The Criminalization of Mental Illness

Why Are Oregon's Jails and Prisons its Biggest Providers of Mental Health Services?


"Housing first" and "harm reduction" policies of treatment towards "People with mental illness are frequently picked up for low-level crimes. Frequently, these folks are off their meds, and they're obnoxious and difficult to deal with..." seems to me to be correct approach. When mentally ill, possibly homeless individuals could be recovering by being assited with cost-saving medical treatment, roofs over their heads when beginning recovering work, and access to wrap-around-services, their criminal behavior will decrease. The jails will be able to attend more to repeat offenders. Harm reduction assumes there are basic services every citizen within America ought to receive; the jails are not set up to provide medical services evidently, nor to transfer people to medical facilities. I hope the research and attention Cascadia gives to this complex problem leads to mature solutions. Rebecca McLaughlin, Portland, OR
Nothing striking about this. Oregon as a state has scored "average" when it comes to providing care and resources for the mentally ill. Sadly, Oregon is one of the "nicer" states to live in if your mental ill,…

Anyway! I say anyway because no one really give a sh#@ about this stuff. The mental hospitals of the country where shut down decades ago and "transferred" to the streets or a local jail or prison near you. The problem in this country is everyone is in a box. We all live near each other, but not "with" each other. The states in this country act no different. They act like everyone else. Like some too cool teenager that's got a rep to uphold. The communication among states and governments is pathetic. Each state "handles" their seemingly "individual" crisis alone, asking for help only if absolutely necessary. This is what no holds barred capitalism looks like. It just didn't happen overnight. This little write-up on the state of mental "care" in Oregon? Lol! Why aren't we running whole sections in the Oregonian on the pathetic state of humanity in our state? It's pretty simple really. We as "individuals" wrapped up in our little consumerists realities are too busy figure out what we want to acquire next with our "hard earned" money in order to smell the coffee. This is but one issue among many, many, many. Quite frankly! my prognosis for this country is shhhit! We've all been cosumerized. In order to affect change we'd have to give up some of our unsustainable cushy life styles. Not gonna happen.

Actually this a good article. It also partially explains why you encounter some many crazies (sorry, mentally challenged or whatever the pc term is now) in downtown Portland. Sadly very few of them get any help coping and managing with their disorder or mental/emotional issues and sadder still they are largely ignored because they have become such a predictable part of the landscape "ignore the man yelling in the street sweetie, he has problems" (overheard more than once). @ Oppland-I am do not have a soft, unsustainable, consumer driven life style, nor am i giving up. If you wish to , you have my full permission wanker
I want to correct an inaccuracy in this article. Hospitals cannot force medications until someone has been committed by a judge--and this happens very rarely indeed. So when hospitals tell the jail they cannot do anything for someone that the jail is doing, this is exactly the truth. Hospitals accept patients all of the time who meet criteria for a notice of mental illness. But you can't hospitalize someone against their will--even if they are in jail--without proof that their mental illness presents DIRECT danger to themselves or others.

In the end, I think the biggest condundrum we have here is a civil rights question. As long as we continue to provide equal civil rights to the mentally ill to refuse treatment (which I damn well think we need to maintain), there will be a refusal to take the unpleasant drugs which keep them off the streets and out of the jails and hospitals.

Matt- If you commit a crime you are a criminal and should go to jail or prision. It should NOT matter at ALL if you are a mental freak! Chasse got what he deserved and maybe the cops can put a few more mental freaks out of their misery as well...they are nothing but a HUGE drain on society.

You really need to start acting like a news writer and NOT an opinion writer, it's getting REALLY old.
@Matt Davis - Was this your first time through MCDC? I'd be interested in your impressions - can you imagine working there?
@Reymont: I've been to the front desk to ask for mugshots and the like before, but it was my first time inside the facility.

It looks to me like working there would be incredibly stressful, although everyone I met did seem very intelligent and compassionate, so it would be nice to work alongside such folks, even in a difficult setting. Similar to the sense one usually gets in the offices of attorneys—the work may be dreadful on occasion, but it's smart people doing it.
Matt, your lead question, "why are Oregon's jails and prisons its biggest providers of mental health services?" is left largely unanswered by this essay, and deserves attention, because we're ripping ourselves off.

1. Rural and suburban counties all over this state and others, by not providing sufficient mental health and addiction services for their own population, cause a forced march of these forlorn persons to metro areas. Our jails are filled with persons with mental illness both from Portland, and from Amboy, Coos Bay and Wagontire.

