A fresh start at Oregon State Hospital

Oregon’s new mental hospital launches its first fully functioning section in early September, a historic milestone in the state’s push to peel away decades of neglect, decay and tragedy.

A compact new kitchen facility, designed to whip up 60,000 meals per month in efficient fashion, will replace Oregon State Hospital’s maze-like existing kitchen, tucked away in the hospital’s antiquated J Building.

The new kitchen will set the table for phased opening of patient-occupied sections of the new 620-bed hospital. Plans call for the first patients to move in to the new facility late this year and for full occupancy by late next year.

Debbie Granum, head of Food and Nutrition Services at OSH, said her staff is feeling the heat to get the new hospital off to a smooth start.

“Absolutely,” she said. “We’ve been trying to keep all the balls in the air and encouraging staff so they aren’t scared to death.”

Replacement of the 127-year-old institution, one of the oldest psychiatric facilities on the West Coast, is part of a long-term strategy to create a progressive era of care for mentally ill Oregonians, state officials said.

Critics of the existing facility call it a crumbling, prison-like eyesore that reflects decades of neglect by state leaders.

Human Services Director Bruce Goldberg has described the new hospital as a “world class” facility that will provide top-flight psychiatric care.

Linda Hammond, hospital replacement administrator for the state Department of Human Services, said the overriding objective of the new hospital is to provide patients with a safe and secure recovery center.

The look and feel of the place won’t resemble a prison, officials said.

“I tend to think of it as a secure university campus,” Hammond said.

On a recent day, Hammond led a tour through the work-in-progress kitchen area of the new hospital, as construction workers toiled around her.

At 17,000-square-feet, the new kitchen has far less space than the old one, which sprawled across 26,400-square-feet.

“This is about building something that can last for many years to come,” Hammond said, extolling the new facility’s durability and state-of-the-art technology.

Shut down and demolition loom for the old kitchen. Workers will pull the plug on steam kettles as big as an eight-person hot tub; a pot washing machine that six people could stand in; ovens that four people could walk into and comfortably stand.

Razing work is set to occur soon after the new kitchen opens.

Some cooking appliances will be salvaged and may be turned over to the state Department of Corrections, officials said.

Kitchen antiques could end up being displayed in a planned hospital museum. One such item is a scale that dates to a bygone era when the hospital operated a butcher shop and sides of beef were carved, weighed and hung from hooks.

Food staffers scramble to adapt

For Granum and the rest of the Food and Nutrition Services staff, moving out of the old kitchen is part of a sweeping overhaul of duties.

In a nutshell, the hospital is totally revamping how food is prepared and served.

Headed for the scrap heap is a method of freezing and reheating meals to be delivered on trays to patients housed on cramped psychiatric wards.

In the new hospital, food will be prepared fresh and served cafeteria style. The idea is to give patients choices about what they eat and match their dining experience to community norms.

“We’re going to a healthier menu where we’ve got a lot of variety of foods for them to choose from,” Granum said. “Instead of just getting preplated food on a tray, they’ll actually get to make personal choices about the foods that they like. We believe that will be a positive change for the patients.”

Another innovation took effect recently when food and nutrition staffers began serving meals to patients on certain wards, assuming duties formerly handled by patient-care personnel.

Hospital officials said the hand-off made sense because experienced food handlers can “follow the food” from preparation to service. It also eases burdens on direct-care staffers, allowing them to focus on patient care and supervision duties.

Daily contact with patients caused some jitters for long-time food-service staffers, Granum said.

“It was a little bit scary for folks,” she said. “They’re just not familiar with the clinical side and working with the patients that much.”

Cancellation of the hospital’s underground meal-delivery system poses yet another significant change for the food-service staff.

Tunnels beneath Center Street NE long have been used for delivering meals and supplies.

Motorized carts loaded with food zipped through the corridors, providing meals to hospital buildings on the north side of Center Street NE.

Underground deliveries will end soon because the new kitchen doesn’t have access to the tunnels. Above-ground shipments will come into play, with trucks delivering meals to the north side of the street.

Eventually, meal deliveries to the north side won’t be necessary. Plans call for patients currently housed in buildings on the north side of Center Street to move into the new hospital, located on the south side of Center Street.

Officials said the fate of the north campus hasn’t been determined. Potentially, emptied hospital buildings could be used for state offices, storage or other government purposes. Or the state could opt to rent or sell portions of the north campus for private use or development, as happened with the former Fairview Training Center property in southeast Salem.

