalists will quickly discover the financial connection between the alcohol industry and these college presidents, and when they do, we expect their respective trustees to demand resignations.

They make make a mistake by attempting to control other persons drinking. If these education leaders were sincere in their concern, it would be more logical, manageable, and thoughtful about the changing character of youth today to raise the age for college admission.

From the Oregonian, August 17 2008

“Eva York died in a bathtub in 1896 at the Oregon Asylum for the Insane. After an inquest, which absolved the hospital staff of any blame, no one claimed her corpse, so she was buried in the asylum cemetery and forgotten.

Eighteen years later Eva’s remains were exhumed, cremated, placed in a copper urn and forgotten all over again. Today the corroding canister containing her ashes sits on a plain pine shelf in what’s called the “Cremains Room” at the 122-year-old Salem institution, now known as the Oregon State Hospital.

Eva York is one of about 5,000 patients whose cremains are neatly stacked in that stark, lonely room like cans of paint in a well-stocked hardware store. Her story one of the rare stories that can be told, thanks to the inquest into her death makes her a perfect symbol for what’s wrong with the way Oregonians treat some of the most frail among us.”

Those are the opening lines in The Oregonian’s 2006 Pulitzer Prize-winning series of editorials. The image of those corroding canisters became a metaphor for a deeply disturbing negligence in Oregon history. Now those same canisters have undergone another metamorphoses — into haunting objects of art.

San Francisco-based artist David Maisel has created a stunning series of photographs of the canisters, to be published by Chronicle Books this fall as “Library of Dust.” The Portland Art Museum has scheduled an exhibition from the book from Sept. 1 to Dec. 6.

Here’s a couple more of the images, and there’s an interesting blog on the project here.

OUR COMMENT – Securing a suitable memorial for the Oregon State Hospital’s patient remains was the sole advocacy campaign of the Mental Health Association of Portland in 2005. We discovered these 3000+ copper cannisters during an unguided tour in 2001, and while strategizing with other advocates how to apply pressure to the hospital to cause clinical change, we decided to tell the story of these remains – largely by stewarding media stories such as were printed in the Oregonian and the New York Times. One of the few happy results of our campaign are the photographs of David Maisel.

Opinion editorial from Salem Statesman Journal, August 16, 2008

State facility needs to start improving conditions now

The news coming out of Oregon State Hospital has not been good lately. But there are signs of improvement.

New Superintendent Roy Orr has started articulating a clearer vision for the hospital. The critical question is whether he can move quickly enough to change the hospital culture.

The hospital is a big deal in Salem and the surrounding area. That’s partly because of the jobs it creates. But local residents and public officials also pay attention to problems at the hospital, including security lapses. And many people think the hospital has neglected its relationship with the community.

Despite stumbles, Orr appears to understand those concerns. He admits that the hospital erred by failing to inform the community and public officials before resuming outings by forensic patients.

That poorly executed decision may illustrate how difficult it will be to change the hospital culture: Last month, OSH officials initially stopped on- and off-campus patient outings in the 470-patient forensic program. That ban followed two escapes, including one from a locked ward.

The state responded to the escapes by launching internal and external security reviews. But the patient outings quietly were reinstated, albeit with closer supervision, before the security analysis was completed.

Hospital officials should have recognized the community ramifications of their decision — and the importance of letting people know publicly.

In the aftermath, Orr is saying the right things about wanting to change the culture: “We want to move the Oregon State Hospital out of its past.”

For example, he said that training has improved, resulting in less staff use of physical restraints and seclusion to handle difficult patients.

Orr favors creating an advisory board — as many community hospitals have — to provide ongoing examinations of quality, security, ethics and other issues. That sounds like a good concept if the board has the authority, expertise and dedication to dig deeply.

Orr also has been open in discussing another sordid incident, the arrest of an employee on charges of sexually abusing a state hospital patient at the Portland campus. Again, that incident reflects the building and staffing problems that plague OSH.

It took a federal investigation and impatient legislators, especially Senate President Peter Courtney, to get the state’s attention about the deplorable conditions at the chronically understaffed hospital.

The Legislature approved adding more than 200 positions, but hundreds more are needed. The state also approved construction of two replacement hospitals, in Salem and Junction City. Groundbreaking for the new Salem hospital is Sept. 3.

Orr’s challenge is to do more than limp along until the new Salem facility opens in 2011. Improved staffing, better training, better relations with the Salem-area community and modern treatment methods — constituting a change in hospital culture — must happen now.

