Mental Health Association of Portland

Oregon's independent and impartial mental health advocate

Juliet Follansbee tells audience at MHAP event about trends, changes at Psychiatric Security Review Board

Posted by Jenny on 1st May 2014

The Lund Report, May 1, 2014

PSRB-logoFewer people than ever before are under the jurisdiction of the Psychiatric Security Review Board, according to executive director Juliet Follansbee who spoke at the annual Mental Health Association of Portland event and gave an overview on trends and changes within the agency.

“We’ve been interested in how the mental health system is migrating, or collapsing, into the criminal justice system,” said the group’s cofounder Jason Renaud.

The 10-person board is appointed by the governor, has the authority to commit people to the Oregon State Hospital, conditionally release them to community-based programs or discharge them from jurisdiction, said Dr. Joseph Bloom, a professor in OHSU’s Community Psychiatry Training Program and nationally recognized an expert on the insanity defense.

“Oregon has always been our laboratory. Until recently, I’ve always felt we had good laws but not enough services,” Bloom said. Now, there are more community mental health services available.

“This has got to be the most diverse audience I’ve ever had to present to,” said Follansbee, an attorney who was executive director of the 10-person board for about a year after former director Mary Claire Buckley was placed on administrative leave before resigning.

The board typically gets involved shortly after an arrest is made for people with a mental health diagnosis, and the insanity defense cannot be forced on a client. But if the client chooses that route, usually there’s not a trial and the person may be hospitalized or placed under conditional release.

In the past 10 years, the board’s witnessed a steady decline in the number of new clients.

“I like to think [people with mental illnesses] are getting services they need,” Follansbee said, before their problems escalate to the point where the criminal justice system becomes involved.

Currently there are 559 clients under the board’s jurisdiction, with 163 in the Oregon State Hospital and 385 on community release. The majority (84.3 percent) are men, most (81.9 percent) are white and the average age is 45.9 years.

The board also oversees 20 juvenile clients – 12 are in the hospital, while eight live in the community. There’s only one young woman in the program, and a large percentage have developmental disabilities with no other mental health diagnosis. Just under half are under the board’s jurisdiction because of sex offenses.

“In general, the diagnostic picture is much more complicated for the juvenile clients,” Follansbee said.

If a client is placed on conditional release, they must undergo some form of mental health treatment (often including medication) and may be required to undergo alcohol or drug treatment.

Clients must also do at least 20 hours of “structured activity” – paid work, attending school, volunteering or other activities such as library visits. Drinking alcohol and driving are both prohibited once people are released.

Follansbee also touched briefly on recent legislative changes that impacted the board’s work. Clients cannot own firearms unless approved by the board, sex offenders are ranked by offense and the criteria for civil commitments has become more narrow.

“The board does what we’re advised to do. We’re technical advisers,” Follansbee said.

In response to questions, Follansbee said most case managers work with about 12 clients – and she declined to discuss a question on an index card asking about an incident in Columbia County under investigation.

“Our concern is public safety for everyone, and that our clients are safe and everyone who works with our clients is safe,” Follansbee said.

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Juliet Follansbee points to progress at PSRB, with more than ever living in community, but others sound cautious note

Posted by Jenny on 12th April 2014

Street Roots, April 12, 2014

oregon-state-hospital04On the desk in Juliet Follansbee’s downtown Portland office is a thick book of Oregon laws. It contains only a few sentences that grant the state agency she operates tremendous power over the lives of hundreds of Oregonians.

In May, Follansbee was made interim executive director of the Psychiatric Security Review Board, a position she was permanently appointed to in November. Created by Oregon lawmakers in 1977, the 10-member interdisciplinary board has authority over individuals who have successfully asserted the “guilty except for insanity” defense, meaning they’ve committed a crime, but because of a mental illness or developmental disability did not fully understand what they were doing at the time.

Follansbee takes the reins of the PSRB at a time when the state has aspired to shift its mental health system to more community-based rather than institutional settings. Follansbee says that the PSRB has more resources to place people in community settings than ever before. Mental health advocates are also hoping that Follansbee will set a new tone for the PSRB, which some say was marked by a climate of fear and intimidation fostered by her predecessor.

Follansbee says she’s open to changing the PSRB’s processes and operations. She also wants to help standardize training and foster a collaborative approach with community health care providers. She says she wants the PSRB to accommodate change, the biggest of which is the increase in resources to treat clients in community settings.

“We (serve) just a small portion of the people who receive community mental health services,” says Follansbee.

