Will Hall

Will Hall was diagnosed with schizophrenia and spent a year in San Francisco’s public mental health system. After trying medications and other treatments, Will found he was able to recover and learn to live with his difficult mental states through holistic health, nutrition, yoga, and meditation, rather than conventional treatments and diagnosis. He went on to become a leading mental health advocate who has spoken and organized internationally for mental diversity and change in systems of care.

He became a board member of the Mental Health Association of Portland in July 2009.

Will is co-founder of the Western Massachusetts support and activism community Freedom Center, which offers groups and holistic alternatives such as acupuncture and yoga, and on the coordinating collective of The Icarus Project, bringing together people outside the view of disorders and illness. Will received the Disability Advocacy Award from the Center for Independent Living in Amherst MA for his work, was a featured philanthropic project by Forbes magazine, and has consulted on mental diversity in Argentina and Peru for Mental Disability Rights International. He has appeared in the New York Times, National Public Radio, and was profiled in the Newsweek magazine article “Listening to Madness.” Will is host of the FM community radio show Madness Radio, and organizing a new initiative in Portland Oregon, Portland Hearing Voices.

Find out more about what Will is doing at www.willhall.net, www.madnessradio.net, and www.portlandhearingvoices.net.

From the Portland Mercury, July 29 2009

At Mental Health Court last Thursday, July 23, a 32-year-old man only wanting to be identified as “A.K.” for this article sat next to his lawyer, Metropolitan Public Defender Liz Wakefield, in Judge Richard Baldwin’s chambers. Wearing denim shorts and a black leather belt with silver studs, A.K. sat with his arms crossed on the table, leaning on them. Pursing his lips, he waited for Baldwin to speak.

“Is there anything new?” Baldwin asked.

“Yes, Your Honor,” A.K. said. “I made a mistake three weeks ago.” He went on to say that he and his wife had gone to Bagby for a day trip. There were people there, he said, passing around jars of whiskey and coke. A.K. told the judge he drank some whiskey.

It was the first time A.K. had made this confession to anyone. Since October, he has been participating in mental health court—a program designed to divert mentally ill people who repeatedly offend away from the criminal justice system and into treatment—because of what he only refers to as “an incident” involving an alcohol blackout and his wife. The result was misdemeanor charges and a no-contact order.

Determined to quit drinking and improve his relationship with his wife, A.K. was ashamed that he relapsed.

“I just got caught up in the moment,” A.K. told Baldwin. “I have no excuse.”

Judge Baldwin encouraged A.K. to think about why his relapse happened and what he can do to prevent similar occurrences in the future.

Because of his participation in mental health court, A.K., who is bipolar and also suffers from major depression, is participating in a treatment program at counseling service LifeWorks Northwest. He’s also in couples counseling with his wife. Their relationship has improved dramatically, he says. “It’s helped us open up lines of communication where there were none,” A.K. says.

Participants like A.K. have been able to use the mental health court to develop a treatment plan individually designed to address issues that may contribute to their criminal behavior, as well as to access housing and mental health services. Since mental health court began last September, 22 people have joined the program. According to Heidi Grant, a coordinator with mental health court, there are 10 pending clients.

“That isn’t very many, is it?” says Doris Minard, a mental health advocate and past president of Oregon’s chapter of the National Alliance on Mental Illness (NAMI).

For a program that has a capacity for 75 people at one time, mental health court is off to a slow start, diverting less than half the people it has the capacity to assist. Many say the eligibility requirements are too strict.

“As an attorney, I think it’s frustrating because I see clients with a much broader spectrum of diagnoses,” Wakefield says, suggesting those clients would also benefit from mental health court.

To participate, one must already be on probation for a misdemeanor or non-person felony. The person must also be diagnosed with schizophrenia, schizoaffective disorder, bipolar disorder, or major depression. Classified as “axis one” disorders, they are the most severe mental illnesses a person can have. Many people point to the district attorney’s office as the reason why the eligibility requirements are as strict as they are.

“You’re taking a culture of locking people up, particularly in the DA’s office, and asking them to have some faith that a mental health court can work,” says Chris Bouneff, the executive director of NAMI Oregon. “There seems to be more reticence at this point to really open up the criteria so you can reach a maximum number of people.”

“I think we’re getting plenty of referrals, and we’re getting new clients every week,” says Jeff Howes, the senior deputy district attorney handling the mental health court caseload. Howes notes that people “with a long or a violent criminal history with a demonstrated history of non-compliance with court orders and obligations” are not good candidates for mental health court.

“I would have liked for there to be additional people by now,” Judge Baldwin says, adding that momentum is gaining.

In the past two months, Baldwin has begun hosting settlement conferences, or meetings between the judge, defense attorney, and prosecutor of individual cases. Discussing the case and the defendant, settlement conferences decide whether or not the defendant could benefit from mental health court. Twelve people have entered mental health court through settlement conferences.

“This is the only way cases are getting in,” Wakefield says.

Mental health court is also finding participants through the probation office’s Mental Illness Offender Unit and people currently on bench probation (a less strict form of probation not requiring a probation officer). According to Grant, 18 people falling into those categories are either participating or about to participate in mental health court.

“We are steadily increasing our numbers,” Grant says. But mental health advocates remain unconvinced.

“We expected this to be online a decade ago,” says Jason Renaud of the Mental Health Association of Portland. “It was a program that promised so much and has delivered so little. Hundreds of similar programs are in operation around the country and all they had to do was adopt the procedures of one of those, and pay for it.”

Oregon State Hospital Superintendent Roy Orr outlines steps the hospital has taken to improve patient care and conditions during his opening remarks to a team sent to Salem by the U.S. Department of Justice.

Federal investigators arrived Monday at the Oregon State Hospital, launching a fresh, week-long review of patient care and conditions at the much-criticized psychiatric facility in Salem.

The visit by U.S. Department of Justice officials to the 126-year-old hospital started shortly after 9 a.m.

Nearly a dozen members of the federal team took designated seats at a large table in the Brooks Conference Room — named for retired state hospital superintendent Dean Brooks.