Mistake caused worst tragedy

The Oregon State Hospital opened in 1883 as the Oregon State Insane Asylum. At the time, it was on the outskirts of Salem; now it’s in the heart of the city.

At its peak, the hospital’s population swelled to more than 3,000 people in the 1950s. Until now, no new hospital buildings had been built since the mid-20th century.

The Salem psychiatric facility now houses fewer than 650 patients, including about 470 in the hospital’s forensic psychiatric program. Forensic patients committed crimes and were found guilty except for insanity, resulting in stints of psychiatric care rather than prison terms.

The antiquated hospital is best known for its role in cinematic history. It was the filming location for the 1975 Oscar-winning movie “One Flew Over the Cuckoo’s Nest.”

The long, checkered history of the institution is littered with scandals and tragedies — from forced sterilizations and brain-cutting lobotomies to last year’s death of a patient who had been neglected by his caregivers.

Long ago, a simple mistake in the kitchen caused Oregon’s worst institutional tragedy.

On Nov. 18, 1942, George Nosen, a 27-year-old mental patient assigned to a kitchen work detail, mistook a metal can filled with cockroach poison for powdered milk. He retrieved 17 pounds of the white, crystalline powder from the hospital basement and cooks dumped about six pounds of the poison into a huge batch of scrambled eggs.

After hundreds of patients ate the eggs at a dinner meal, they were stricken by severe cramps, nausea and paralysis.

Some patients fell to the floor, where they cried out as they vomited blood and their faces turned blue.

Throughout the night, one patient after another died.

In all, 47 patients died and more than 400 patients and employees were poisoned.

Gov. Charles Sprague initially called the calamity a case of mass murder. But detectives soon discovered Nosen’s mistake.

No criminal charges were brought against Nosen, who remained at the state hospital for the rest of his life.

In 1983, Nosen, 68, died on a geriatric ward. He suffered a fatal heart attack during a fight with another patient.

In the 1980s and ’90s, the hospital became severely crowded and understaffed as the aging facilities decayed.

The state’s push to replace the hospital gained momentum after Senate President Peter Courtney, D-Salem, toured the rundown hospital in 2004 and came away determined to push for reforms.

In 2005, state-hired consultants deemed the clustered array of hospital buildings obsolete and unsafe, spurring state plans to build two new replacement hospitals.

After the 620-bed hospital opens in Salem, plans call for building a 360-bed hospital on state prison land in Junction City. The Lane County facility is scheduled to open in 2013.

Budgeted construction costs for the two new hospitals total $458 million.

New hospital no cure-all

As opening of the new hospital in Salem draws near, OSH employees are coping with rapid changes and pressure from federal investigators to provide better patient care.

Workers say the new hospital is no cure-all for the facility’s long-standing problems, and they have concerns, anxieties and uncertainties.

Among them:

-There is no end in sight to a four-year federal investigation of the hospital by the U.S. Department of Justice Civil Rights Division.

It’s unknown whether the feds will carry out a threat to sue the state, legal action that could place the state institution under federal court control.

-New hospital leadership is on the way, prompting speculation about the management style of incoming superintendent Greg Roberts.

Roberts, who currently oversees four state psychiatric hospitals in New Jersey, will start working at OSH on Sept. 20. He will succeed Roy Orr as hospital chief. Orr was sacked in April by Goldberg and Richard Harris, director of the Addictions and Mental Health Division.

-Workers are bracing for the results of an outside consulting firm’s evaluation of the hospital.

-Despite an influx of more than 70 newly hired front-line employees, concerns remain about adequate staffing for the new hospital.

-Sluggish release practices keep some patients cooped up at the hospital long after they have been deemed ready to go by their therapists, contributing to chronic overcrowding.

Like many patients, Matthew Kirby complains about being warehoused at the hospital.

“I think the new facilities are going to be good, but some of the policies need to change, too,” he said.

Kirby blames stalled patient discharges on the state’s Psychiatric Security Review Board, which monitors forensic patients and controls their discharge dates.

“The DOJ is investigating the hospital, but really the hospital has no say over how long people stay here,” Kirby said. “The PSRB is the problem. They treat this place more like a jail than a place for recovery and rehabilitation. They tend to lock you up and throw away the key.”