Otherwise, Oregon will have new buildings housing an antiquated hospital.

OUR COMMENT – In 2007 Oregon state legislators, unwilling to confront complacent union bosses, instead offered a new $600 million dollar multi-location facility as the solution for the problems at the Oregon State Hospital. No doubt good news for those who live and work in the antiquated structures, but excellent mental health treatment can be provided in a wigwam. Focusing attention on new buildings has been political sleight of hand by Peter Courtney and others, misleading and misguiding the public to believe a clinical solution comes as a subset of bricks and mortar. The state hospital is not intended as a jobs program, not a prison, and currently not even much of a hospital – it is where effective, outcome-driven psychiatric treatment for those most unable to help themselves ought to be available on demand.

From the Oregon Historical Society Journal, Summer 2008

A Patient’s Memories and Recent Interview of her Doctor

The three-storied, spired building stretched for a full block along Center Street in Salem, Oregon, just a few blocks from my childhood home. On weekend walks, my mother would sometimes take us past the seemingly endless structure, and, when I asked about it, she explained that crazy people lived in the building and that the bars and screens over some of the narrow windows were there to keep them from getting out. Little did I know that, by the time I turned sixteen, I would be a patient at Oregon State Hospital (OSH).

A 1952 brochure published by the hospital for visitors indicates that patients were not allowed onto the 180 acre campus without an escort.1 When I arrived at the hospital in 1965, however, the sidewalks crisscrossing the park-like expanse, landscaped to bloom in the spring and summer, bustled with patients, student nurses, and young interns passing each other on their way to various destinations. Ground privileges were earned by patients. In return for devoting a few hours a day to an Industrial Therapy (IT) assignment, patients were rewarded with a “number 2 card,” which allowed them to come and go from the buildings at will during certain hours.

For a time, I was allowed the card as a result of my efforts in two separate assignments. In the first, I helped feed by hand the disabled and wheelchair-bound patients on a geriatric ward. In the second, I donned a shower cap and cape, then soaped and rinsed patients who responded to me with vacant stares and passive cooperation. Other patients accepted IT assignments in the main kitchen, warehouses, landscaping crews, greenhouses, beauty or barber shop, and sewing room.

In nice weather, I walked outside on the southeast corner of the campus and saw numerous greenhouses. I was told they provided starts for vegetables grown to feed patients and for the flowers that lined the walkways. Near the greenhouses, long-shuttered structures with attached loading docks bordered the several acres of arable land between the hospital grounds and the Oregon State Prison walls. I thought the buildings looked like the remnants of a farm. I later learned that, at one time, the hospital — a largely self-contained community when I was a patient there, having its own library, fire trucks, morgue, and religious services, for example — had depended on patient workers to produce and harvest all of the agricultural products consumed at the institution. In 1893, the hospital actually produced enough to feed not only themselves but also the institutions for the deaf and for the blind.

When I was a patient at the hospital, the fields appeared unused, although the tracks of a narrow gauge railway remained, leading from the fields and into the entrance of a tunnel. The system — still in use in 1965 — allowed for the transportation of all kinds of goods to different sections of the hospital, even in bad weather. As a new patient, I had been escorted into the tunnel system to have my picture taken and to get tested for tuberculosis. Men pushing hot-food carts passed us, headed for the elevator that took them into the building above. Other carts were heaped with laundry, which I later learned was sent to the prison for processing.

READ the remainder of this interview.

The Mental Health Association of Portland has followed the what happened to Lukus Glenn since 2006 on our web site – What Happened to Lukus Glenn.

The family of an 18-year-old Tigard man shot to death by police during a domestic disturbance in 2006 filed a federal wrongful death lawsuit Wednesday against the county, city and officers involved.

Hope Glenn, the mother of Lukus Glenn, filed the suit against Washington County, the two deputies who shot her son, the city of Tigard and a Tigard police officer.

There are two claims for relief in the lawsuit. Each seeks more than $7 million.

“We were forced to go ahead and file this to shed light on the events of that night,” Hope Glenn said. “It’s all been very hard and it just gets worse not better.”

Spokesmen for the Washington County Sheriff’s Office and the Tigard Police Department declined to comment on the lawsuit.

A Washington County district attorney’s office investigation into the shooting, completed in October 2006, called the incident “tragic” but “legally justified.” The probe ultimately rejected Hope Glenn’s call for a public review of the shooting.