The federal guests included a handful of U.S. DOJ attorneys and an equal number of mental-health experts employed by the agency.

Seated on the opposite side of the table were Oregon team members, including state hospital administrators, clinicians, nursing leaders, outside mental-health consultants and lawyers with the Oregon Department of Justice.

Facing the feds, hospital Superintendent Roy Orr gave a 30-minute summary of steps taken to improve patient treatment, safety and living conditions.

After Orr’s opening remarks, the Statesman Journal was asked to leave the meeting. As dictated by the U.S. DOJ, the rest of the week-long review has been deemed off-limits to press coverage.

“It’s an ongoing investigation, and our investigations are never really done in the public light, simply because of the nature of law enforcement,” Justice Department spokesman Alejandro Miyar said Monday. “The other rationale is that there are privacy implications concerning the patients. So that really just doubles down the aspects.

“When the matter has been resolved, we communicate as much as we can in terms of giving all the information that is fit for public consumption. That’s been the practice of the department through different administrations for many, many years.”

The initial U.S. DOJ visit to the Oregon State Hospital occurred in November 2006. More than a year later, in January 2008, the agency issued a damning report that criticized nearly every facet of the institution.

The 48-page report put Oregon officials on notice that the feds could sue the state over alleged massive violations of patients civil rights linked to subpar treatment and unsafe conditions.

Oregon officials launched efforts to fix the hospital’s flaws even before the blistering federal report was made public.

In August 2007, the hospital adopted a Continuous Improvement Plan, a thick document that became the framework for ongoing hospital improvements.

As it stands, about 35 percent of the 216 tasks outlined in the multi-year improvement plan have been accomplished, according to Orr’s report. By December, the hospital predicts that 69 percent of the improvements will be completed.

Orr rattled off various signs of hospital progress, including steep reductions in staff use of seclusion and restraints to control unruly patients, creation of new treatment malls designed to expand patient therapy and activities, and opening of six remodeled cottages as transitional homes for 36 patients nearing their discharge dates.

Decades of legislative neglect spawned abysmal conditions at the state hospital. However, Orr told the federal team that state lawmakers have made the hospital a top priority in recent years. He said state spending gradually is bolstering the hospital’s chronically thin staffing levels and will pay for building two new state-of-the-art psychiatric facilities.

Among the funding highlights mentioned by Orr:

- Lawmakers have greenlighted spending $458 million to build two new hospitals to replace the existing facility. A 620-bed hospital in central Salem is scheduled to partially open in late-2010 and become fully operational in 2011. A 360-bed hospital is scheduled to open in Junction City, about an hour’s drive south of Salem, in 2013.


- Since the federal agents’ initial visit in November 2006, the hospital has hired 293 new employees. Plans call for adding 540 more employees in the 2009-11 budget period, which started July 1.


- The hospital’s $324 million budget for 2009-11 amounts to a 31 percent increase over the $248 million budget for 2007-09.

As hospital officials began showcasing reforms to federal investigators Monday, two mental-health advocates contacted by the Statesman Journal expressed doubts about the hospital’s touted improvements.

“Patients and family members and staff people aren’t saying that there’s anything different,” said Jason Renaud of the Mental Health Association of Portland. “There’s not a whole lot that I can see as an outside but close observer of the hospital that would show me that there’s been any changes.”

Beckie Child, president of Mental Health America of Oregon, said the hospital deserves credit for curbing the use of patient seclusion and restraints. However, she’s skeptical about whether marked progress has been made in many other areas.

“I talk to a number of state hospital employees who feel that the changes being made are smoke and mirrors,” Child said.

EXTRA – Superintendent Message: Update on USDOJ Return Visit to OSH, July 2 2009 (PDF)
EXTRA – the Oregon State Hospital staff newsletter, July 2009 (PDF)
EXTRA – The Oregon State Hospital’s continuous improvement plan, July 17 2007
EXTRA – Tarrytown Tattler, July 1943 – a Oregon State Hospital patient-written newsletter (7 MB PDF)

A scathing report by federal officials in 2008 spurred major changes at Oregon State Hospital, including plans to build a new facility.

Secondary inspection will gauge progress toward improvements

Patient care and conditions at the Oregon State Hospital will draw new scrutiny this week from a familiar critic.

Starting Monday, a team dispatched by the U.S. Department of Justice will tour the hospital campus, examine patient records and hear progress reports from hospital leaders and staffers.

Hospital Superintendent Roy Orr said in a recent interview that he looked forward to showcasing hospital improvements for the federal team.

“I think this return visit is about progress, it’s not about perfection,” he said. “It’s about seeing firsthand the good-faith effort that the state of Oregon has made to put Oregon State Hospital on the right path.”

The weeklong, on-site federal review comes 18 months after the Justice Department issued a searing critique of Oregon’s main mental hospital.

In a report issued in January 2008, the federal agency slammed the hospital for widespread defects in patient care and conditions. Among the reported problems: high rates of patient-on-patient assaults; poor supervision of suicidal patients; severe understaffing; excessive use of seclusion and restraints; inadequate psychiatric treatment; and dangerous medical errors.

The blistering report rattled state officials and legislators, spurring them to allocate extra money for the hospital to hire hundreds of new employees.

Monday’s follow-up visit by the feds will start with an opening presentation by Orr. He is expected to summarize sweeping changes, including sharply reduced use of seclusion and restraints to control patients, creation of a new treatment mall that provides expanded treatment and activities for dozens of patients and opening of six cottages as transitional homes for 36 patients close to their hospital discharge dates.

Then hospital officials plan to escort the feds on a guided tour of the sprawling campus in central Salem, starting with the remodeled cottages.

The visitors also will be taken to the new treatment mall and get a close-up look at the hospital’s construction zone — a busy area that signals progress toward development of a new $280 million replacement hospital.

Plans call for the new 620-bed hospital to partially open next year and become fully operational in 2011.

