From the Oregonian, July 6, 2008

Oregon stuck between law and community fears as it releases mental patients with violent pasts

On his first time outside alone in decades, Wade Slaughter [pictured right] stayed close to home: He went next door to the Goodwill and bought a blue plaid dress shirt.

“It felt great,” he says, smiling broadly.

In 1987, Slaughter killed a man during a psychotic breakdown. Found “guilty except for insanity,” he was sent to the state mental hospital in Salem. Then, two years ago, doctors determined Slaughter healthy enough to leave the hospital and live in a secure group home with 14 other men.

Slaughter was lucky there was a place for him to go.

The state’s policy of moving people with sometimes violent pasts from the Oregon State Hospital back into the community is legally required by the Americans with Disabilities Act and has been praised by mental health professionals as humane.

But it has also ignited a firestorm of opposition — sweeping from Albany to Milwaukie to Cornelius — from neighbors worried that people who committed crimes while mentally ill may still be dangerous.

The public rebellion has put state officials in a serious bind: On one side they face growing public opposition, on the other they risk getting sued.

Oregon is replacing the dilapidated state hospital with two smaller hospitals. By 2011, when the new hospital in Salem opens, the state must have nearly 400 additional beds in communities throughout Oregon for patients to go to once their recovery has reached the point where they do not need to be institutionalized.

Right now, the state is 117 beds short.

“I have concerns that they can’t get the job done,” says Robert Joondeph, executive director of Disability Rights Oregon, a nonprofit that provides legal aid to the disabled and mentally ill.

Joondeph’s group has sued the state before, and he’s closely watching whether officials secure the beds they’ve promised.

“We feel the state does have a responsibility to assure the rights of these patients are honored,” Joondeph said.

Oregon officials also face potential legal trouble on a second front.

Earlier this year, a scathing review by the U.S. Department of Justice noted that patients were waiting too long for release from the state mental hospital. If federal authorities aren’t satisfied, they could seize control of the state’s mental health system — a move that has proved very expensive in other states.

Meanwhile, late last month, more than 30 state hospital patients approved for community placement were waiting for beds.

They include Charles Horton [pictured right], 36, a disabled vet with a bipolar disorder who was sent to the hospital in early 2006 after he threatened a neighbor with a knife.

Approved for conditional release several months ago, Horton says there’s no value to the treatment he’s receiving now.

“I’ve been through the standard groups they offer here eight times,” he says. “I’ve been through the groups so many times that they even jokingly say that I can teach it.”

Slaughter, 46, confesses that he was worried he couldn’t make it three months outside the hospital. Now, more than two years later, he’s starting to feel really good about his future.

Until his one-hour solo pass came through last week, Slaughter was accompanied by staff whenever he left his group home.

More than 6 feet tall, topping 300 pounds, and with a handshake like a well-worn baseball glove, Slaughter is aware that some people find him scary. He says he tries to put everyone at ease with a smile and a “good morning.”

“I’ve been given choices and I’m making the right ones,” he says. “I just want to be responsible in my community.”

Such reassurances do not calm Oregonians who are uneasy about having a group home for mentally ill people who have committed crimes in the neighborhood.

Greg Horner, chief deputy district attorney for Clackamas County, says as long as he can remember, people who were sent to the state hospital for violent acts stayed there for a long time. That’s why he was shocked when state hospital officials recommended the release of Lee Joseph Vojta to a community-based program.

Emboldened by voices in his head, Vojta shot and killed 20-year-old Sarah Huang in April 2003 while she was working on a farm near Vojta’s home.

Late last month, Huang’s parents traveled from the East Coast to plead with the Psychiatric Security Review Board to keep their daughter’s killer locked up.

“I wouldn’t want someone like this gentleman living in my community, next to my children, or my grandchildren, or my nieces and nephews,” said Huang’s mother, Janet Buehler.

The board unanimously agreed that Vojta is not ready for release. If and when he is, he would be subject to close supervision.

The review board sends patients who refuse to take their medication, go AWOL from a group home or break other rules back to the state hospital immediately.

Dr. Joe Bloom, former head of psychiatry and dean of the medical school at Oregon Health & Science University has observed the board’s actions since it was created in 1978.

One of the board’s strengths is its conditional release program, he says. “They’ve had very few really bad incidents.”

Over the past decade, the board has placed more than 1,200 people found guilty but insane on conditional release. Of those, 12 — one in 100 — were charged with new felonies.

In contrast, consider the convicted felons who aren’t insane: About one in three commits a new felony within three years of release. There are about 34,000 of those folks under community supervision in Oregon.

Slaughter’s home in Woodburn has recorded no violent incidents or conflicts with law enforcement since it opened in May 2006. But in Cornelius last month, the state shut down a controversial home after a mentally unstable man walked away.

State Rep. Linda Flores, R-Clackamas, says she worries that patients with violent histories are being released to facilities that the neighbors know little about and that are not secure.

“There’s a lack of transparency and openness and notification,” Flores says.

She and other lawmakers may introduce legislation next year requiring state officials to notify local law enforcement and neighbors of their plans to open a community facility.

Gov. Ted Kulongoski also has asked a group of legislators, mental health experts, law enforcement officials and others to make recommendations about how to handle issues relating to patients released from the state hospital.

“We can work through a lot of these issues,” says Dr. Bruce Goldberg, director of the Oregon Department of Human Services. “I don’t see these as insurmountable.”

Slaughter will remain under the Psychiatric Security Review Board’s supervision for life. Yet his goals are all about freedom.

He dreams of extending his solo walks to the Arctic Circle, where he hopes to buy some ice cream.

He wants to prove he can be trusted enough to extend his one-hour solo pass to six hours.

Someday, Slaughter says, he hopes to have a bank account and an apartment of his own.

“I am finding out there are things I thought I couldn’t do,” he says, “and I can.”