Psychiatric Security Review Board Reform Moves Forward

From The Lund Report, June 1, 2011, by Amanda Waldroupe

Nevertheless, concerns about more aggressive changes to the Board persist

A bill that fundamentally changes the way people are evaluated who are found “guilty except for insanity” is winding its way through the legislature, and represents the most significant changes to the Psychiatric Security Review Board (PSRB) since its inception.

House Bill 3100 passed out of the Ways and Means Subcommittee on Public Safety yesterday, and now moves to the full Ways and Means Committee, the final step before proceeding to the House and Senate for a vote.

READ – Oregon House Bill 3100

The bill makes four fundamental changes – among them — certified psychiatrists or psychologists must evaluate a person who pleads “guilty except for insanity.”

“The goal is to bring some consistency and confidence to the system,” said Mary Claire Buckley, the Board’s executive director.

Those committing misdemeanor-level crimes would be removed from the PSRB’s jurisdiction, which has authority over Oregon State Hospital’s patients found “guilty except for insanity,” meaning that they committed a crime under the influence of their mental illness.

Anyone who commits a Class C felony must undergo an evaluation to determine if they can be placed in a community treatment setting. And those unable to assist their lawyer in their own defense trial would seek treatment in a community setting. Currently, both of these populations are sent to the Oregon State Hospital.

“This bill would advance the efforts to place individuals with criminal issues and mental health issues in the most appropriate place for treatment, supervision and restorative services,” said Richard Harris, the director of the state’s Alcohol and Mental Health Division.

Senate Bill 420, which advocates say would make more aggressive changes to the PSRB, would move the jurisdiction of hospital patients from the PSRB to the Oregon Health Authority, failed to move out of committee. It would have given clinicians and doctors working with hospital patients more say in determining whether someone could leave the hospital.

But it came under opposition from the Oregon District Attorneys Association and the Oregon Psychiatric Association, which were not privy to a work group that drafted the legislation.

“We have, as an organization, participated in every mental health bill for the last 30 years, and we were not part of this work group,” said Dr. Joseph Bloom, a psychiatrist at Oregon Health & Science University, who testified on behalf of the psychiatric association. “I don’t believe that there was one clinician [involved] with this bill.”

He criticized the bill because it didn’t clearly specifying the hearing procedure that the Oregon Health Authority and the hospital’s physicians would need to follow before releasing a patient. “It should not leave everything up to administrative rule [making],” he said.

Elizabeth Cushwall, the executive director of the district attorney’s association, objected because people could be released who posed a risk into the community.

“These are our most dangerous people,” she said.

However, Bob Joondeph, the executive director of Disability Rights Oregon, felt the legislation should move forward.

“Why do you want to change something that has been successful for 33 years and has a two percent recidivism rate?” Sen. Joanne Verger asked him.

“We think [the Board] has been overly restrictive, and this has been a detriment in terms of the amount of time people have to spend in the hospital,” he responded. “We are wasting resources when we do not have resources to waste.”

Since no action was taken, the bill did not move forward. It is not dead, and the Ways and Means can still move it out of committee.

“There’s been a lot of work on this bill,” said Sen. Jackie Winters (R-Salem). “Many of us have looked forward to the day in Oregon when we actually deal with the mentally ill in a more humane way. This is just one piece of the discussion.”