The Oregon Health Authority oversees the Oregon State Hospital in Salem. (Oregon Health Authority)
Disability Rights Oregon wants a federal judge to hold the state in contempt of court for failing to move people from jails into Oregon State Hospital for mental health care within a court-ordered deadline of seven days.
Instead, they wait weeks to enter the Salem-based psychiatric hospital as their health deteriorates. In the past three years, at least two people died after extended waits in jail to enter the hospital and start mental health treatment.
The contempt finding is needed because of Oregon’s failure to comply with a 22-year-old federal court order that requires the hospital to efficiently admit patients from jails who need mental health care before they can face criminal charges, Disability Rights Oregon attorneys argued in a motion filed on Tuesday in U.S. District Court in Portland. The motion asks a judge to order changes in hospital admissions. Those include limiting entry to the hospital when people only face low-level misdemeanor charges and establishing new deadlines for people to exit the hospital when they are ready to be discharged.
The original seven-day court order was issued to get patients admitted quickly to the state hospital for treatment. But people still wait weeks on average in jail to be admitted. Those delays affect their mental health and slow the justice system because they need treatment to face charges.
“Despite a 22-year-old federal court order, the state of Oregon has shown little regard for the well-being of people with mental illness languishing in jail. Jail is the last place a person experiencing ongoing psychiatric crises should be,” said Jake Cornett, Executive Director and CEO of Disability Rights Oregon, a watchdog advocacy organization. “We will not stand idly by as Oregon thumbs its nose at the judicial system — there must be consequences.”
Amber Shoebridge, a spokesperson for Oregon State Hospital, declined to comment on the filing.
Persistent challenges
Oregon State Hospital’s struggles to move patients from jails to the hospital have persisted for years.
In 2002, a federal judge ordered the hospital to admit patients unfit to stand trial on criminal charges within seven days of a court order. Disability Rights Oregon, then called the Oregon Advocacy Center, took the state to court and won the order.
For years, the state hospital complied, but since 2018, the state hospital has been out of compliance most of the time, the filing said. Since 2021, the state hospital and Disability Rights Oregon have worked with a court-ordered outside neutral expert, Debra Pinals, to come into compliance.
The average time someone waits to enter the state hospital is nearly 27 days, according to Pinals’ November 2024 report. That report also notes other challenges, like the uncertainty of staffing new community residential programs slated to open up in Oregon in 2025, offering space outside the state hospital.
In its motion on Tuesday, Disability Rights Oregon said the state hospital has failed to fully implement Pinals’ recommendations from the last three years.
Those include discharging patients sooner when they are ready to leave the hospital and community programs and placements for people outside the Oregon State Hospital.
“The state hasn’t implemented all of her recommendations,” said Emily Cooper, legal director for Disability Rights Oregon. “That’s one of the big problems here. If they had implemented all of her recommendations, I’m not sure we’d be here.”
Mental health care services for people charged with crimes stretches beyond the state hospital. Community mental health programs serve people when they exit the state hospital and they also treat people who don’t need intensive hospital care.
But those resources — along with the state hospital’s capacity to serve 742 patients in Salem and a satellite campus in Junction City — are often limited.
Cooper, with Disability Rights Oregon, also worries about the potential for criminalizing mental health challenges. And she said Oregon needs to fully fund community restoration programs to help people outside the state hospital. Examples can include deflection programs that help people access addiction recovery services and avoid misdemeanor drug possession charges.
“You have to look at why are so many people with mental illness doing so poorly and decompensating to the point where they even enter the criminal justice system,” Cooper said.
State data and the admissions of hospital officials in court records show that compliance with the court order is an ongoing challenge.
In Nov. 18, 2024, court hearing, state officials said they couldn’t say when they would return to compliance.
“Unfortunately, we do not have projections,” testified Carla Scott, an Oregon Department of Justice attorney representing Oregon State Hospital, according to a court transcript.
As of Dec. 15, 81 people in jail were waiting for admission to the state hospital, according to a state report. Another 75 people at the hospital no longer need hospital-level care, the report said.
Years of work ahead for Oregon to address its lack of behavioral health beds
Two deaths before treatment
Delays in treatment can be deadly. The court filings give two examples of people who died after long waits in jail cells for mental health care in the state hospital.
Bryce Bybee died on April 17, 2022 in the Washington County Jail, nine days after he was ordered to the state hospital. For weeks before his death, he was often unresponsive without eating or drinking. At the jail, he was diagnosed with dehydration and hypokalemia, a condition with low potassium in blood also associated with malnutrition, the filing said.
Before his death, he was so immobile that he had bed sores while in jail.
Skye Baskin died on April 18, 2024. He was not officially declared dead until the day he arrived at Oregon State Hospital from Douglas County Jail. But when he arrived at the hospital, he had lost nearly 100 pounds, or 40% of his body weight, court records show.
He spent six weeks in an isolation cell in jail, and a medical examiner found he died of a heart arrhythmia linked to starvation and dehydration.
In Baskin’s case, a mental health crisis put him in jail. Motorists saw him wander around a highway around cars and contacted police, leading to his arrest.
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