After that, the state intends to build another hospital in Junction City. The 360-bed facility, planned for construction on state prison land in Lane County, is scheduled to open in 2013.

Combined costs for the two new hospitals are budgeted at $458 million.

Passing federal muster?

A pivotal question looms: Is Oregon doing enough to pass federal muster and avert a lawsuit that could place the state hospital under federal court control?

“My bias is that it’s impossible to deny an almost half-a-billion-dollar commitment in new facilities and an increase in our budget, essentially all for additional staff in an economy like we’re in now and a legislative session like we just went through,” Orr said.

Even so, the hospital chief acknowledged that the U.S. Justice Department could decide to sue the state.

“I oftentimes have people ask the question, are we really at risk of having the DOJ come in here and take over? Well, they don’t take over. What they do is sue you,” he said. “They take you into a court environment, into a trial, and then you’re under a court decree of some sort. And that gets phenomenally expensive.”

The Justice Department’s first on-site visit to the state hospital occurred in November 2006. It came after the federal agency sent a letter to Gov. Ted Kulongoski, informing him of the pending investigation into allegations that patients civil rights were being violated at the state hospital.

As part of the initial investigation, the feds conducted a massive review of hospital records.

For the new review, the feds asked the hospital to provide another huge load of documents.

“It’s several thousand pages that we’ve collected on nearly every aspect of our hospital operation,” Rick Varnum, OSH director of strategic planning, said Friday.

In recent weeks, two-dozen hospital workers were assigned to collect records requested by the feds, Varnum said. Two more staffers assembled and copied the documents.

In keeping with the federal request, about half of the paperwork was shipped to the agency by July 15. The rest of the batch will be available for inspection by the on-site review team.

The state doesn’t intend to bill the feds for records-retrieval work and copying costs.

“We won’t be billing them,” Varnum said. “This is something we’ll do at our expense.”

Limited press coverage

State and federal officials have deemed most of the Justice Department visit off-limits to the press.

In response to Statesman Journal requests for access to the important visit, hospital officials and a state lawyer representing the hospital agreed to allow a reporter and a photographer to attend Monday’s opening presentation by Orr.

After the 15-minute presentation, the newspaper will be shut out of the rest of the week-long visit.

U.S. Justice Department officials on Friday expressed opposition to even the token access granted for press coverage.

A spokesman for the department said in an e-mail to the Statesman Journal that the federal team would skip Monday’s kickoff presentation if a reporter was present.

“I know that is the arrangement proposed by Oregon State Hospital officials and I understand the value to the Hospital of your presence during their opening remarks. However, if you are present we will have no choice but to not attend the portion of the meeting,” wrote Justice Department spokesman Alejandro Miyar.

“Our outside experts cannot be named or identified in media reports. Our attorneys cannot comment or be involved in discussion with a member of the press present. In reality, it becomes basically a press conference where the Hospital is making a presentation to you without our involvement, as we are prohibited from discussing the investigation with a member of the media present as per Department policy.”

Later Friday, the Justice Department’s lead attorney, David Deutsch, informed Micky Logan, Oregon’s senior assistant attorney general, that “Oregon has put the USDOJ in a difficult position by allowing a Statesman Journal reporter to be present on Monday morning,” according to an e-mail that Logan wrote Friday afternoon, recounting her latest conversation with Deutsch.

Logan’s e-mail, circulated to various hospital officials and the governor’s office, was relayed to the newspaper by one recipient.

Despite the concerns stated by the Justice Department about press access, Logan’s e-mail indicated that the federal team will in fact attend Monday’s opening presentation by the hospital superintendent.

“Deutsch reiterated that they would like the presentation to be as short as possible — 15 minutes would be good,” Logan wrote. “They will likely have questions when the presentation is over (and after the reporter leaves).”

Plans call for the federal team to spend four days at the state hospital in Salem, then move on to the hospital’s Portland campus for the final day of the visit on Friday.

Hospital officials said they hope for an “exit interview” in which the federal review team sums up their impressions and findings from the visit.

However, the feds haven’t given any definitive statement about whether they intend to provide such feedback before they leave Oregon, officials said.

EXTRA – The email for the lead attorney in the DOJ inpection of the OSH is David.Deutsch@usdoj.gov
EXTRA – Everything about the Oregon State Hospital

Most of the historic ''J'' building and several smaller buildings at the Oregon State Hospital in Salem are being dismantled to make room for a new hospital building to be completed in 2011.

Changes are happening at Oregon’s 126-year-old state mental institution. How much and how fast it is changing are what U.S. Department of Justice investigators will consider when they return this week for their first comprehensive evaluation since November 2006.

Following that last visit, the team released a report in January 2008 chronicling abysmal conditions at the hospital that not only hindered patients’ recovery but threatened the safety of both patients and staff.

They’ll return to see metal scaffolding snaking up the old “J” building, where the movie “One Flew Over The Cuckoo’s Nest” was filmed. They’ll hear hammers and power drills.

Demolition of some deteriorating buildings has begun to make way for a new hospital scheduled to open in 2011. A second hospital is scheduled to open in Junction City by 2013.

Until then, most patients will continue to live in crowded, outdated wards. But a string of six craftsmen-style cottages were recently refurbished to house patients nearing discharge.

Hospital leadership stresses that the changes are more than cosmetic. So far, reviews from staff are mixed.

“I think there are a lot of improvements started in patient care,” said Dan Smith, a psychotherapist who has worked at the hospital for seven years. “I would rate it as a C — I would like to see it be an A”

But Randy Davis, a mental health therapist and hospital employee since 1997, is slightly more positive. “I’m known around the hospital as being pretty cynical. If we can staff the new hospital the way it needs, then I’m very hopeful.”

Following their last visit, federal investigators criticized the hospital for relying too much upon seclusion and restraints as a way to control out-of-control behavior. Since then, data shows a decline in both practices.

Changes at the hospital have also helped reduce violent incidents. From January to June, there were 226 incidents of aggression between patients, down from 386 incidents in the first six months of 2008. The hospital reported 362 patient attacks on staff in the first six months of this year, down from 404 during the same period last year.