The incident began about 3 a.m. Sept. 16, 2006, when Hope Glenn called 9-1-1 from her Tigard residence, saying her son was drunk, out of control and threatening the family. Three officers arrived minutes later to find Lukus Glenn outside his house holding a knife.

When Glenn refused to drop the weapon, Tigard police Officer Andrew Pastore shot him with nonlethal beanbags. As Glenn turned and moved back toward his house, where his family members were, Washington County sheriff’s Deputies Mikhail Gerba and Tim Mateski opened fire with their service weapons, killing him.

An autopsy showed that two of the eight bullets that struck Glenn inflicted fatal injuries by severing large pelvic arteries. Nonfatal shots also struck Glenn in the legs, buttocks, lower back and right shoulder.

A medical examiner’s report found that Glenn, a former high school soccer and football star, had a blood-alcohol level of 0.18 at the time of his death. Oregon’s legal limit for driving is 0.08.

The lawsuit, filed in U.S. District Court by Lake Oswego attorney Lawrence K. Peterson, says official accounts of the Sept. 16, 2006, shooting contained “glaring inconsistencies and self-contradictions that were never resolved.”

The official account of the shooting, for instance, said the beanbag rounds fired at Glenn had no effect and he continued to “act out” after they were shot. The lawsuit says, however, that an audio record of the events shows the lethal fire was discharged almost simultaneously to the beanbags.

The officers’ failure to use appropriate crisis intervention techniques, to engage Glenn in conversation rather than relying on yelled commands and to use the beanbag shotgun in a manner that moved Glenn toward the doors of his residence, among other factors, all contributed to his death, according to the lawsuit.

[youtube=http://www.youtube.com/watch?v=6aQmA3klKDc]

EXTRA – From AP.com, August 13 2008
EXTRA – For all previous stories about what happened to Lukus Glenn from the Oregonian CLICK HERE.
EXTRA – Lukus Glenn family files wrongful death suit, Tigard Times August 13 2008
EXTRA – Myspace – group memorial for Lukus David Glenn

From KPTV.com, August 11 2008

A healthy, newborn girl has been taken into protective custody after she was found in a field Sunday, police said.

At about 10 a.m. Sunday, a man walking his dogs discovered the infant. A Portland Police Bureau spokesman said the man entered the field after his dogs wouldn’t stop barking and he heard what he thought might be a kitten.

The man found the baby girl and called for help, police said.

People who live in the area said the mother is mentally ill and lives on the streets.

Andrew Reuscher said he has seen the woman on a nearby street corner in recent months. He said she was obviously pregnant, but often drinking beer and asking him for cigarettes.

“It was hard to watch and it’s like (there was) nothing really I could do,” Reuscher said.

Other neighbors said the mother didn’t mean to abandon the girl; they said she went to find a water hose to get cleaned up before she touched the baby.

“She says she was screaming for help and no one came, so she just did it on her own,” said Dawn Blanchard, who knows the birth mother.

The baby was found near Northeast 102nd Avenue and Pacific Street near the Gateway Fred Meyer.

The mother could face charges, but some people who live in the area said she’s not the only one to blame.

“She was in a mental hospital and they released her knowing she was pregnant,” Blanchard said. “And I think they should’ve gotten her more help.”

To prevent unwanted newborns from being abandoned or killed, Oregon passed the Safe Place for Newborns law in 2001. The law allows a parent to leave an infant that is 30 days old or younger with an employee of a medical facility or law-enforcement agency — no questions asked, unless there are signs of abuse.

EXTRA – Witness: Homeless mom stayed near newborn before it was found, KATU.com August 11 2008

Lone Fir Cemetery on SE Morrison and 20th Avenue is one of Portland’s oldest resting places, holding over 50,000 bodies, most interred prior to 1920. Spectral, romantic, certainly haunted, filled with beautiful oaks, firs and thousands of ornate and rapid aging headstones, Lone Fir is a vault of Portland’s history.

One of the untold stories of Lone Fir is the asylum patients of Dr. James Hawthorne. The Mental Health Association of Portland has received a draft of a new historical text, the describing in accurate detail the burial of the Asylum patients of Dr. Hawthorne.