2. We voters have repeatedly elected people, both left and right, Democrat and Republican, who have cut mental health and addiction health care. They've cut preventative care. They've cut shelter housing, food stamps, employment services. They've closed clinics, fired counselors, reduced opportunities for people to get well. The mess at MCDC is entirely our fault - we voters. We voters remain ignorant and get what we deserve. But the people at MCDC, both the staff and the inmates, don't deserve our stupidity.
I work in the field and recently spoke to an old coworker at one of the larger mental health providers in the area (this was in Washington County). He stated that the average level 2 (there are three levels) case manager there now has about 70-80 clients. When I was there a year and a half ago, I left with about 50. But, started out with about 25 or so. Case managers there now have basically enough time in a week to do a couple of groups and complete the required paperwork and recertifications. I have talked to clinicians in Multnomah County and it is even worse than Washington.

Furthermore, in order to get community mental health services in Multnomah County, one has to have OHP. If someone worked a little while before becoming disabled, he will wind up on SSD which will get you Medicare. However, that will not work for community mental health in Multnomah County unless there is a lot of proof the person is a threat to be jailed or hospitalized repeatedly. But, if there is no evidence of that, people struggle staying on meds and getting any other necessary services. This also goes for people that have been denied SS benefits.
Wow! Spartacus you really have some issues is there anyone toward whom you don’t express anger? It is sick beyond imagination to suggest that anyone deserved to be beaten to death by the police; to suggest that it should be a common practice is simply inhuman. The problem with this plan is that this wouldn't have helped Chasse in the least because the Police who beat him to death continue to defend their action arguing that they didn't know he was mentally ill. The system for getting mentally ill people to county for observation has been in place for years but they determined that Chasse was a criminal. There are two conclusions: 1) Chasse never had the benefit of observation because his fate was determined by the Police who served as judge jury and torturous executioner in a summary action in the street 2) Portland Police have made it clear that they reserve the right to beat anyone to death in the street regardless of their mental state. Spartacus; you would be wise to temper your anger when on the streets, if possible, especially if you are encountered by the Portland death squads.
@fuzzle - just a correction for you: it was FIRE MATT DAVIS NOW who condoned the Chasse killing not Spartacus
@fuzzle-I know I'm no lefty, but to be confused with a reactionary hatemonger kind of shows a certain amount of prejudice on your part.

As for Portland Police, it's easy to look at sensationalized media cases in isolation with individual officers making inhumane or impulsive choices.

BUT...I work every day with individuals who are either under the influence of narcotics or floridly psychotic and/or manic. Project Respond can interview them, but the only people qualified to get them out of the community are the Police. I can only recall 2 incidences when someone arrived at the Emergency Room after having been tased. The vast majority of folks are treated with respect and skill by the officers on the scene and--despite their own violence and resistance to intervention--are brought safe and unharmed to the hospital. In fact, IMO people who probably should be brought to jail or detox are brought to the ED instead because the police are so cognizant of the presence of mental illness. So the next time you want to cite police brutality, ask a hospital social worker about the thousands of raving, assaultive folks who are transported without a scratch to the nearest emergency room.
Spartacus says: "Chasse got what he deserved and maybe the cops can put a few more mental freaks out of their misery as well...they are nothing but a HUGE drain on society."

Nobody forced you to write those words (with the possible exception of those voices you hear) it was a choice and I took offense your expression. Similarly I take offense to the Police Department ongoing defense of violent cops and avoidance of accountability. Saying that it was an isolated incident and that 90% of cops are good and prudent is disputed by the cops themselves a large number of whom make public proclamations: “I am Chris Humphreys”. That is frightening.

Correction acknowledged: Not Sparticus but Fire Matt Davis Now who made angry hateful statement.

