Junction City hospital the worst way to treat mentally ill

The Eugene Register-Guard, October 31, 2011, by Jason Renaud and Jenny Westberg

The Mental Health Association of Portland is Oregon’s leading public advocate for people with a diagnosis of mental illness. We mean to stop discrimination in Oregon.

Today, mental illness is ground zero of the civil rights struggle. People with mental illness are the most discriminated against group in Oregon and throughout society. We are routinely treated with contempt and excluded from participation, an invisible subclass whose rights and freedoms are sparingly parceled out and capriciously withdrawn.

From Ward 81 by Mary Ellen Mark

From Ward 81 by Mary Ellen Mark

We encounter discrimination in all areas of life, including housing, employment, insurance, health care, educational institutions, the justice system, the military and the media. Many of us live in abject poverty or in restricted environments. We even die prematurely, an average of 15 years sooner than people without mental illness.

But the clearest reminder of our status can be seen in the shadow of large, locked buildings, the so-called “mental hospitals.”

Our group has been a long-standing critic of the Oregon State Hospital, and of incarcerating people due to mental illness.

We oppose any further development of a public psychiatric hospital at Junction City.

We urge Gov. John Kitzhaber to withdraw his endorsement of this project’s construction, and to direct the project’s budget toward effective community-based treatment that will actually benefit us.

The Junction City project is a high-priced offense to logic and conscience, a luxury our community neither needs nor wants. Especially after renovating and expanding the Oregon State Hospital facilities in Salem, building a new hospital would represent a financial and clinical commitment to the same regressive “lock-’em-up” model of care Oregon has supported for more than 150 years — and worse, would continue this disgrace into the next 150 years.

The inadequacies of the community mental health system do not justify starving it further. Putting money into segregated care takes dollars away from the few, underfunded community resources we have, while creating excuses to spend even less in the future: “We gave at the (Junction City) office.”

And let’s be clear: a new hospital is not some sort of necessary “transitional” step on the road to community care. Transition implies movement, not stasis, and certainly not entrenchment. Investing in a new psychiatric institution can be called “transitional” only in the manner that investing in new deck chairs transitions you off the Titanic.

Over a decade ago, the Supreme Court’s Olmstead decision affirmed that unjustified institutional isolation of people with mental illness is a form of discrimination; it further mandated that states provide care in the least restrictive setting possible.

Oregon’s response plan pledges development of “a robustly funded community-based system of care.” That’s an empty promise if money is flowing away from community treatment and toward more big-box lockups.

Recovery from mental illness isn’t just a set of solitary tasks for an individual to take. It’s a constellation of clinical tools, vocational options, and spiritual directions made available to an impaired individual. These tools, options and directions have no set script — and that is entirely their strength. Owning our illness gets us and keeps us well.

Study after study shows people sick with mental illness recuperate and recover when friends and family are engaged with their treatment and care. In this light, there could hardly be a worse location in Oregon than Junction City for a psychiatric hospital.

Junction City’s social infrastructure does not have and cannot sustain the array of external supports needed for recovery from mental illness — churches, libraries, 12-step meetings, parks, schools, bookstores.

Since the town is not served by buses or trains, the only visitors would be those who have cars, essentially excluding many patients’ families and friends, and virtually guaranteeing no new friendships. Junction City also lacks sufficient opportunities for competitive employment. For many of us, worthwhile work — not weaving baskets or hammering furniture — is central to the chance of recovery. In Junction City, that can’t happen.

From Ward 81 by Mary Ellen Mark

From Ward 81 by Mary Ellen Mark

We would oppose the Junction City hospital even if it were a bargain. Cheap discrimination is still discrimination. But given the recession, we can’t ignore the cost — neither can the governor.

Perhaps in better times, it wouldn’t matter so much if Kitzhaber threw our money at a few bad choices along with the good ones. It matters a great deal now, and every dollar Oregon puts into the Junction City hospital is a dollar that can’t be put elsewhere.

On a cost basis alone, community-based care is the wise choice. On any other basis — our rights, our recovery, or simply “do unto others” — community-based treatment is wiser still.

There is no soft middle ground here. Any support for the Junction City hospital is opposition to our community. Kitzhaber’s record is one of strong leadership in health care policy and equal rights for all Oregonians. We stand united against this hospital, and we ask the governor to stand with us now, to take action, to change his mind.