A Crisis in Costs, Day 3: Outpatient treatment is by far the best option

Guest opinion by Jason Renaud, published in the Salem Statesman Journal, May 25, 2010

Advocates for persons with mental illness remain unconvinced the state should return to the bad practices of the 19th century by both building and committing a future hundred years of resources to state psychiatric hospitals.

This financial and political commitment, from politicians aligned with public employee unions, from tired and cynical mental health administrators, from local construction and property interests, is impossible for us, unpaid advocates concerned for the welfare and civil rights of persons who have mental illness, to block or even track.

To us — to many of us — it’s millions of dollars of precious public money dumped at the wrong end of the continuum.

We know excellent outpatient care costs one-tenth of hospital care — but that’s not what gets bought.

We know in-patient treatment needs to be integrated with family, housing, employment, that health and re-entry is the only goal — but that’s not what gets done.

We know addiction treatment is done best by peers in a 12 Step community such as AA — but walls and barbed wire defeat indigenous programs of recovery.

Over and over, the new OSH is sold as a jobs program, as a stimulus to local business, as a long-term plan for economic stability for Salem and perhaps Junction City.

But it’s really a prison for people with a treatable illness.

Persons with mental illness are the most discriminated against persons in the world — in all places and throughout the ages.

Every horror story in literature is about mental illness. In housing, education, in the law, health care, in employment — they are legally discriminated against. They are intentionally impoverished. They are attacked. They are isolated and abused.

So I am not surprised at this small-minded corruption. This hate and disregard is expected from our legislature and local commissioners. There is no counterbalancing force.

At some point, arguably, they may have said, we have the moral high ground; we are helping people, or we are protecting people.

Neither of those ideals have been true for a long time at OSH, and no one outside of those directly benefiting from the continued existence of the hospital would say those things. No one wants their children at the state hospital.

So, to me, those advocating for the perpetuation of the hospital are hypocrites at best.

Until a counterbalancing force is produced to offset the demands of the construction crews, the hospital will grow and grow, demanding those outpatient dollars with more threats of hatred and fear and dread.

Jason Renaud of the Mental Health Association of Portland thinks the state is making a mistake by moving forward with a $458 million plan to build two new hospitals to replace the 127-year-old Oregon State Hospital in Salem. Renaud favors dramatic downsizing of the state hospital, and he calls for state leaders to expand community-based outpatient treatment, housing and support services for people with mental illness.