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SALEM, Ore. — The latest push in a decades-long legal fight asks a
federal judge to hold the state of Oregon in contempt of a court
order for once again violating the rights of people in jail who are
ordered to receive mental health treatment.

Disability Rights Oregon filed a motion Tuesday to hold Oregon in
contempt for failing to admit defendants who are unable to aid and
assist with their own defense to the state psychiatric hospital —
Oregon State Hospital — within seven days.

A contempt ruling could force Oregon to pay significant penalties
for noncompliance and compel the state to make sweeping investments
in its overwhelmed mental health system.

U.S. Judge Adrienne Nelson, now overseeing the lawsuit between DRO
and the Oregon Health Authority, brought up the idea of a contempt
order forcing changes at a hearing in November, expressing
frustration that the state has fallen back out of compliance with
requirements.

"You've had time. I understand it takes time. But what have you
done with the time that you've had?" Nelson said, according to a
court transcript. "I can raise (the idea of contempt) because it's
part of what I can order."

Nelson noted that the state legislature has the power to
significantly invest in its mental health systems in the upcoming
session, which starts in two weeks, and asked OHA's lawyer to
investigate the likelihood that lawmakers will approve $55 million
in suggested investments.

KGW has reported on failures and challenges within Oregon's mental
health system for years through our ongoing "Uncommitted" series,
including how Oregon has effectively criminalized severe mental
illness.

Disability Rights Oregon legal director Emily Cooper told KGW that
a jail is a punitive and damaging place for someone with mental
illness, and there's a human cost for noncompliance.

"Every day a person with mental illness spends in jail is a risk
that they aren't just deprived their liberty, but they're at risk
of losing their life," Cooper said. "The past two years we've lost
two young men who are being held in jail for these services. I was
just talking with one of those mothers and she wants her son's
story and his loss to have made a difference in a system."

In need of more funding
Oregon officials complied with the 2002 judicial order requiring
court-ordered mental health treatment for defendants within seven
days up until 2018, when the state again fell out of compliance.

In 2022, U.S. District Judge Michael Mosman issued a new order,
limiting the amount of time that patients can stay at the Oregon
State Hospital for treatment, thereby forcing OSH to release
patients sooner and open up new slots for defendants waiting in
jail.

The Mosman order helped Oregon reach compliance with jail wait-time requirements, and the average wait time for jailed defendants
dropped from around 40 days to less than seven days for much of
2023 and the beginning of 2024, according to OHA data.

In the summer of 2024, Oregon saw a couple months of high aid and
assist referrals, the state couldn't meet demand for mental health
services, and wait times have since climbed back up to the current
average of 27 days.

"To not only get in compliance, but to stay there, we've got to
fully fund community behavioral health," Cooper said.

Nearly all parties involved — from DRO to OHA to Judge Nelson and
others — recognize that Oregon needs to expands its mental health
system capacity by adding new state psychiatric beds, community
treatment facilities, and other alternatives.

An OHA study, completed in June 2024, called for an 3,714 new
mental health and substance used beds to close existing gaps and
meet future projects.

That kind of investment would cost at least $500 million, not
accounting for staffing increases and incentives. OHA has requested
around $55 million from the state legislature in the upcoming
session.

REPORT: Thousands more mental health, drug treatment beds required
in Oregon to meet the need

Contempt ruling could spur investment
Cooper said Disability Rights Oregon is asking Judge Nelson for
sanctions to make sure that the state invests in this crisis that
overlaps between the mental health and criminal justice systems.

"If the state can't find the money to pay for these services, one
of the reasons our motion asks for contempt sanctions is they can
be in the tens of thousands a day," Cooper said. "We can get the
money to potentially pay for the system, but it comes from contempt
fines instead of being appropriated by the legislature."

In Washington, a 2018 contempt ruling for failing to provide mental
health services to people in jail sparked investments and
improvements in mental health services and infrastructure.