Being placed under the PSRB, says Follansbee, who previously ran a program that restored the gun rights of Oregonians whose mental health had prevented them from owning firearms, is different from a civil commitment, where someone is involuntarily placed in a mental health setting. “This is something that our clients have chosen to do because they thought that they would do better in a mental health setting,” she says.

However, those who successfully assert the insanity defense grant the PSRB sweeping control over their lives. Depending on the severity of the crime committed, the PSRB (in consultation with community-based mental health providers) determines the settings clients are released into along with what sort of treatment and supervision they receive. Some clients living in more independent settings may have to check in twice a day with mental health workers. If someone is placed under the purview of the PSRB, odds are it will have authority over them longer than if they had gone to prison. Sometimes they will remain under the board’s authority for life. For most PSRB clients, the first stop after successfully pleading insanity is the Oregon State Hospital.

“We have the least amount of people in the hospital than we ever have, and the most amount of people in the community than we ever have,” says Follansbee. “And the reality is that whenever the hospital says someone is ready to be placed on conditional release, the board almost always approves it.”

Of the 559 people under the PSRB’s jurisdiction, 385 are on conditional release.

In 2011, lawmakers passed legislation that reformed the PSRB system and created a separate board run by the Oregon State Hospital to determine when patients, who haven’t committed violent crimes, can be released. Follansbee, who says there are about 90 people under the separate board, describes this reform as positive, saying that it offers patients one more avenue to obtain conditional release.

At the State Hospital, patients are subject to widely varying degrees of supervision, ranging from closely monitored settings to living semi-independently in group homes on the facility’s grounds. In late March, a patient at the State Hospital who had pleaded guilty except for insanity to an attempted murder charge walked away.

Rebeka Gipson-King, spokesperson for the Oregon Health Authority, says that people are often surprised that some patients live semi-independently at the State Hospital.

“The State Hospital is not a punishment,” she says. “They are sent there to get better.”

However, some mental health advocates have seen things differently.

“You have the use of the State Hospital as a punishment, a very expensive punishment,” says Chris Bouneff, the executive director of the National Alliance on Mental Illness Oregon. Bouneff says that under the PSRB’s previous executive director, Mary Claire Buckley, clients would be sent back to the State Hospital for relatively minor infractions, such as failing a drug test, which could be addressed in a less costly way. “It certainly wasn’t helping with the smooth operating of our mental health operation,” he says.

Patrick, who doesn’t want his real name used in this article because he’s still under the jurisdiction of the PSRB, says that his defense lawyer talked him into pleading guilty except for insanity to what he says was a bogus burglary charge. His lawyer told him he would spend a few months in the State Hospital. Instead he got 10 years of being under the PSRB’s jurisdiction.

After spending three years in the State Hospital, he was released to a group home in Portland, where he says the threat of being sent back was used as a threat to keep residents in line.

“The overall structure is, if you bring an issue to your case monitor that could result in very negative things happening to you,” he says.

An investigation into allegations that Buckley was verbally abusive was dropped following her resignation this past summer. She was hired by the Portland Police Bureau as a policy analyst in November.

Follansbee wouldn’t speak to criticisms leveled against her predecessor, but she did say that she wants clients, victims and mental health advocacy organizations, which she refers to as “partners,” to be heard throughout the process.

“They often have competing interests and views,” she says, noting that stakeholders’ interests won’t always align. “That’s challenging, and one of the ways we want to work collaboratively is to build relationships where all of our stakeholders feel like they’re getting a fair shake.”

Although Follansbee says she doesn’t want to keep someone in the hospital unnecessarily, she says a cautious approach is still needed.

Oregon law directs the board to have “as its primary concern the protection of society” when making decisions regarding the conditional release or discharge of patients. And to get out of the hospital, patients still have to go through four separate layers of approval, all of which  Follansbee says are needed.

“The data suggests that slow incremental moves will give our clients the tools, so when they are no longer under our board, they can continue their stability,” says Follansbee. “It’s clear by our recidivism rate that when you’re under our board you’re going to remain stable.”

One thing that everyone agrees on is that the PSRB has been effective in carrying out its public safety mandate. The recidivism rate for the PSRB for the last 15 years is 2.66 percent. Of the 1,655 people who’ve obtained conditional release over the last 15 years, only 17 have committed new felonies.

“When you look at Mary Clare Buckley’s record and lack of recidivism, it’s clear that she didn’t take a lot of chances on people,” says Jason Renaud, spokesperson for the Mental Health Association of Portland.

“It seems like what happens when you have a strong personality in charge of an organization, the process just sort of fades,” says Bob Joondeph, the executive director of Disability Rights Oregon. Although the PSRB is designed to move carefully, he says, Follansbee has so far “brought a less hierarchical and more collaborative approach to making the process work the way it’s supposed to.”

