A bad proposal – Closing psychiatric hospital would hurt health care

Op Ed from Eugene Register Guard, December 8, 2016

Gov. Kate Brown’s plan to close the Junction City psychiatric hospital to help fill a $1.7 billion gap in the state budget came as a shock to just about everybody — the people who run the hospital, state legislators, patients’ families and the Junction City mayor and council.

This isn’t the best idea she’s ever had.

For starters, the taxpayers have shelled out $130 million for the facility, which is not yet two years old and employs 330 people. These same taxpayers are already in an ugly mood about the more than $700 million wasted on projects such as the still-unbuilt Columbia River Crossing bridge, the Cover Oregon insurance exchange, the first attempt at rebuilding U.S. Highway 20, and the state’s dubious Business Energy Tax Credit program.

Chief among the flaws in Brown’s proposal is that it hinges on removing people from the state mental health system and dumping them on community health care systems — which are already stretched to the breaking point.

Brown estimates that closing the hospital would save the state about $34.5 million a year, mostly from employee wages and benefits. None of those savings are earmarked for community mental health facilities.

The Junction City hospital currently houses 81 patients. Most — 46 — have been judged by a court to be guilty except for reason of insanity. Of these people, 21 have committed violent offenses requiring mandatory prison sentences under Measure 11.

Thirty-three patients are civil committments, meaning they have been sent to the hospital by authorities or families for treatment, with the goal of returning to the community. They have committed no crimes. (Two additional patients are classified simply as “other.”)

It’s not clear where these patients will go if the Junction City hospital were to close.

Brown has expressed a preference for community-based mental health care. But offenders who have been sent to the psychiatric hospital by court order can’t be released into the community. The most likely outcome would be to send them to the psychiatric hospital in Salem, the only other state hospital with secure beds. But that hospital also is generally full, which could mean sending other patients currently housed there back to the community to make room for incoming patients from Junction City.

Where the resources are going to come from to serve these patients, and others who will be looking for community-based mental health care, is a large question.

Several Register-Guard readers have already weighed in on the proposed closure, saying there aren’t adequate mental health resources locally and that the new hospital was literally a lifesaver for family members.

A new audit of the Lane County community mental health program backs them up. The audit concluded that community-based mental health care, with a focus on recovery that includes intensive case management, is the most effective way to treat and manage serious and persistent mental illness, The problem is, Lane County doesn’t have either the trained staff or the money to meet demand. This is true throughout the state.

The Curry County Pilot, for example, reported earlier this year that patients waiting there for space in a state mental hospital were ending up in the local hospital’s “hold room” — which has no windows, doors, restrooms or security — back out on the streets, or in jail.

The country has suffered from inadequate mental health care for decades mainly because of two factors. A series of court cases in the 1960s, while well-intentioned, made hospitalization more difficult and relied on the incorrect assumption that there would be adequate community resources as an alternative. And changes in federal funding, culminating in the Budget Reconciliation Act of 1981, slashed spending for community-based mental health care.

Mental health is a serious issue. Looking to balance the state budget at the cost of a facility, and programs, that are helping Oregonians is a bad idea. Legislators, Democratic and Republican, should turn thumbs down on it.