Street roots
June 10,. 2011
Safe - or
unsound?
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■ I ■ ISÄÄ
Will concerns about public safety win the day when it
comes to reforming the Psychiatric Security Review Board?
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BY AMANDA WALDROUPE
STAFF WRITER
A s minimum security patients at the
Z \ Oregon State Hospital, Matthew
X AKirby, 22, and a 40-year old man
identified as “Emmanuel Goldstein’" for this
article are allowed to do quite a bit.
They can leave the hospital’s grounds
under the supervision of one hospital staff
person^ and could, for instance, eat at any of
Salem's restaurants. Other higher security
patientsTéave their wards in shackles, if
they leave at all.
Kirby and Goldstein can wear their own
clothes, have their own cell phone, laptop,
and' other possessions with them. They can
access the kitchen in the middle of a night
for a snack.
One might say their lives are bearable.
But Kirby and Goldstein say they are still
institutionalized.
“There is only so much Jello you can eat,”
Goldstein says. “There is only so much Uno
ybu can play.”
Only so much before they are reminded
that they are not free to go wherever they
want, whenever they want, spontaneously
join a group of friends at the local bar; that
the Oregon State Hospital’s guards will
shine a flashlight in their eyes every hour at
night; that they are still under 24-hour,
seven days a week supervision; that they
may have to re\nain at the hospital, under
the jurisdiction of the Psychiatric Security
Review Board, for years to come.
The Psychiatric Security Review Board,
also known as the “PSRB,” is the state
agency with jurisdiction over mentally ill
persons who commit a crime and are found
by a court to bè “guilty except for insanity,”
meaning that the crime would not have
occurred if the person wasn’t mentally ill.
With the mission to protect public safety,
the PSRB has the power to decide when a
patient is( ready to be released from the
Hospital, either to live independently or in a
treatment program at thé community level.
As of May 1, 736 individuals are under
the PSRB’s jurisdiction. Of those,’324 of
those reside in the Oregon State Hospital.
The rest have been “conditionally Released”
back to the community in various residential
settings - supported housing, intensive case
management settings, etc.
Once conditionally released, patients are
still under the board’s jurisdiction, and the
board can send them back to the hospital if
necessary.
“They aré the gate keepers,” says Harris
Matarazzo, who has defended patients in
PSRB hearings for 25 years.
By all accounts, the PSRB is successful at
its mission. The board’s recidivism rate — or
the rate of people who
reoffend once back in the
community — is extremely low,
at 2.3 percent
Mental health advocates and patients like
Kirby and Goldstein say the recidivism rate
is more indicative of a conservative board
that achieves its mission at a steep human
cost: rarely choosing to release a patient,
the board keeps patients at the Oregon
State Hospital far past the point that, they've
received the necessary treatment to live
independently
“There are patients who are considered
to be clinically ready for discharge...but
they’re unable to leave,” says Bob Joondeph,
the executive director of Disability Rights
Oregon. “They can spend months and years
in there, frankly.”
“They often don’t let someone out,” says'
Chris Bouneff, the executive director of
Oregon’s chapter of the National Alliance of
Mental Illness.
Bouneff says the reason is simple: fear.
“They are afraid of what happens if
someone commits another offense,” he
says. “Unless the risk is zero, they hesitate
to release someone.”
“The way we have things structured right
now is heavily Weighted in terms of public
safety,” Joondeph says.
The Oregon State Hospital has, in the
last five years, been under the critical and
scrutinizing eye of the United States
Department of Justice and Oregon’s
legislature. There have been changes. The
hospital’s new superintendent is actively
working.to create treatment programs that
are evidence-based and patient-centered.
The mindset of reform has trickled down
to the PSRB. Three bills are working their
way through the Legislature, set to adjourn
in three weeks.
Two bills — Senate Bill 420 and House
Bill 2701 — would substantively change the
PSRB and how the Hospital’s forensic
patients are treated, by taking jurisdiction
away from the PSRB, creating assessment
and treatment deadlines, and mandate that a
patient, once deemed ready for release, be
released within 60 days.
With the clock ticking, none of the hills
are scheduled for votes on the House Or
Senate floors. Two have been referred to -
the Joint Ways and Means’ Subcommittee
on Capital Construction, a seemingly
innocuous budget subcommittee made up of
legislative leadership. But the odd referral
indicates to lobbyists and insiders that
negotiations will continue behind the
scenes, and the hills may appear for floor
votes during the final days of the session.
They have come under the criticism of.
»
district attorneys, proponents of public
safety, and the PSRB itself. AU argue that
public safety would be jeopardized by the
bills because a dangerous class of criminals
could be more easily released into the
public.
But Bouneff, Joondeph and others argue
that public safety is not at question. Rather,
the question becomes whether there are
lucid people with treated mental illnesses at
the Oregon State Hospital, waiting for
release and costing taxpayers $200,000 a
year, who are ready to restart their lives.
“The idea behind both of these pieces of
legislation is to create more movement
where appropriate, so people don’t
languish,” Bouneff says.
eginning one year ago, a range of
stakeholders including legislators,
advocates, community mental health
workers, and the PSRB, began meeting to
discuss changing the PSRB.
Out of those meetings came House BiU
3100. It would require that a state-certified
psychologist or psychiatrist evaluate,
someone before they make a “guilty except
for insanity” plea.
“Currently,” Matarazzo says, “the PSRB
decides the evaluator. That is a real flaw.”
The idea is that the evaluator could
potentially prevent some people from
making the plea, which is already
challenging to do—a person must prove that
they are mentally ifl, and committed the
crime under the influence of that mental
illness.
Those people would then likely be
referred to community treatment programs,
rather than the hospital.
House Bill 3100 also includes a provision
that people committing misdemeanor-level
crimes and Class £ felonies be sent to the
hospital only if they need the hospital’s high
level of care.
“This bill would advance the efforts to
place individuals with criminal issues and
mental health issues in the most
appropriate place for treatment,” says
Richard Karris, director of the state’s
Addictions and Mental Health Division.
But Matarazzo doubts the bill is
necessary. “Judges need to challenge and
make sure the evaluations are good ones,”,
he says, adding that the evaluators, who
would be hired by the court, would always
be “hired guns.”
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See UNSOUND, page 9
PHOTOS BY
AMANDA WALDROUPE
Above right:
Matthew Kirby is
one of a small
group of Oregon
State Hospital
patients who has
been heavily
involved in
advocating for
changes and
reforms to the
PSRB.