Yet at the same time, the hospital has seen a rise in the number of cases in which patients harm themselves — 184 last year up from 128 in 2007.

In an interview last week, hospital superintendent Roy Orr said he’s concerned about the trend of patients harming themselves and has a plan to address the problem.

Staffing remains the toughest challenge the hospital faces. Key leadership positions — including a chief psychiatrist, nursing officer and pharmacy director — have been filled since the federal investigators visited in 2006.

But a shortage of workers means nurses, aides and other front-line staff are still routinely required to work double shifts –despite warnings from federal investigators that a fatigued work force increased chance of injury to patients and staff.

“We have more work ahead of us than behind us,” said Orr, who was hired in February 2008, a month after the Department of Justice report was released.

John Carlgren

John Cole Carlgren bowed his head and waited for Judge Christopher Brauer to pronounce a sentence.

Carlgren pleaded guilty earlier this month to recklessly causing the deaths of four people after he smashed into their car on Cabbage Hill while drunk. Jessie Cline, 29, William Johnson, 24, Fred A. Young, Jr., 31, and Michelle Marie Sawyer, 29, died in the Oct. 19 crash.

Brauer prefaced sentencing with a statement that left little doubt the punishment would be stiff for the Carlton man, who has four prior drunk driving convictions.

“You might as well have decided to juggle with nitroglycerin in a crowded theater wearing grease-covered gloves,” Brauer said, referring to Carlgren’s trip from Utah to Eastern Oregon with stops for six-packs of beer at markets along the way.

Carlgren didn’t seem surprised when Brauer finally rendered his sentence – 130 months for each manslaughter charge, to be served consecutively – 43 years and four months. Another year for driving while intoxicated will not add extra time to the sentence.

Under Ballot Measure 11 restrictions, Carlgren will not be eligible for release for 40 years.

“Mortality data demonstrates that you are likely to be confined in prison for the rest of your natural life,” Brauer told Carlgren.

At the beginning of the four-hour sentencing, prosecutor Dan Wendel, Umatilla County deputy district attorney, described the events leading up to the early-morning crash. From the gallery, the victims’ family members listened somberly.

Carlgren, Wendel said, had worked a 60-hour week, finishing a job for Chevron in Northern Utah. He changed, showered and checked out of his motel and started driving the 700 miles home. Receipts from the journey show he stopped at two stores along the way for six-packs of Coors he kept on ice.

Witnesses reported erratic driving by Carlgren.

Just east of Pendleton on Interstate 84, Carlgren crossed the fogline and plowed into the back of the victims’ red Beretta, stopped or nearly stopped on the shoulder. The car’s occupants died instantly.

Wendel flashed an image onto a screen.

“This is what happens to a 1991 Beretta when it is slammed into by Dodge Dakota pickup truck,” he said.

The misshapen hunk of metal only vaguely resembled a car.

“The wreckage of the Beretta was such that the victims could not be extracted from the scene,” Wendel said. “The car was loaded onto the back of a flatbed truck.”

One witness at the scene, Frank Moutray, reported that Carlgren walked around the scene, dazed and wondering why the car he hit had been stopped on the highway, rather than on the shoulder where investigators determined the car actually was.

“He walked over to the red vehicle and said, ‘What the (expletive deleted) were you doing parked in the middle of the road? That’s what you get,’” Moutray said in a statement to investigators.

A blood draw two hours later showed Carlgren’s blood alcohol level was .207 percent.

Carlgren’s attorney, Kent Fisher, didn’t gloss over his client’s horrible history, but said Carlgren wasn’t so much “raging and blaming” as trying to figure out what happened. The crash happened, Fisher said, after Carlgren reached for his cell phone.

“He was still trying to put the pieces together,” Fisher said.

He quoted Carlgren as later saying, “I’m heartbroken – I just killed four people.”

Wendel and his co-counsel, Deena Ryerson, called for a long sentence.

“This defendant begs for the court’s mercy,” Wendel said, “but the blood of the victims cries out for justice, blood spilled at Milepost 219.”

Family members also spoke to the judge and to Carlgren.

John Johson, the father of William Johnson, described his son as images glowed on the screen. The photos showed William playing sports, wearing a Donald Duck hat at Disneyworld and playing Twister, his favorite game.

Johnson offered forgiveness to Carlgren, while adding justice must be done.

“He was stolen from us that night,” he said.

Jason Young, brother of Fred Young, Jr., said his brother was fun-loving and caring. He was getting ready to marry another of the victims, Michelle Sawyer.

Young read an excerpt of Michelle’s last letter to Fred.

“I could spend the rest of my life in your arms,” Michelle wrote. “You take my breath away every time you glance my way.”

She signed the letter “The future Mrs. Michelle Young.”

Alan Cline, father of Jessie Cline, said Carlgren’s crime is worthy of serious punishment.

“This wasn’t an accident,” he said. “This was the inevitable.”

Michelle Sawyer’s 6-year-old daughter, Mickey Mouse doll under her arm, approached the judge with photos of her mom.

Carlgren watched with emotion. His attorney said his client has experienced “engulfing mental pain and anguish at the enormity of the damage and destruction he has caused.”

“He never designed this,” Fisher said. “It was never his intent.”

Carlgren, tears threatening, addressed the families.

“I am very sorry,” he said. “There are no words that I can say to bring back your loved ones.”

EXTRA – 43-year prison sentence for drunk driving may set Oregon record, KGW.com
EXTRA – Repeat drunken driver who killed four receives 43-year sentence, Oregonian July 24 2009
EXTRA – Drunk Driver Gets 43 Years In Prison, KEPRTV.com

Amber Jackson talks July 16 about the things she has learned while a patient at Oregon State Hospital. She currently lives in one of the cottages and is scheduled to be released July 28.

Amber Jackson counts herself lucky to occupy a private room in a newly refurbished cottage on the Oregon State Hospital campus.

“It’s the best room in the whole hospital,” she said.

