Release System at State Hospital Debuts

By Alan Gustafson, Statesman Journal, Jan. 19, 2012

A new two-tiered system for releasing criminally committed patients from the Oregon State Hospital is being launched at the Salem psychiatric facility, raising hopes that some patients will have shorter, less costly stints of care.

But even as some patients and mental health advocates welcome the new hybrid system, they also worry that it will function much like the previous one, long criticized for taking a cautious approach to releasing patients.

Effective Jan. 1, release authority for 114 forensic patients — sent to the hospital after being found guilty but insane of non-violent crimes — shifted from the state Psychiatric Security Review Board to a new state hospital review panel.

New PanelThe five-member panel now has authority to decide when patients committed to OSH for non-Measure 11 crimes are fit to be released.

The PSRB retains release authority over 182 patients who committed violent crimes. The board also retains jurisdiction over former patients who have been conditionally released to live in group homes and other community-based settings.

Creation of the two-tiered release system was authorized by the 2011 Legislature, after complaints about the PSRB taking an overly strict approach to releasing patients, resulting in stays at the psychiatric facility that are too long and costly.

It costs taxpayers more than $200,000 a year to keep a patient at Oregon’s main mental hospital.

State Sen. Jackie Winters, R-Salem, a chief sponsor of Senate Bill 420, the legislation that created the two-tiered system, is hopeful that it will lead to timely discharges for non-violent patients “who are clinically ready to be released.”

Winters said the legislation was aimed at preventing patients from languishing at the hospital after therapists have determined they are fit to be released.

“It is trying to break open that logjam that exists at the hospital when individuals actually have been deemed ready to transition back,” she said. “We can’t afford from a budgetary standpoint just to continue this big logjam — from the humane side and the budgetary side.”

Patient Richard Laing complained this week in a phone call to the Statesman Journal that the hospital has failed to provide patients with detailed information about the two-tiered system.

“They don’t know nothing,” he said, referring to patients. “There’s total ignorance here.”

Laing, an outspoken critic of the PSRB, describes the new hospital review panel as a step in the right direction.

“Obviously, they’re holding too many people too long,” he said.

Officials said there is no guarantee that the retooled release system will produce speedier discharges.

In fact, the new panel is set up to operate much like the PSRB, said Arthur Tolan, director of the new Forensic and Legal Services Department at OSH.

During a Wednesday interview, Tolan gave this answer when asked to delineate how the new panel is different than the PSRB:

“Really, not much. If you look at it, the standards are the same. The criteria that patients have to meet in order to be considered for conditional release are exactly the same. The exhibits required for the hearings are the same. The clinical work that needs to take place and the types of assessments that we provide for these hearings are the same.”

Tolan said the hospital review panel is charged with taking an objective approach to release decisions.

Like the PSRB, its foremost consideration is public safety.

“The patients will have to demonstrate that they are no longer a risk to the community due to their mental illness,” he said. “They demonstrate that by being able to show skills to manage certain risks. Then we really have to look at what resources are in the community to manage that risk. So it’s hard to tell at this time how it will go.”

The panel is scheduled to hold its first full slate of hearings today at the state hospital. The four cases up for review aren’t release hearings, dealing with other matters, officials said.

Members of the new hospital review panel include a psychiatrist, a psychologist, a lawyer, a probation officer and one member from the general public.

In choosing panelists, Tolan said objectivity and “expertise in their fields” were primary considerations.

“What we wanted to do is ensure that the folks coming in on this panel don’t come in with any hidden agendas,” he said. “They’re not pro-patient, pro-release. They’re not pro-correctional approach, ‘let’s keep them locked up.’ They’re people that don’t have a bias towards patients that are mentally ill and have also committed crimes. So we wanted people that are pretty objective.”

The Legislature allocated more than $577,000 to establish the new system, covering start up costs and funding for two employees.

A key hire for the hospital came late last year, when Micky Logan became the first director of legal affairs at OSH.

Logan formerly was a senior state assistant attorney general, employed by the state Department of Justice for 20 years. She represented the state hospital on legal matters, including an ongoing five-year federal civil rights investigation of OSH.

New hospital duties for Logan include ensuring that the review-panel process works smoothly.

As a state lawyer, Logan represented about 15 agencies within the state Department of Human Services and the Oregon Health Authority.

“I was probably wearing about 15 different hats every day,” she said Wednesday. “Frankly, my favorite hat was the state hospital but it was a small part of my job before and now I can wear the hat all the time. I’m very happy to be doing that.”

OSH’s roll out of the new release system will benefit from having Logan on board, said Bob Joondeph, executive director of Disability Rights Oregon, which has represented hospital patients in lawsuits brought against the state.

“I think it’s really good for everybody concerned, actually, because she knows the area very well and gets along well with all the different parties,” he said. “In order to make something like this work effectively, you have to get along with a lot of different types of folks. She seems to do that, and she also knows her stuff.”

Joondeph is reserving judgment on whether the two-tiered release system is a positive development or bureaucratic duplication.

“The answer is, it depends on how it works. I think it’s good that it’s being given an opportunity to see if it can be successful. But we won’t know whether it is or not until it’s had an opportunity to do its thing.”