All the same; Spartacus, unlike you I can’t take the Police Department seriously or support them when they passionately refuse to accept any accountability and continue to support the actions of Humphreys, Nice, and Burton. If the police department delivered on any promise in this case: transparency, accountability, open investigation etc. then I might have a different opinion but the ongoing defense of the actions of these thugs and the self-identification of supportive "I am Chris Humphreys" officers is appalling. The specter of denial and defense by the police department eliminates any shred of credibility. If the KKK handed out Christmas presents to poor kids at Christmastime it wouldn’t change my opinion of the organization as a minister of hate likewise all the public statements and political spin by the department is mere blather without fundamental change including; police and departmental accountability, verifiable oversight, independent review, and general decency. The police behave as though the public is the enemy and that is intolerable. In short; if 90% of cops are so great why do so many identify with Chris Humphreys and defend this violent homicide that continues to drag the whole department down? Seems to me if they were really "sworn to protect and dedicated to serve" they wouldn't spend so much time and effort blaming the public and defending departmental homicidal dead wood.
um, fuzz, I think the article is about mental health patients in the jails, not about your grudge against the Man.
Excellent reporting.
I was at MCDC recently because of a PV. Because I take meds for a mental illness I was housed on the mental health unit. I have to say that the mental health staff and doctors are some of the best. I was in there for a PV, but some were in for murder or rape. From the staff you would never know we were criminals, they treated us with respect. I saw inmates scream at them, i heard about a guy throwing crap on them. Guys that have to have spit masks on..and they still show up on the unit everyday and check in on us and help us through some serious stuff. One doctor even comes to the unit herself everday and if a guy yells at her, she comes back the next day and the next.
What I mean to say is that whether or not its "right" that the mentally ill people are in jail - we have to see that the staff could easily work somewhere else, but they choose to work with us. We owe them a lot and they are truley good at what they do.
Thanks for the great article, Portland Mercury. Brings attention to an important issue.
Your only one decision away from making the worst one of your life.

Your destiny is on the tip of your tongue.

Its a great idea, I hope it works, If you have ever been that close to
doing something you never would....Congratulations.
I don't live on the "interweb" like you "posters" do, I live out in the real world and I'm damn sick of all the flat out crazies out here. I can't save them all with my spare change! Menatal health clinics and medication can't solve their problems either. There's nothing that can restore these people to normalcy.

They really need to be sent away to nice little farms in the country.

You can "flame" away, but I have a real opinion and it's not the same as yours.
I liked this article, it is important and insightful. It is interesting to me, that so many people suffering from mental illness are simply left to fend for themselves. I work for an elderly gentleman of almost 80, who is active but suffers memory loss and had trouble with activities of daily living, not unlike some of the people in this article.

There are also striking differences between this gentleman and most of the people this article focuses on. This gentleman is not homeless, he owns his home free and clear, in a nice area and has just a few dollars in the bank. He, like the homeless people here, has no medical insurance, and the lack of medical care options more likely than not, greatly contributed to his current situation.

The homeless are promptly sent back to the streets with nowhere else to go, no matter the weather, but I'm having trouble getting this gentleman out of costly nursing care and back into his own home.

The real difference here, is that this elderly gentleman has ASSETS that can be attached, to pay his bills. The idea of unnecessary nursing care is outrageous, but when you put it up against how the forgotten people in this article are treated, the contrast is even more striking...the homeless have nothing left to take but their freedom.
Actually FMDN!, the universe doesn't care whether they go to jail, so it's just you wanting that, no "should" about it. Also, I'm kind of creeped out by your post's lack of basic empathy for your fellow human beings.

As for LMA! (apparently the same person): we're already providing mental health services, just expensively and ineffectively. We could do more with less if we did it through social services instead of through the criminal justice system. And as above, just because you want to do something to somebody doesn't make it what "they need" done to them; no really, the universe doesn't care what you want.

I'm disturbed by your posts' violent rhetoric and self-centered absence of compassion for others. (For anyone who didn't know, "sent away to nice little farms in the country" is a standard American euphemism for the euthanasia of household pets.) Of course, the violently insane show those traits too, which puts your outrage at the existence of "mental freaks" and "flat out crazies" in a rather unsettling light.
Excellent reporting. The Multnomah County Cabal and the City of Portland politicos pay much lip service to being progressive and responsive to community policing and providing assistance to vulnerable populations. And yet -- where the wheels meet the road -- they spend more time issuing press releases and subsidizing real estate developers than delivering tangible services to the mentally ill, the addicted, and endangered minors.
this is effing stupid they shouldnt jail mentally ill people because its not fair THEY ARE ILL AND CANNOT CONTROL IT A DUH and the dum asses who are jailing them are retards they r putting money into having ppl call in the mentally insane to be jailed before a crime happens, OH SO THEY WANT TO JAIL THEM NOW FOR NO REASON? isnt that illegal? they should be putting teh freaking money into a mental hospital ward just for that and admiting them there and treating them ¡¡¡¡¡¡PROPERLY!!!!!! that is all i got to say, this was a good article though.==but PRETTY lengthy XD lol....