Her gleaming room has a bay window and a side door that opens to a large porch, affording Jackson scenic views of the hospital’s park-like grounds.

“You look out here, it’s like God’s music box in the morning,” she said. “The birds are singing, the squirrels are playing.”

Despite the bright side of cottage residency, she can’t wait to leave the hospital’s forensic psychiatric program and build a new life in the community.

Jackson, due to be discharged from the hospital July 28, said she’s intent on staying clear of illegal drugs, reknitting bonds of marriage and pursuing a career as a real estate agent.

As Jackson tells it, her stint of hospital treatment demonstrates a rarely recognized truth: Many people with mental illness do recover at the state hospital. Their success stories get lost amid relentless criticism of the outdated, understaffed and crowded hospital, she said.

The state’s push to reform the 126-year-old mental hospital will draw rigorous scrutiny Monday, when a team from the U.S. Department of Justice arrives for a fresh evaluation of patient care and conditions.

The weeklong, on-site review will come 18 months after the U.S. DOJ issued a report that harshly criticized the hospital, citing sweeping defects that allegedly violated patients’ civil rights.

Jackson tells a different story, extolling hospital therapists and staffers who gave her hope about the future.

“I really think they’re liberal in their ways,” she said. “They take your life story and guide you onto a better path.”

In the past, Jackson, 35, paid a steep price for abuse of methamphetamine and cocaine. The drugs contributed to severe psychiatric symptoms, including hallucinations and delusions.

“I gave myself a mental condition,” she said.

She regrets losing custody of her two children: her son, now 8, was adopted by her mother; her daughter, now 17, lives in a foster home.

Jackson’s current hospitalization stems from a drug relapse late last year. She linked the episode to lingering stress, hopelessness and guilt.

“I lost so much in my past, my children and everything, so I became desensitized,” she said. “I didn’t care whether I lost anything more, and it didn’t matter to me whether I went out and did drugs.”

As Jackson prepares to leave OSH, she’s confident that she won’t resume self-destructive habits.

“I strongly know that I’m not coming back here,” she said. “I’m tired of starting over.”

Cottage life ‘a gift’

Some hospital patients denounce OSH, calling it a bleak, prison-like warehouse.

Jackson strongly disagrees.

“People should realize that it’s not a hotel,” she said. “We still have to do our time for our crimes. We’re still obligated to be policed.”

The hospital’s forensic program houses more than 400 patients who were judged guilty except for insanity of crimes, ranging from shoplifting to murder. They were sent to the hospital for treatment, not punishment.

Hospital buildings have been deemed obsolete and unsafe by state-hired consultants. But Jackson touts new innovations in patient treatment and housing.

“The cottages really are a gift,” she said.

Thirty-six patients have been assigned to live in six restored cottages, clustered on the southwest section of the hospital campus. In a bygone era, hospital administrators lived in the stately homes. After decades of decline, recent remodeling work converted the structures into transitional homes for patients nearing their discharge dates.

Jackson shares a large, two-story cottage with seven other patients, all men.

“We get along,” she said. “We do things in a respectful manner, respect everyone’s boundaries.”

Household chores are shared by residents, but she does most of the cooking.

“I’d rather be doing something productive instead of watching TV,” Jackson said. “So I take the initiative and I do cook the meals. It’s a lot of time to put in, but I would do that if it was my own home.”

New treatment mall

Jackson is one of about 60 forensic patients enrolled in the hospital’s new treatment mall.

Patients gather at the mall to participate in wide-ranging types of therapy and activities, from relapse prevention to yoga.

“I think of it almost as a junior college,” said Michelle McGraw-Hunter, manager of the treatment mall.

Treatment malls have become common at psychiatric hospitals across the country. By some accounts, the U.S. DOJ investigation spurred Oregon officials to create such a program.

The OSH treatment mall opened this spring, about the same time as the new transitional cottages.

Jackson’s a big fan of the mall.

“It’s so much better than staying in bed and feeling guilty,” she said. “It’s better to get up, go to the treatment mall and work through your problems. It helps you feel more confident that you can actually become one less mental patient, one less drug addict that society has to worry about.”

Hospital officials said the treatment mall conforms with an important federal DOJ standard that calls for patients to participate in 20 hours of treatment per week.

At OSH, each patient determines his or her treatment mall curriculum, in consultation with a treatment team.

“We try to honor what the patients want; they’re the deciders,” McGraw-Hunter said.

Every weekday morning, patients leave their housing units and walk or bus to the mall. It’s located inside a brick building that formerly housed a now-defunct treatment program for mentally ill and emotionally disturbed children.

Staffers go to the mall, too.

The centralized mall provides patients with opportunities to socialize and meet with therapists and staffers who can best meet their individual needs, McGraw-Hunter said.

It’s a dramatic change from past treatment practices, which kept patients cooped up on cramped hospital wards.

Not everyone favored the advent of the treatment mall, but the program gradually has gained acceptance from patients and staffers, McGraw-Hunter said.

“It’s a different way of doing business. For some people that can be scary, especially for staff,” she said.

Currently, the treatment mall is limited to patients housed in the cottages and in Ward 35A, another transitional unit.

However, another mall is planned for the hospital’s 50-building, three-story complex that houses hundreds of medium-security forensic patients.

Longer-range plans call for treatment malls to become cornerstones of patient therapy at a new $280 million state hospital. The 620-bed facility is scheduled to fully open on the existing hospital campus in 2011.

Will federal reviewers be impressed by the hospital’s phased addition of treatment malls?

“We’re trying to address the issue in an incremental way. We’ll see what the DOJ thinks,” McGraw-Hunter said.

Leaving OSH

Jackson is scheduled to be conditionally released from OSH late this month and enter a group home in Cornelius, a small town in Washington County.

Jackson expects to stay at the group home for about eight months before graduating to a more independent type of housing, possibly her own apartment.

At some point, she expects to live with her husband. They met several years ago at the state hospital, when both were patients. They subsequently got married.

Jackson looks forward to him making weekend visits to see her at the group home.

