From the Portland Tribune, April 26, 2012
Advocates push for more freedom; board sees trouble ahead
Matthew Kirby, a mental health activist in the new group Fair Shake, is challenging the authority of the state’s Psychiatric Security Review Board.
For a decade, Rex Gorger had lived at the Oregon State Hospital in Salem following a 2002 conviction for murder in Washington County, where he was found guilty except for insanity.
The 31-year-old Gorger is preparing for a new life after the state Psychiatric Security Review Board approved his release, accepting the hospital’s claim that he was stable.
All he wanted was to avoid the stigma of mental illness that would follow him outside the hospital walls, possibly into a group home or other facility that could limit his freedom.
Today, Gorger is part of a group called PSRB Fair Shake that is promoting state legislation in 2013 to challenge the Psychiatric Security Review Board’s public safety mandate. The group wants to add a clause to the board’s mission statement giving people under its care more autonomy.
In January, four members of Fair Shake asked state Rep. Mitch Greenlick, D-Portland, to sponsor the bill and recruited a Fair Shake member to intern in his office. The group, which has about 30 members, wants the state to loosen its legal grip on people who have been convicted of crimes through the insanity defense.
“The idea of keeping society safe from ‘us crazies’ once we leave the hospital is based on stigma,” says Matthew Kirby, 22, of Portland, one of Fair Shake’s leaders.
In February, Kirby, who had been charged with first-degree burglary and found to be guilty except for insanity in 2009, was appointed to the hospital’s advisory board.
The group’s effort has raised red flags with Mary Claire Buckley, Psychiatric Security Review Board executive director, who says Fair Shake members are giving the public a warped view of their situation.
“They want to pose as these poor mentally ill people that are being mistreated,” Buckley says. “That’s the kind of stuff you’ll hear, but these people committed serious crimes and they chose to insert the insanity defense. Our mission is to protect society.”
According to the board, Only 2.2 percent of its clients commit new felonies after their release, compared to about 27 percent of people who are released from state prisons managed by the Oregon Department of Corrections.
“We should be committed to creating an actually therapeutic system, not just locking people up,” says Greenlick. “It might take three or four sessions.”
A balance of priorities
Buckley became executive director of the board in 1978, around the time the Legislature founded it. John Beatty, a retired Multnomah County senior judge, led a 1975 subcommittee that examined criminal arrests and sentencing for people with mental illnesses.
“It made sense to have control over people with mental illnesses for a longer period of time,” Beatty says. “The problem was, you’d send people to the state hospital, and the hospital would give them meds and turn them loose. There were no requirements to help people stay well after they got out.”
Today, Oregon and Connecticut are the only states with independent adjudicators overseeing people found guilty except for insanity; in other states they are assigned to the courts. The Oregon board’s clients rose from about 300 in 1980 to more than 700 in 2011.
“Maybe it was a bit overrated in the beginning, and that meant defendants flocked to it. And now it’s overly criticized,” says Joel Dvoskin, a forensic psychologist in New York who has trained Oregon Psychiatric Security Review Board members.
Imposing limits on people is sometimes considered good care, Dvoskin says. “There’s nothing about the recovery model that says there are no restrictions on personal freedom. It’s a message of hope and autonomy. It’s also about responsibility.”
About half of the board’s clients live in communities today under sometimes strict conditions, a 255 percent increase since 1992. Buckley says the rise reflects the board’s growing ability to balance the priorities of safety and freedom.
Limits on freedom
Following his 2009 conviction for burglary, Kirby found himself sentenced to be under the board’s supervision for 20 years. When Kirby was released from the state hospital to a Southeast Portland group home, he challenged the limits he faced, including a system of graduated freedom — the privilege to leave the house was automatically six months in the future — that he says was superficial.
“We put it in place for security, for the PSRB,” says Eric Sevos, clinical director of forensics at Cascadia Behavioral Healthcare, a community provider contracting with the state to house Kirby and about 50 other board clients in Multnomah County. “It does feel like it groups folks too much, like it’s not individualized. We were looking at it before, but Kirby put the gas pedal on the scrutiny.”
Sevos says the board’s public safety priority often conflicts with a person’s recovery. “As a social worker, I might want to see a person take a risk, take chances, prove that they can live on their own,” he says. “We might have to talk to that person and say, ‘Look, it’s going to be hard for us to convince the board.’ So that person stays at a certain level of care longer than I think is good for them.”
Kirby and Fair Shake’s members aren’t strangers to advocacy. During the 2011 legislative session, Kirby, then a state hospital resident, wrote letters to lawmakers and testified in support of measures to limit the Psychiatric Security Review Board’s authority. Two of the bills that he supported — House Bill 3100 and Senate Bill 420 — became law in August 2011, reducing some of the board’s authority as of Jan. 1, 2012.
That’s what Fair Shake members say they aim to do more of during the 2013 legislative session, Kirby says. “It’s our Arab spring.