Joondeph says that movies and TV have long fueled the notion that mentally ill people are dangerous and need to be locked up. He says that the PSRB should focus more on recovery and individuals under it should receive treatment in the least segregated settings possible, which he says the board doesn’t have the best track record on.

“It’s a difficult position to be in because public safety is our mandate,” says Follansbee. “It’s difficult to have everyone in our system happy with the results.”

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Juliet Follansbee named new executive director of Psychiatric Security Review Board

Posted by CoffeeX3 on 13th November 2013

From The Oregonian, November 13, 2013

Juliet Follansbee has been named as the new executive director of the Psychiatric Security Review Board, whose previous director resigned amid a state investigation of board management.

Follansbee had been serving as interim executive director after Mary Claire Buckley was placed on paid administrative leave May 2. The state dropped its investigation after Buckley agreed in June to resign, and her resignation became effective Aug. 15.

Follansbee previously served as manager of the board’s gun relief program, which works to restore gun rights to Oregonians whose mental health backgrounds previously disqualified them from owning guns.

She has been with the board for more than three years, according to a news release about her appointment.

“Juliet’s experience with the board, and knowledge of what’s working and what needs improvement, will allow her to hit the ground running,” board chairs Kate Lieber and Eric Johnson wrote in the prepared statement.

Follansbee holds a Bachelor’s degree from the University of Colorado and a J.D. from the University of Hawaii. Follansbee previously managed a court-appointed advocate program in Kansas, served as a staff attorney for the Hawaii Legislature and served more than six years as an active-duty judge advocate in the United States Army, the news release said.

A board employee did not immediately respond to a message seeking information on Follansbee’s salary and benefits.

Buckley previously had an annual salary of $99,636, not including benefits.

The Psychiatric Security Review Board has had a rough year. In addition to administrative turmoil, a robber under the board’s jurisdiction escaped from a Milwaukie secure residential treatment facility in August. He was recaptured a week later.

In May, the board lost records containing the personal, medical or criminal information of 27 people after they were stolen from an employee’s car.

The Psychiatric Security Review Board has jurisdiction over people found “guilty except for insanity” of a crime. The 10 board members, who are appointed by the governor, have the authority to commit people to the Oregon State Hospital, conditionally release them to community-based programs, or discharge them from their jurisdiction.

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PSRB executive director Mary Claire Buckley resigns

Posted by Jenny on 18th June 2013

By Yuxing Zheng, The Oregonian, June 18, 2013

Oregon State Hospital

Oregon State Hospital

The executive director of the Psychiatric Security Review Board has resigned.

Mary Claire Buckley‘s resignation is effective as of Aug. 15, board chairwoman Kate Lieber said at the board’s meeting Tuesday evening. The terms were not released.

Buckley has been on paid administrative leave since May 2 after the Department of Administrative Services launched a review of board management April 25 at the request of Lieber. Lieber  declined to say why she requested the investigation.

The board also appointed Juliet Follansbee as interim executive director. Follansbee, previously a program manager, had been filling in for Buckley while she was on leave.

The state is dropping its investigation in light of Buckley’s resignation, said Matt Shelby, spokesman for the Department of Administrative Services.

Buckley has worked at the board since June 1991. Her annual salary was $99,636, not including benefits.

State investigators in February 2011 found Buckley had verbally abused an Oregon State Hospital patient who had declined to enter a secure residential treatment facility. Buckley implied the patient would suffer ramifications for defying the board and refusing the placement, according to a report from the Department of Human Services’ Office of Investigations and Training.

The Psychiatric Security Review Board has jurisdiction over people found “guilty except for insanity” of a crime. The 10 board members, who are appointed by the governor, have the authority to commit people to the Oregon State Hospital, conditionally release them to community-based programs, or discharge them from their jurisdiction.

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Program restores gun rights to some Oregonians with a mental health history

Posted by Jenny on 15th June 2013

By Noelle Crombie, The Oregonian, June 11, 2013

May 2013 NRA meeting attendees

May 2013 NRA meeting attendees

In 2009, lawmakers crafted a way to help the estimated 29,000 people whose mental health histories disqualify them under federal law from buying firearms in Oregon: a formal mechanism to ask for their gun rights back.

Four years later, with a two-year budget of $576,184 and a staff of three, the Oregon Gun Relief Program has held three hearings.

The most recent one was last July. No future hearings are scheduled, according to Juliet Follansbee, the attorney who manages the program.

