What the Oregon State Hospital sent home in a cardboard box

By Kathy Walsh, published May 17, 2014 in the Oregonian. She lives in Bend.

Last week, I received an unexpected delivery from the Oregon State Hospital. I am guardian for a family member (let’s call her Beth) who was discharged from OSH’s Portland facility in July 2013. OSH security staff came to our home in Bend to drop off two large cardboard boxes of “her possessions,” sealed and clearly labeled with her name. I am writing not because I am concerned by the tardy delivery, nor even because most of Beth’s missing items are still missing, but because I think a look at these boxes can be instructive for those who haven’t had my experience of daily visits to the hospital and yet are curious about how Oregon’s mental health system works.

Groundsmen stand with lawnmowers in front of the Oregon State Hospital, 1910.

Groundsmen stand with lawnmowers in front of the Oregon State Hospital, 1910.

One box was filled with ragged clothing. Out of the large pile of mismatched shoes and torn jeans, two tee shirts belonged to Beth. The second box contained a bewildering array of objects and papers, the detritus of wrecked lives, with only one brief document for Beth. Along with hygiene and makeup products, keys, cheap jewelry, stuffed toys, a single tennis shoe and so many other lost objects, I was troubled to find a welter of personal photos, correspondence and official documents referring to perhaps five other patients. These included Department of Human Services, hospital and court reports, Department of Motor Vehicles correspondence, patient journals and ID cards. Some documents appear to have been gathered by the hospital, others to have been brought by patients (like a child’s birth records).

This box provides a chilling encounter with the loss of personhood experienced by those who suffer severe mental illness — and the chaotic system we have in Oregon to provide treatment for such individuals. (Forget “private hospitals.” With extended psychosis, this is where you end up.) And except for rare cases like Beth, who lived with and returned to family, most patients have lost their residences, cars, jobs, funding and families by the time they experience such a medical event. Along with the question of how the hospital handles records is the question of where such patients are to leave their stuff so they can begin to rebuild lives and identities when discharged.

OSH is staffed by many dedicated and overworked professionals who do the best they can with slim resources and within a culture of chaos. But individuals get lost in this system. When we read about floods or fires, we ask, “what would you take with you when fleeing disaster to help you hold onto your past and rebuild your life?” For those with serious mental illness, who are at least temporarily at the mercy of their illness and our care systems, the questions are, “how in the world would you keep hold of what you take? How do you retain your identity when your clothes and other belongings have become communal property on the ward? How do you emerge to resume your life?” Can’t we provide a better care environment for these suffering individuals? That would require more funding, more administrative/clerical support and more coordination.