Her conditional release from the hospital will be monitored for at least a year by the state Psychiatric Security Review Board. Any slip-ups could result in Jackson being returned to the state hospital.

A review of Jackson’s hospital file, authorized by her consent, indicates that she abused drugs after a previous round of state hospital treatment.

Records indicate Jackson was committed to the hospital in 2006 for Multnomah County charges of assault and criminal mistreatment.

In February 2008, the psychiatric review board granted her a conditional release to live in a group home in Portland.

Jackson initially fared well, reports say. She eventually moved into an apartment, attended Portland Community College and studied to become a drug and alcohol counselor.

But the review board revoked her conditional release last November after Jackson admitted to using cocaine. She reportedly hid the drug abuse from her husband and community-based mental health providers for about a month.

When Jackson returned to the state hospital, she was racked by guilt. A report by a hospital social worker summed up the anguish of the newly admitted patient: “She is very concerned about how her relapse will affect her current marriage. She feels very guilty that she lied to her spouse and is concerned that this will affect their relationship.

“She feels that this hospitalization is needed and sees it more as a punishment for herself that she deserves.”

Since then, Jackson has made excellent progress in her treatment, and she now is ready to return to the community, according to hospital reports.

“She is very motivated to maintain her stability and mental health,” concluded a recent progress report, dated June 21.

On the verge of leaving OSH, Jackson feels good about her recovery.

“It’s difficult sometimes to live with people who are negative,” she said. “But if you stay on your own path, you don’t get detoured.

“I’ve really worked hard on my recovery. I find value in myself and others now.”

From the Willamette Week, July 22 2009

Police Chief Rosie Sizer was quick to take credit when the city’s Independent Police Review Division reported last week that use of force against all citizens by Sizer’s officers had dropped from previous years.

“I think we started managing the issue better,” Sizer told The Oregonian.

But at the same time that City Auditor LaVonne Griffin-Valade is embarking on what she says will be a months-long audit of the Police Bureau’s use of Tasers (as first reported July 15), one statistic buried on page 22 of the IPR’s 33-page report has some observers calling for closer scrutiny of the bureau.

That statistic: Subjects with mental illness are now the most likely out of all groups to get Tasered by Portland cops—even more than people who are actually armed or who assault an officer.

The IPR report, based on data from November 2007 to November 2008, shows 52 percent of subjects with mental illness who had force used against them got Tasered. Armed subjects, meanwhile, were Tasered slightly less, at 51 percent of the time. And those who assaulted an officer were Tasered 31 percent of the time.

Use of force in general against people with mental illness dropped 26 percent since the last period IPR reported on, which was August 2004 to October 2006. But despite that overall drop in force, which includes other methods like control holds and blunt strikes, reports of Taser use against subjects with mental illness rose 26.4 percent since the last IPR report.

Mental health advocates say they’ve long been concerned about reports of police using inappropriate Taser strikes against people with mental illness—whether out of convenience or a fear by police of touching the sick. Now they want more detailed information to determine what’s behind the rise in numbers.

“I find it hard to believe on the surface that this increase was somehow justified,” says Chris Bouneff, head of the Oregon chapter of the National Alliance on Mental Illness. “To me it signals that law enforcement hasn’t yet figured out how to deal with someone with a mental illness.”

While Bouneff admits it’s not always possible to recognize that someone is having a mental-health crisis, he says with proper training police can tell the difference more often and react more appropriately.

More than 300 Americans have died since 2001 after being Tasered by cops, according to Amnesty International. Because many of those people also suffered from mental illness, the human rights nonprofit has called for an end to Tasering the mentally ill except in cases where there’s a threat of serious injury to an officer.

Portland police policy, however, allows officers to Taser anyone who physically resists or shows that they intend to do so, regardless of their mental state.

The issue of police dealings with mentally ill people takes on greater resonance here after James Chasse Jr. died of blunt-force trauma following a violent encounter with police in 2006. The 42-year-old schizophrenic man was Tasered several times during the struggle, and advocates who pushed for reforms after Chasse’s death reject the notion that Tasers offer a more humane way for police to assert control.

“These statistics show us that what happened to James Chasse could happen tomorrow to someone else,” says Jason Renaud, a friend of Chasse’s and head of the Mental Health Association of Portland. “This seems to be a continuing problem where [police] don’t have the skills or the resources to do their job.”

Chasse’s death led to a new requirement for all Portland officers to receive crisis-intervention training. That training does not include instructions on Taser use or other tactical training, says police spokeswoman Detective Mary Wheat.

Sizer did not reply to a request for a phone interview. But in an email to WW, she said the people with mental illness police encounter are “more likely to be armed or more combative than other people against whom we are using force.” She added that police are looking forward to the opening of a new sub-acute mental health facility, which Multnomah County officials say is slated for 2012 or possibly sooner.“

READ – Use of Force by the Portland Police Bureau Follow-up, (Use of) Force Task Force, July 2009
READ – New Use of Force Report Shows, But Does Not Explain, Disparities, Portland CopWatch, July 2009
READ – Use of force by Portland police drops in two divisions, Oregonian July 21 2009
READ – Cops Using Tasers More Against People Suffering With Mental Illness , Portland Mercury July 21 2009

From the Portland Mercury, July 21 2009

Portland Police are using their Tasers almost twice 26 percent more against people with mental illness as they were in 2006 according to a new report. A use of force report released by the city in November 2006 showed only 26% of force used against people with mental illness was Taser use, but a new use of force released yesterday puts that statistic at 52%.

There were 110 Taser uses against people suffering with mental illness in the most current reporting reporting period, November 2007 to November 2008, and in a previous 12-month period between October 05-September 06 there were 87 uses of Tasers against people suffering with mental illness.

“While officers appear to be using force on fewer mentally ill suspects overall,” reads the report, “reported Taser use on this population is up…Additional analysis would be needed to evaluate the possible causes of data fluctuations in this area.”

The report said understanding those fluctuations would be beyond its scope. You can download the whole thing here.