The program’s staffers have so little work that they do double-duty for the state Psychiatric Security Review Board, the gun program’s parent agency whose main job is supervising people found guilty except for insanity. Because federal dollars that launched the program are expected to dry up, Oregon taxpayers would foot most of the gun program’s cost under a 2013-15 budget bill awaiting legislative approval.

READPSRB budget bill, 2013-15 (PDF, 115KB)

New federal law

The little-known program is a byproduct of federal legislation designed to push states to do a better job of forwarding names of people banned from buying firearms to the FBI.

The federal government has long maintained a database called the National Instant Criminal Background Check System, or NICS. It relies on states to forward names of people who are unable to aid in their own defense, were found guilty except for insanity or have been involuntarily committed.

But states have spotty records of submitting names of people with disqualifying mental health issues to the federal database, a gap highlighted by the 2007 Virginia Tech massacre. The man who carried out the shooting, which left 32 people dead, was previously determined to be mentally ill by a judge. That determination should have disqualified him from buying a firearm.

Congress responded by offering states grant money to ensure names of such individuals reach the FBI. The dollars came with a catch, the result of lobbying by the National Rifle Association: States had to use some of the money to start up gun relief programs.

“The NRA insisted on this relief mechanism,” said Kristen Rand, legislative director of the Violence Policy Center, a national gun control group that opposed the legislation mainly because of the gun relief provision. “They weren’t going to support it without the inclusion of the relief mechanism. They are 100 percent responsible for it being there.”

Many states have passed up the grant dollars, said Mark Glaze, director of Mayors Against Illegal Guns. He said that including mental health records in gun background checks isn’t a priority for some state political leaders, and that penalties for not forwarding names to NICS are relatively small.

Oregon, meanwhile, has received nearly $4 million in federal NICS improvement funding since 2009. The money helped the state forward its first large batch of mental health records to federal authorities in 2011. So far, the state has submitted the names of nearly 30,000 people to the federal database.

In addition, Oregon is one of 21 states with a federal gun relief program, according to the U.S. Department of Justice. The agency does not track how many people have had their gun rights restored.

It’s left to each state to decide how to administer its program. In Oregon, lawmakers opted to place gun relief duties with the psychiatric security review board.

Sen. Arnie Roblan, D-Coos Bay, led the committee that drafted the state’s gun relief law and said lawmakers worked closely with a representative of the National Rifle Association in designing a way for people to seek redress.

“It was difficult to take away this right, and there had to be a process through which they could get it restored,” Roblan said. “They were important issues to them and a lot of us.”

The National Rifle Association did not return a call seeking comment.

Kevin Starrett, executive director of the Oregon Firearms Federation, a gun rights group, views the gun relief program as a waste of tax dollars and a “humiliating” experience for applicants. He opposes gun background checks.

Starrett sat through one of the Gun Relief Program hearings.

“They come up with these programs because they have this federal money dangled in front of their face, and who says no to that?” Starrett said. “They have to justify their existence.”

He added: “You’ve got to wonder, what are they doing the rest of the time?”

The work

Follansbee, the head of the Gun Relief Program, has been acting as temporary executive director of its parent agency, the psychiatric board, since May. The longtime director, Mary Claire Buckley, is on leave pending a state investigation into board management.

Follansbee said when the program was designed, the state didn’t know how many people would petition to have their gun rights restored.

“Now that the names are in NICS, more people are going to be denied, so I anticipate we will have more as people go out and attempt to purchase” a firearm, she said.

Oregon is one of 21 states with a federal gun relief program.

Follansbee’s salary as the Gun Relief Program manager is $62,136 a year. She said when she first started the job in 2010, she spent 100 percent of her time setting up the gun relief program. But since then, work has tapered off.

Follansbee said except for preparing for three hearings in the past three years, her gun relief duties consist of handling about a half dozen calls each month from prospective gun buyers who have failed state police background checks. She fills in callers on their right to a hearing, although most haven’t gotten that far.

Follansbee is responsible for sending names each day to NICS of people found guilty except for insanity.

She also fields questions from law enforcement officials about questions raised during background checks.

Holding hearings

The three men who petitioned to have their gun rights restored each appeared before a three-person panel drawn from the psychiatric review board, which is appointed by the governor.

The committee deliberates in private, and audio from each hearing lasts less than an hour. Eric Johnson, a forensic psychologist and panel member, peppered the men with questions about their mental health, alcohol and drug use, arrest records and whether they had violent tendencies.

In each case, the panel restored the applicant’s rights.

Steven Stewart, one of the successful petitioners, said some people who have lost their gun rights should get a second chance.

“I definitely believe there should be a process,” he said.

