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PORTLAND, Ore. — A federal judge says Oregon created a crisis by
underinvesting in mental health. Now, the state is forced to make
changes or pay millions of dollars in court-ordered fines, and two
bills advancing in the legislature could spark even more
significant reforms to the state's beleaguered mental health
systems.

On Friday, a federal judge found Oregon to be in contempt of court
for repeatedly failing to admit people in jail, in need of mental
health care, to the state psychiatric hospital within seven days.

Judge Adrienne Nelson ordered the Oregon Health Authority to pay
$500 per person per day every time someone ordered to receive
treatment at the Oregon State Hospital waits in jail longer than a
week.

"If you just look at the past year, if the state (had been) held in
contempt, we're talking about $10 million," said Emily Cooper,
deputy legal director for Disability Rights Oregon, the plaintiffs
in the contempt order case. "That's a lot of money to try to get
the state to act differently."

These cases are known as "aid and assist" cases, describing
situations in which people are ordered to receive mental health
care so they can "aid and assist" with their legal defense.

Mental health leaders around the state believe sanctions will get
Oregon to act, but there’s a concern that OHA and lawmakers could
miss a bigger point.

"The fear is that every dollar that now goes to fines and every
dollar the state invests in mental health will go exclusively to
serving people entangled in the criminal justice system," said
Chris Bouneff, executive director of NAMI Oregon. "And nothing will
go to keeping people away from that (criminal justice) system."

Bouneff is spearheading two bills, one that lowers the state’s
criteria for civil commitment — or involuntary mental health care
outside of the criminal justice system — and one intended to help
develop more licensed residential treatment options in Oregon.

The civil commitment bill would broaden definitions for commitment,
allowing a judge to look at a person's recent history and determine
if it's reasonable that the person could be a threat to themselves
or others in the near future, rather than simply assessing
"imminent" danger, which is the current standard.

Bouneff said he's confident both bills will pass. They advanced to
the legislature’s Joint Ways and Means Committee on Tuesday.

"We can't just do aid and assist or civil cases," Bouneff said. "We
have to do both, we have to invest in both and we have to build
faster so we can add capacity."

Bouneff affirms what KGW has exposed in its ongoing "Uncommitted"
series: Oregon has effectively criminalized severe mental illness,
forcing people to commit a crime to gain access to involuntary care.

"Right now, the advice we give on our resource helpline when a
family calls and they have a loved one at very high (mental
illness) acuity and they’ve cycled through things is, you have two
options: Watch your loved one further deteriorate, or call the
police and hope they get arrested," Bouneff said.

Judge Nelson, in her order Friday, came to the same conclusion
about Oregon's lack of investment in its mental health care system
at large.

"The State has failed to invest in community behavioral health
systems such that, for many individuals, the only opportunity to
receive treatment is upon facing criminal charges," Nelson wrote.

Community mental health services and earlier intervention are
priorities for Cooper with DRO.

"At the root of it, it's a human life that we all value, that we
want to get the services they need to get better," Cooper said.

OHA's most recent report on compliance shows that 32 people were on
the waiting list for the Oregon State Hospital as of the end of May.

On average, people waited an average of 15 days during the month of
May, about double the amount of time allowed under the federal
order.

In Washington state, a similar contempt ruling forced the state to
invest more than $100 million to improve its mental health systems,
eventually reaching compliance and reducing the number of mentally
ill people waiting in jail to constitutionally-acceptable levels.

Bouneff said the time is now for Oregon to kickstart into action,
with just weeks left in the legislative session and costly fines
racking up each day.

He believes simultaneous investment to the aid and assist, civil
commitment, and community restoration systems are the only way
Oregon will create an effective system.

"The pressure is on the governor, the pressure is on the
legislators, the pressure is on budget writers," Bouneff said. "If
they fall short, the state will suffer."

OHA told KGW it is reviewing the judge's contempt order and
evaluating next steps.

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