The state paid about $200 million in fines for noncompliance in a
similar case and the legislature appropriated $90 million to
purchase and renovate a previously closed behavioral health
hospital.

The state purchased the facility, got it up and running, and moved
70 patients there within two months — helping cut the number of
people with mental illness waiting in jail from 500 to 15, and
meeting compliance standards that had been a problem for a decade.

Washington also fast-tracked other projects, such as less-
restrictive mental health treatment facilities.

Decline in restoration leads to increase in crimes
Cooper, through DRO, said she believes that reducing jail wait
times should be Oregon's top priority to improve its mental health
and judicial system crises.

However, critics and some of Oregon's leading judges who oversee
mental health matters pointed out concerning ripple effects from
the 2022 Mosman order and OHA's corresponding shift in priority to
meet judicial requirements.

A November court filing — from Presiding Judge Matthew Donohue of
Benton County, Presiding Judge Jonathan Hill of Tillamook County,
and Judge Nan Waller of Multnomah County — explained how the Oregon
State Hospital started releasing more patients earlier in 2022 to
make room for aid and assist defendants waiting in jails.

As a result, the percentage of defendants who were found mentally
"fit" to proceed at the end of the OSH treatment decreased from 59%
to 40% — a 19% drop in restoration, per Oregon Judicial Department
data.

For patients found not fit to aid and assist with their own cases
at the time of release, their criminal charges are often dropped.

With shorter treatment stays and a lack of follow-up mental health
service options, this larger group of "unfit" defendants committed
more crimes within six months of their release, per OJD data.

OJD tracked a 46% increase in new felony cases and a 90% increase
in new misdemeanor cases for defendants who had their aid and
assist cases terminated after being released from OSH in the
previous six months.

Through a public records request, KGW received data showing more
than 500 people who fit this criteria and now face new charges
including murder, burglary, assault, harrassment, and others.

In their filing, the judges said the data is highly concerning,
this is one of Oregon's most ignored crises, and there are serious
consequences for everyone involved.

Does Oregon need more options for restoration?
Even if these effects were unknown or unanticipated, the intent of
the Mosman order was to compel Oregon to meet judicial requirements
for mentally ill defendants waiting in jail for treatment.

Instead, Oregon has since fallen out of compliance again, and the
current system has proved to be worse at restoring individuals who
need care and treatment and are therefore a greater threat to
themselves and the community.

Judge Waller, in a previous interview with KGW, addressed her
concerns about the state's mental health care and judicial systems
and also pointed to substance use as a contributing challenge for
recidivism.

"It's not good for the individual. It's not good for community
safety or just the community well-being that we have people who are
very mentally ill using controlled substances in a way that makes
their behavior even more difficult and we can't get them into the
right level of placement," Waller said.

KGW asked Cooper about the ripple effects of getting jail wait
times under the 7-day requirement. She said the effects are
additional evidence that Oregon needs more places for community
mental health restoration. She said she wasn't surprised by an
uptick in crimes without community care options.

Declining role of civil commitment
Oregon's priority on aid and assist cases has created the near-
elimination of civil commitment cases in Oregon — when a person is
forced into mental health care treatment because medical and
judicial leaders deem their mental illness to be a threat to
themselves or others.

Without this option, Oregon often cycles individuals through
healthcare systems, effectively waiting for someone with severe
mental illness to commit a crime before mandating care, as KGW has
covered through its Uncommitted series.

KGW asked Cooper if, based on current mental healthcare capacity
across the state, Oregon needs to deprioritize tools like civil
commitments in order to make space for aid and assist patients
whose constitutional rights are being violated.

"Yeah, we're in this terrible situation — who is going to be hurt
the worst, so we need to prioritize," Cooper said. "I would like us
to get beyond this sort of emergency triaging where people can get
services when they need them."

DRO, OHA, Judge Nelson and other invested parties have a status
conference hearing set for Friday to discuss updates on the ongoing
lawsuit.

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