Stewart, who said many people in his life don’t know his personal history, reluctantly agreed to talk about his experience with The Oregonian. He spoke on the condition that his employer and hometown not be identified.

Many years earlier, when Stewart was in his early 20s, he said he was addicted to meth and refused his parents’ pleas to get help. His parents sought Stewart’s involuntary commitment to a Portland hospital psychiatric ward as a last resort, he said.

Stewart remembers attending the commitment hearing having been high on meth for days.

“God only knows what I told those people,” he said.

He didn’t realize the court-ordered 30-day commitment, which helped him kick meth, would disqualify him from buying guns permanently under federal law. Indeed, because background checks for mental health issues were so hit-or-miss at the time, Stewart succeeded in obtaining a concealed handgun license despite his involuntary commitment.

Stewart said he first learned he was barred from purchasing a firearm when he tried to buy a shotgun at a Portland gun show about a decade ago. An Oregon State Police background check flagged him.

Stewart said people with mental illness who are violent shouldn’t get a chance to regain their gun rights. But he said his distant past shouldn’t permanently block him from buying a gun.

“I don’t suffer from depression, delusions, hallucinations,” said Stewart, a married father of two who’s got a steady job. “I am pretty mentally fit. I am very successful.”

His parents, his wife and his supervisor spoke on his behalf at his gun relief hearing.

Two weeks after his gun rights were restored, he walked into a gun store. The gun dealer ran Stewart’s name through the state background check. Again, he was denied.

Stewart stepped outside and called Follansbee, the administrator of the gun relief program. She called the state police to say their records were outdated. A few minutes later, Stewart walked out of the shop, a new XDM Springfield handgun at his side.

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Buckley’s administrative leave from PSRB due to investigation of board management

Posted by Jenny on 14th May 2013

By Yuxing Zheng, The Oregonian, May 14, 2013

120209-New-Oregon-State-Hospital-660The executive director of the Psychiatric Security Review Board is on paid administrative leave amid an investigation of board management, state officials said Monday.

Department of Administrative Services officials launched a review of the board’s management April 25 at the request of Kate Lieber, the chairwoman of the board, said Amy Velez, a department spokeswoman. Mary Claire Buckley, executive director of the psychiatric review board, was placed on leave May 2.

“Because we’re doing the review, we placed her on administrative leave,” said Velez, who declined to elaborate.

Lieber and Buckley did not return messages seeking comment Monday.

The Psychiatric Security Review Board has jurisdiction over people found “guilty except for insanity” of a crime. The 10 board members, who are appointed by the governor, have the authority to commit people to the Oregon State Hospital, conditionally release them to community-based programs, or discharge them from their jurisdiction.

State investigators in February 2011 found Buckley had verbally abused an Oregon State Hospital patient who had declined to enter a secure residential treatment facility. Buckley implied the patient would suffer ramifications for defying the board and refusing the placement, according to a report from the Department of Human Services’ Office of Investigations and Training.

READInvestigative Report on incident involving Mary Claire Buckley 2011 (PDF, 478KB)

“Buckley’s conduct was an instance of poor judgment,” the report concluded. “She was also disrespectful of the patient, yelled at (the patient) in public, and was clearly coercing or ordering (the patient).”

Buckley earns an annual salary of $99,636, not including benefits. Juliet Follansbee, a program manager on the board staff, is currently filling in for Buckley.

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PSRB executive director Buckley placed on administrative leave

Posted by Jenny on 13th May 2013

By Hannah Hoffman, Statesman Journal, May 13, 2013

PSRB logoMary Claire Buckley, the executive director of the state Psychiatric Security Review Board, has been placed on paid administrative leave, according to the Department of Administrative Services.

Spokeswoman Amy Velez said the reason could not be disclosed because it is a personnel matter.

Juliet Follansbee, the program manager for PSRB, is filling in for Buckley during her absence.

The PSRB consists of a small staff and ten board members appointed by the governor. It has jurisdiction over people in Oregon found “guilty except for insanity” of a crime. Since 2005, it has also had jurisdiction over youth found “responsible except for insanity.”

The board has the authority to commit a person to the Oregon State Hospital, conditionally release or discharge a person from the hospital, or revoke that release.

Buckley has been the executive director of the PSRB for more than 20 years. In 2011, a state investigation found that she had verbally abused an Oregon State Hospital patient. The report called her behavior “coercing” and “disrespectful” and said she exercised “poor judgment.”

Marion County Circuit Court records show there are no cases open against Buckley or the PSRB, and the three civil cases that have ever been filed against Buckley by people under PSRB jurisdiction have all be dismissed. The most recent was filed in July 2008.

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