“Without raw numbers, it is hard to compare one-on-one,” says Portland Copwatch activist Dan Handelman. “But the report explicitly states that Taser use is up against those identified as having mental illness.”

That data has mental health advocates concerned.

“Having a Taser pointed is a particularly traumatizing experience for someone with a mental illness,” says Jason Renaud of the Mental Health Association of Portland. “The person may not be able to respond to a police officer appropriately.”

The police bureau introduced new Crisis Intervention Training for its officers in dealing with people suffering from mental illness following the death in police custody of James Chasse, a man suffering from schizophrenia, in 2006. But while the bureau says it has now trained all its officers, mental health advocates are concerned that there is no way to measure the success of that training.

“There’s concern that the CIT is not sufficient,” says Renaud. “There’s still no measurable evidence of the success of this program.”

Numbers released last year also showed cops using a disproportionate amount of force against African Americans—a trend that continues in the latest report. You can read the Portland Mercury article about Taser use here in Portland written last November by clicking here.

The report is not all bad news. It shows a drop in most uses of force by cops between November 5, 2007 to November 4, 2008:

REPORT: TASER USE STEADY, CONTROL HOLDS WAY DOWN...

Complaints about uses of force are down 58% since 2004, from 118 to 50.

A police bureau spokesperson is yet to return a call for comment, but Police Chief Rosie Sizer is scheduled to present the report to the city’s Citizen Review Committee this afternoon at 5:30, at city hall. Hopefully the chief will announce plans to probe this issue further.

“In July 2006 Officer Paul Ware who was then in charge of the police bureau’s crisis intervention program came to a citizen forum and told the group that yeah, sure, we’ll talk to them for thirty minutes but if they’re not complying then we’ll just Taser them,” says Copwatch’s Handelman. “I wonder if that’s what’s happening here. But it’s also possible that officers are better trained to recognize mental illness and are reporting it more.”

Handelman would like to see more research done into the reasons behind the increase.

Handelman is also extremely concerned about police apparently using the Taser as a compliance tool. Tasers were used 61 times against people who “failed to comply,” and 18 times where no resistance was indicated on the use of force form.

“For the benefit of the doubt, it could be that the officer did not write down the amount of resistance used,” says Handelman. “But it also could be that there was no resistance.”

READ – Use of Force by the Portland Police Bureau Follow-up, (Use of) Force Task Force, July 2009
READ – New Use of Force Report Shows, But Does Not Explain, Disparities, Portland CopWatch, July 2009
READ – Use of force by Portland police drops in two divisions, Oregonian July 21 2009
READ – Report: Mentally ill are most likely to get Tasered by Portland police, Willamette Week July 22 2009

Junction City

Junction City, a community of 5,000, prepares for a huge influx of 2,100 inmates and mental patients

Even in rapidly growing state such as Oregon, Junction City’s expected growth is unusual. The Lane County community of 5,000 is preparing to accommodate more than 2,100 new people.

Fortunately, planners know exactly where to put them: two state prisons and a new state mental hospital.

Construction is expected to begin this fall to prepare Junction City for the massive project. The minimum- and medium-security prisons and site work will cost an estimated $450 million.

The hospital is part of a project that would replace the Oregon State Hospital in Salem. The $458-million project cost includes a 620-bed hospital in Salem along with the 360-bed hospital in Junction City, which is between Corvallis and Eugene.

Junction City officials lobbied the state to build a hospital in their community, said Mayor Dwight Coon. “That was where the prison was going, and it made sense for the state,” Coon said. “The infrastructure needed for one was needed for the other.”

It also makes sense for the city, Coon said. Junction City will receive improvements to its water and sewer systems as it prepares for the prisons and hospital.

Under an agreement between the city and state, expected to be signed Monday, the city would pay $4.4 million for the upgrades, with the state picking up around $31 million. In addition, the state is advancing Junction City the $4.4 million.

Junction City’s $4.4 million piece would build a bigger sanitary sewer pipe than the state needs. That would allow the city to bring sewer service to future industrial and commercial development in the area, Coon said.

The city will pay the money back only if the project gets built, said Steve Ward with Westech Engineering, the city’s engineer. “If the state (Department of Corrections) pulls out, we would not have to reimburse them anything,” Ward said.

Getting a prison built at the site has been a slow process, said Doug Young, administrator with the Department of Corrections. The state has owned the land for more than a decade. In 2002, the state halted an effort to build there as prison population forecasts slowed.

This time, Young said he’s confident the project will move forward. “A prison will be built there,” Young said. “It’s a real low-risk thing.”

But the department still relies on population forecasts, Young said, which could delay the prison opening. The minimum-security prison is scheduled to open in 2014, with the opening of a maximum-security prison to follow.

JE Dunn Construction received notice of intent to award a contract for construction manager/general contractor services on the prison project. A contractor hasn’t been selected for the Junction City hospital site; Hoffman Construction will build the Salem hospital.

The Junction City community will welcome the construction jobs as well as the long-term jobs the prisons and hospital are expected to create, said John Lively, incoming president of the Lane Workforce Partnership, which helps find training for the community’s job needs.

Lane County’s unemployment is more than 14 percent, Lively said. Construction jobs can help residents in the near term, but the prison won’t open until 2013.

“The unfortunate thing from the timing standpoint is that we have high unemployment now, and that’s still four years out,” Lively said. “People can’t be on unemployment that long.”

OUR COMMENT – Advocates on behalf of persons with mental illness have opposed building a new state mental hospital, and siting it in Junction City. These advocates, former patients, friends, family members, professionals and general public, have been ignored by politicians and state bureaucrats eager for bricks and mortar.

It is base corruption to divert state moneys dedicated for the care and welfare of persons with chronic treatable illness on what this article describes – a jobs program for Lane County.

States which have engaged in policy conversation with the community about the future of mental health services are choosing to provide enhanced community based services and not rebuilding 19th century institutions; mental health treatment integrated with housing, social services, local churches, employment and vocational rehabilitation, family, addiction treatment and twelve step support.