*im maddy and im 13*
*reiceezzzz peiceezzzz outttttttt*
As a Retired RN, BSN, and clinical MSW, who worked nearly all of my 25+ full-time year career, amongst most Portland area health care systems, I have this to say about the matter. Nearly ALL of the inappropriate SHOOTINGS of unarmed citizens stem from the fact that Dammasch State Hospital was closed, along with Holladey Park Hospital, Cedar Hills (Psychiatric) Hospital, Bess Kaiser Hospital, and (later) Pacific Gateway (Psychiatric) Hospital, in the 1990's. I KNOW! Mental health services are MY specialty, in this area!

Too many "mental health advocates" believed (erroneously, IMHO), that if we just "dumped all of the severely mentally ill people" of Oregon, out into the streets, that would save the taxpayers of Oregon SO MUCH MONEY! WRONG! People with SEVERE disabilities need SAFE, SUPPORTIVE, PREDICTABLE environments, in which to live.

Unfortunately, too many of them have TRASHED one group home, after ANOTHER group home, until there are NO group homes that will TAKE them! Taxpayers have been picking up the COSTS of these trashed group homes, though few are aware of it! Having spent some time working at Dammasch State Hospital, it SICKENS me, to know that some people are considering turning it into a PRISON now, INSTEAD of building the long-term MENTAL HEALTH HOSPITALS we NEED, here in Oregon!

Psychiatric/Mental PROFESSIONAL STAFF do NOT SHOOT their patients! We REALIZE that their brain chemistries are OFF, so provide APPROPRIATE SUPPORT SERVICES and LIMITS, until their thinking is clearer, again! Police officers are NOT TRAINED TO DO THIS!!!!!!! Most of them know nearly NOTHING about mental health, let ALONE severely mentally impaired individuals!

They are SO AFRAID of severely mentally ill individuals, that they scream "I'm SCARED", at the drop of a HAT, IMHO! Until LICENSED, FULL-TRAINED mental health professionals AND SECURE long-term psychiatric hospitals RETURN to Oregon, these inappropriate shootings WILL CONTINUE! NO ONE WANTS to be severely or permanently DISABLED, though some people appear to believe that persons dealing with these illnesses WANT them!

Because Oregonians CHOSE to dump our Mental Health system, in the 1990's, we are REAPING what has been being "sowed" for DECADES, NOW! Some severely mentally ill individuals CANNOT live in group homes! They REFUSE to take their medications, they don't eat/sleep/bathe/groom/etc. themselves, on a regular basis, they get into trouble with illicit drugs/alcohol/prostitution/crime/gambling/violence in our COMMUNITIES, then end up homeless, severely physically ill, malnourished, ignored, overlooked, dead and/or DUMPED INTO PRISONS, which are NOT appropriate locations for people with severe/permanent mental health disorders!

PRISONS/JAILS are INAPPROPRIATE locations to WAREHOUSE ILL CITIZENS! However, throughout history, the GREEDY and CALLOUSED amongst us, have ALWAYS PREFERRED prisons, to hospitals! They are, generally, completely INDIFFERENT to BOTH populations! "Out of SIGHT = Out of MIND" to FAR TOO MANY Americans!

Forcing severely ill people to live homeless lives, is ALSO, inappropriate! If they were capable of making wise, responsible CHOICES, most of them would NEVER have CHOSEN to live on the streets! Yet, most Oregonians have CHOSEN to treat these ill individuals as IF they WERE wise, responsible adults! Wrong choice, IMHO!

One of the FIRST things any hospital mental health RN will DO, is to REMOVE the gun of a public safety officer, the MINUTE that officer arrives on the mental health unit. Been there, done that, countless times! WHY does that occur? Because we DO NOT ALLOW WEAPONS of ANY type to be out of OUR control.

No guns, knives, razor blades, scissors, ropes, lighters, matches, or other potentially hazardous implements are allowed on hospital mental health units! None of the PROFESSIONAL staff wants to end up dead, nor do we want our patients to end up that way, EITHER! That is what WE work to PREVENT!

However, as long as the politicians and general public of Oregon remain INDIFFERENT to the safety of our ill citizens, MORE of them will, unnecessarily, DIE! That is due to the FACT that police officers/prison guards are NOT licensed HEALTH care providers, for the most part! There is a HUGE DIFFERENCE between being a police officer/prison guard and being a licensed health care provider!

If Oregonians, INCLUDING our MD Governor got their PRIORITIES straight, in this state, we would ALL be MUCH better off, IMHO! Stop dumping ill people into our PRISONS or on the STREETS and there will be a REMARKABLE shift in how our entire state looks, feels, and lives! We MUST have stable, reliable, SECURE housing, created for our long-term, unstable, mentally ill citizens. Facts ARE facts, everyone!

Janiece Staton Retired RN, BSN, MSW, MAT