Lynne Saxton came to Oregon lawmakers in late May with a calm but urgent plea.
For years, the state’s top health official had watched as the mental health beds she controls at the Oregon State Hospital (OSH) were increasingly filled with a tricky population—criminal defendants charged with minor crimes, who are not mentally fit to face those accusations.
Those patients were, and are, streaming into the state hospital courtesy of judges in counties throughout Oregon. Saxton wanted to press lawmakers to give state officials more say in the matter.
“With a limited number of beds, we should reserve admission to OSH only to those who actually need hospital-level care,” Saxton, the director of the Oregon Health Authority (OHA), told members of the House Judiciary Committee on May 30. “It is not the appropriate place for people who have been arrested for public urination, general nuisance crimes, or drug-induced behaviors.”
The testimony landed with a thud. Lawmakers moved on to other matters immediately after Saxton spoke, and her proposal wasn’t adopted.
But the issue is far from settled. Saxton’s got plenty of company in crying foul over the way Oregon uses its limited mental health resources to slap hugely expensive Band-Aids onto criminal defendants. Those concerns have led to some progress in Multnomah County, but critics say Oregon’s still spending far too much on an often-ineffective system of care—with no end in sight.
“Of all the ways you can deal with a person who’s got mental illness, this is probably the worst,” says Bob Joondeph, director of the advocacy group Disability Rights Oregon.
At issue is a process commonly known as “aid and assist.” It’s one of several ways a mentally ill individual might wind up admitted to the state hospital’s 578-bed campus in Salem.