Junction City has none of these values which are essential for recovery from mental illness.

From the Curry Coastal Pilot, July 11 2009

A state audit of Curry County mental health services showed the county lacking, Curry County Commissioner George Rhodes said Friday.

“Basically, they’re saying we’ve got the same issues we had a year ago,” said Rhodes, the county commission liaison to the Human Services Department.

He said the state and Jefferson Behavioral Health met with county officials for three days this week.

“At this point, the state will complete the report and we’ll have 90 days to respond,” Rhodes said.
He said the main issues are record keeping and staffing issues.

“We’ll be working with JBH to come up with a funding level that’s appropriate,” Rhodes said.

He said that one problem is that JBH issues money to Curry County based on population, not need.

Jefferson Behavioral Health is a mental health services organization and has a contract with the State of Oregon to manage mental health services covered by the Oregon Health Plan.

JBH, headquartered in Grants Pass, provides services through the Community Mental Health Programs in Coos, Curry, Jackson, Josephine and Klamath Counties. JBH also contracts with Psychiatric Residential and Day Treatment Providers to deliver intensive treatment services for children.

Rhodes said the state will be putting pressure on JBH to increase funding for Curry County.

“It’s the whole mental health program throughout the county,” he said, including such organizations as Hammond House. “We will be meeting with Carol Raper, the interim director of the Department of Human Services. She’s an outstanding clinical director. She’s working hard to fill both positions.”

Raper was named interim director effective July 1 when Joe Adair retired.

“We have some really good applicants for that position,” Rhodes said. “Previously, we didn’t have any applicants.”

When David White left two years ago to work for JBH, Adair, a former director of the Josephine County Human Services Department, agreed to come out of retirement to temporarily handle the job after the county got no applicants. He eventually agreed to stay on but said earlier this year he would retire for good on July 1.

“There is a tool for us to use to get better,” Rhodes said. “We’re getting things started with JBH. They recognize to be successful we have to have a partnership with the state and JBH, Curry General Hospital, law enforcement, the District Attorney – everybody who has to work for our mental health.”

The third anniversary of the death of James Chasse is September 17 2009. We’re starting to plan a commemoration – and want your help.

We’re mulling a few ideas – but for brainstorming, the more the merrier. Want to help? Send us an email at info@mentalhealthportland.org.

The Mental Health Association of Portland has applied fairly constant pressure for truth and transparency about what happened to James Chasse since his death on September 17 2006.

In September 2006 we applied direct pressure to the mayor’s office with personal visits and ongoing correspondence.

From October 2006 to today we’ve provided local and national journalists with background interviews, documents and explanations of Jim’s death, the what happened before and after, the cast of characters, and the various twists and turns of the story.

From October 2006 to today we’ve collected every public document about what happened to Jim and put it online, including the complete homicide investigation, policy document, and news account.

What Happened to James Chasse – October 2006 / September 2008
Mental Health Association of Portland – tag ‘James Chasse’ – since September 2008

In October 2006 with help from Portland CopWatch and the First Congregational church, we helped organize a memorial service for Jim’s family. Dozens of speakers included Jim’s family, local civil rights advocates, mental health advocates, friends, community leaders and spiritual leaders.

We helped form the short-lived but helpful Justice for James Chasse Committee.

We organized the first annual memorial for James, a peaceful protest at City Hall where we presented the mayor’s staff with a list of continuing questions from the community about what happened to James. The mayor did respond – but did not answer the questions.

We are producing ALIEN BOY, a feature length documentary film about what happened to James Chasse. The director is Brian Lindstrom, creator of Finding Normal; the director of photography is John Campbell, the composer is Charlie Campbell or Goldcard and Pond fame. We’re 80% finished, and have raised $150,000 in cash and in kind contributions.

Go team!

From the Willamette Week, July 16, 2009

File this under “your tax dollars at work.”

Researchers at Oregon State University have concocted a snapshot of illicit drug use by sampling our municipal wastewater.

The results show how much cocaine, ecstasy and methamphetamine Oregonians pissed out in towns and cities from Astoria to Ontario.

“Municipalities across the state generously volunteered to help us test our methods by collecting samples more or less simultaneously, providing us with 24-hour composite influent samples from one day — March 4, 2008,” one of the researchers is quoted as saying in a news release.

Read on to see the maps.

OUR COMMENT – Over the decades, addiction research has had little impact on the practical day-to-day work of getting people clean and sober; the disconnect is remarkable considering the potential impact of intelligence could make on what is largely a spiritual endeavor. The survey above, without context of a public policy discussion, involving community leaders, law enforcement, public health officials, legislators and politicians, community church groups, addiction and mental health service providers, is pointless and trivial. Sadly it fills the limited space, both financially and in the public attention, representing hope and achievement.

EXTRA – The spatial epidemiology of cocaine, methamphetamine and 3, 4-methylenedioxymethamphetamine (MDMA) use: a demonstration using a population measure of community drug load derived from municipal wastewater, Addiction, July 2009
EXTRA – Wastewater used to track drug use in Oregon, Water Technology Online

Ever wondered about the roses painted all over downtown Portland? On the exterior walls of commercial buildings, sometimes mixed with red white and blue flags. They’re a bit of a puzzle. Who makes them? How have they so skillfully evaded the City’s mural code?

Well here’s the secret. They’re sponsored by Joe Weston, one of Portland’s longest lasting downtown property owners. Here’s the other secret – one of the murals tells the story of Portland’s heroin plague of the early 1990s.

See – Joe’s Collage of Roses – from 2006

Draw your attention to one of the most curious and interesting of the set – the Jo-Lyn Rose, Portland’s Unsecret Tragedy. It’s located near the East side of the Broadway Bridge. You’ve probably driven by a thousand times.

A perfect Portland memorial.

Today’s going to be sunny and warm – a perfect day for a picnic.

Join us from Noon until 4 PM or so at Sellwood Park for a picnic. We’ll grill stuff – and veggie stuff too.

Potluck is welcome.

Here’s how to get to Sellwood Park.