Bruce Goldberg Wakes Up

Bruce Goldberg, MD - director of the Oregon Department of Human Services

Bruce Goldberg, MD - director of the Oregon Department of Human Services

To: All DHS employees
From: Bruce Goldberg, M.D., director
Subject: Our clients’ voices
Date: October 24, 2008

    “We are not the worst moments of our lives.”
    ~Sister Helen Prejean, author of Dead Man Walking

Recently I participated in a panel discussion about community treatment facilities for people with mental illness. It was clear from some of the questions to the panel that there is a great deal of misunderstanding about mental illness in our society. And, unfortunately, that misunderstanding can breed fear. I also was struck by something else as I sat in the front of the room next to several public officials: There was no one on the panel speaking from the perspective of a person who is living with mental illness.

The lack of that perspective in these types of forums is a mistake, because it allows people to marginalize, stigmatize and fear mental illness, and that creates barriers that prevent successful mental health treatment.

The reality is that people with mental illness live independently, hold down jobs and do quite well on their own. Others need more supervision for their illness, just as people with other illnesses do. Some people need intensive treatment in the hospital. Others move in and out of the hospital. And some individuals have committed crimes as a result of their mental illness.

One of those people is Ashleigh Brenton, who spoke last month in front of the Clackamas County Board of Commissioners at a public meeting about a community treatment facility in Milwaukie. She said that people who meet her are surprised to learn about her criminal record and that at one point she was a danger to herself and others, which led her to spend time in the Oregon State Hospital. People are surprised because today she is a student at Portland State University who looks more like a kindergarten teacher than the stereotype of someone with mental illness.

“Mental illness is a chemical imbalance for the most part and it can be treatable and people can live very productive lives and give back to society,” Brenton told the county commissioners.

Brenton’s story is particularly important today because it’s also an example of why community treatment facilities are so important. Her treatment was completed, she was stable and ready to be discharged from the hospital, but there were no openings in a community treatment facility for her, so her discharge was delayed. She said she wanted to speak out because she believes that stigmas against mental illness can contribute to lack of community support for local treatment options.

“Our community members are just too afraid of what they don’t understand,” she said.

Brenton is one of the nearly 400 people in Oregon who are living examples of the state’s safe and successful program for integrating people who committed crimes as a result of mental illness back into the community. There are people like her in nearly every county in the state. Approximately 25 percent live independently — on their own or with their families. Another 25 percent live in a treatment facility. The rest are clients who live in a range of supported housing.

The fact is, people with mental illness who require treatment have been successfully living in your neighborhoods, in my neighborhood, for decades. The safety record of this program is stellar, with a recividism rate of just 2.2 percent compared to more than 30 percent for people coming out of the prison system.

Community placement is so successful that it is the cornerstone of the modern mental health treatment system we are building for all our clients — both forensic and civilly committed. It is part of the continuum of care that starts and ends locally so that everyone in Oregon can get treatment that may help prevent their illness from requiring hospitalization and also get the support they need when their time in the hospital is finished.

In order to succeed we must work together to overcome the stigma of mental illness that results in fear and prejudice. And we must listen to people like Ashleigh Brenton when they tell us their stories.

Thanks to DAWG Oregon for bringing this note to our attention.

OUR COMMENT – Presenting this message prior to the cavalcade of fear surrounding the Columbia Care Services project in Clackamas County – which started in JANUARY – would have shown the county commissioners outside expertise instead of accepting a default mode, which has been to agree with whoever is in the room at the moment. Outside expertise, a voice of authority, is one of the few useful assets the state DHS leadership can provide locally.

Wonder why Dr. Goldberg decided to wait eleven months before speaking up?

By not being a active advocate for persons with mental illness and for the law, and by not supporting independent mental health advocates, Dr. Goldberg undermined the Columbia Care Services project and allowed neighborhood activists to use fear and stigma to characterize the discussion.

Our suggestion – Dr. Goldberg needs to put the welfare of persons with mental illness and addiction at the forefront of his workload and DHS needs to provide support for community mental health advocates who have been shouldering this load to date.