OR: State Hospital Chief Urges Mental Competence Evaluation Changes

Orego.gov, cropped

Oregon State Hospital Superintendent Greg Roberts is urging lawmakers to require that so-called “aid and assist” patients undergo an evaluation of their mental competence before they are admitted to the state hospital.

“Aid and assist” patients are people who have been accused of committing a crime and are moved from county jail to the state hospital because a local court has deemed them mentally incompetent to aid and assist in their own trial.

Roberts told members of the House human services and housing committee on Feb. 26 that currently 62 percent of the hospital’s admissions are aid and assist patients, and about one third of those patients have not undergone an evaluation of their mental competence before being admitted.

Oregon law does not require that aid and assist patients undergo an evaluation of their mental competence — called a “365 evaluation” — prior to being sent to the state hospital.

That needs to change, according to Roberts.  He said having the hospital’s staff conduct the evaluations after admission is a drain on staff resources. And in some cases, the evaluation shows that the patient doesn’t necessarily need to receive care at the hospital, but can be served in a community-based setting.

“The question arises whether the Oregon State Hospital is necessarily the appropriate place for the restoration of competency,” Roberts said.

He asked legislators to consider pursuing legislation next year that would require evaluation prior to admission.  He also suggested lifting the requirement that aid and assist patients be sent to the state hospital in cases when individuals are accused of misdemeanor offenses.

Those changes could dramatically reduce the number of admissions and reroute people with mental illness to more community-based settings, which is a goal set by legislators and the state as part of an ongoing effort to improve Oregon’s mental health programs.

Roberts said the state hospital is currently conducting a pilot program in Marion County that involves sending hospital staff to the county jail to administer evaluations “in order to determine whether [potential aid and assist patients] really need to come to the state hospital.”

He said the pilot program, if effective, may expand to Multnomah, Clackamas, Linn, Benton and Lane counties, which account for approximately 80 percent of the state hospital’s aid and assist patient population.