DOWNLOAD & READ – The Lone Fir Cemetery and the Asylum Patients of Dr. James C. Hawthorne – PDF

Sections include

A Brief History on the Origins of Mental Health Care in Oregon
The Patients of Dr. Hawthorne Interred at Lone Fir Cemetery
Brief History of Plots at the Lone Fir Cemetery
The Asylum Grounds

Hawthorne stands out as a pioneer in the planning and caretaking of people with mental illness. Mental health activist Dorothea Dix visited Hawthorne’s Asylum in 1869. Her recommendation to maintain the state’s contract with Dr. Hawthorne was testament to the excellence of his hospital. Hawthorne and his immediate family are buried at Lon Fir.

When a Multnomah County office building was razed in 2005, archaeologists and local historians began to tell two very different untold stories; the first about Chinese workers temporarily buried at Lone Fir (and unfortunately temporary turned into forever for some) and Asylum graves for people with mental illness. Both sets of graves are in part under the old building or it’s access roads.

Multnomah County has agreed to make the area adjacent to the Chinese and Asylum grave sites a memorial area. What that should look like is undecided. The text above has been prepared by Historical Research Associates in preparation for a public discussion about how to present a suitable memorial for the asylum patients interred at Lone Fir. A similar discussion is nearing completion about Chinese buried at Lone Fir.

The Mental Health Association of Portland will advocate an open public discussion be facilitated by the planners of the Lone Fir memorial about the design of the memorial with people who have a mental illness. We’ll announce on this web site when and where this public discussion will take place.

EXTRA – Memorial to Chinese Workers at Lone Fir Cemetery – Asian Reporter, July 2007
EXTRA – Reminders of Grief – Art review (!) of Lone Fir Cemetary, September 2005
EXTRA – Metro’s Lone Fir Pioneer Cemetery web site
EXTRA – Lone Fir Pioneer Cemetery master plan and Morrison property site design
EXTRA – list of some Asylum patients buried at Lone Fir

From the Oregonian, August 8 2008

Study – Treatment admissions in the state for prescription drugs rose 332% in a decade

Oregon’s per capita drug use exceeded the national per capita average in 2006, according to a state annual drug threat assessment released Thursday.

The report found that Oregonians most used marijuana, methamphetamine and illicit painkillers and stimulants, said Chris Gibson, who heads the Oregon High Intensity Drug Trafficking Area Program.

Formed in 1999, the state program helps provide federal funds to multiagency drug task forces in Multnomah, Marion, Clackamas, Washington, Umatilla, Deschutes, Jackson and Douglas counties.

While local methamphetamine lab seizures have continued to decrease largely because of strict controls on pseudoephedrine, methamphetamine addiction in Oregon is still widespread. Mexican drug traffickers import meth from labs in Mexico and other states, the report says.

Oregon is listed as one of the top seven marijuana-producing states in the country. Large outdoor marijuana grows have been discovered on public and private property, according to the report. In 2007, law enforcement eradicated more than 240,000 outdoor marijuana plants, six times the amount seized in 2005, Gibson said

Illicit use of prescription drugs is the fastest growing type of substance abuse nationally and in Oregon. In Oregon, treatment admissions for illicit prescription drugs increased 332 percent in the past 10 years, surpassing admissions for cocaine in 2005, the report says.

Drug-related deaths increased 8 percent statewide in 2007, with overdose deaths rising from 213 in 2006 to 231 in 2007. Heroin was responsible for the sharpest increase, and the largest number of deaths in 2007. Between 2006 and 2007, meth-related deaths dropped for the first time since 2001, declining by 21 percent, the report says.

Multnomah County reported the highest number of drug-related deaths in Oregon, 111 in 2007.

Paul Schmidt, assistant special agent in charge of the Oregon DEA office, joined with Oregon State Police Superintendent Tim McLain and Portland Chief Rosie Sizer to call for continued enforcement. Law enforcement has identified 140 drug-trafficking organizations in Oregon.

“If we don’t work together, we’re not going to get the job done,” Schmidt said.

EXTRA – Oregon High Intensity Drug Trafficking Area Drug Market Analysis 2008
EXTRA – State Medical Examiner Releases 2007 Drug Death Statistics
EXTRA – Oregon State Medical Examiner Department of State Police Drug Related Deaths 2007, county breakdown

OUR COMMENT – A brief survey of offshore online pharmacies by the Mental Health Association of Portland found dozens of opportunities to purchase addictive medications without a prescription. These medications are created and trademarked by USA corporations, such as Xanax, Ativan, Ambian, Valium, Tramadol, Percocet, Darvocet, Oxycodone and many others. Reports show in comparison to most illegal drug sales, these are pharmacies are inexpensive, under-regulated, convenient and predictable.