New leaders at Oregon State Hospital will speak about future

From the Portland Mental Health Examiner, October 28, 2010

In 1883, the Oregon State Insane Asylum opened its doors in Salem. In 2010, now called Oregon State Hospital, it is a crumbling reminder of the past.

Chief Medical Officer Mark Diamond, DO, and Superintendent Greg Roberts, MSW, think they have what it takes to lead OSH into the future, and tonight, they’ll have a chance to explain how. It’s the first time they will speak in public since their recent hires ended a lengthy, nationwide search process.

“They’re charged with making a big change, and we’d really like to hear how they plan to do that,” said Jason Renaud of the Mental Health Association of Portland.

The lecture on “The Future of Oregon State Hospital” will take place Oct. 28 at Oregon Health & Science University in Portland. The reception begins at 6 p.m., with speakers at 7 p.m. Presented by the Mental Health Association of Portland and OHSU Dept. of Psychiatry, the event is free and open to the public.

Diamond, an osteopath with a background in prison psychiatry, told the Statesman-Journal he’s looking forward to being “part of a care system driven by patient needs, and a plan of continuous improvement to meet those needs.” Roberts, who has managed psychiatric hospitals in New Jersey, is also optimistic: “There is no problem that can’t be solved.”

The difficulties facing Oregon State Hospital might cause Diamond and Roberts to reconsider their optimism.

In 1975, the hospital was a grim backdrop for the film “One Flew Over the Cuckoo’s Nest.” Since then, it has gone from grim to patently unsafe. Inside the dilapidated buildings, recent investigations have found inadequate patient care and rights violations. There have been tragedies like the death of Moises Perez, whose body lay for hours across from the nursing station before staff noticed he was dead.

A 2008 U.S. Dept. of Justice Civil Rights Division investigation documented conditions and practices such as these:

* “Inappropriate and inadequate care… Patients can receive medication and other treatment for conditions they do not have.”
* “In practice, planned seclusion and restraint often is the only component of a patient’s treatment plan.”
* “…many of them remain in seclusion indefinitely.”
* “No member of the Department of Justice site visit team had ever encountered the use of continuous seclusion as a planned treatment strategy.”
* “Staffing shortages fall dangerously below the minimum levels…”
* “Clinicians prescribe [antipsychotics and benzodiazepenes] for their secondary sedating effects and as a substitution for appropriate therapeutic interventions… This practice constitutes chemical restraint.”
* “[The building] is in a state of severe deterioration and serious dilapidation.”
* Problems with infection control; lack of hand-washing… “Indeed, of the 28 patient deaths [in one year], 15 were from pneumonia…”
* Problems with ventilation or cooling leading to risk of heat stroke… “It is fairly routine for indoor temperatures to exceed 90 degrees.” Mice in patients’ rooms; norovirus outbreaks; scabies outbreaks…
* “Some patients remain at OSH for months or even years after having met the criteria for discharge.”

Can Roberts and Diamond turn it around?

“I expect them to be leaders,” says Jason Renaud. He adds, though, that he has not met many who have lived up to that expectation.

Join us for an eye-opening presentation:

Thursday, October 28, 2010 Reception 6 PM, Speakers 7 PM – 8:30 PM

OHSU Auditorium (Old Library) 3183 SW Sam Jackson Road Portland, Oregon 97239

Free and open to the public

Presented by the Mental Health Association of Portland and OHSU Dept. of Psychiatry
Sponsored in part by Portland Hearing Voices, NAMI of Multnomah County, Disability Rights Oregon, Cascadia Behavioral Healthcare, and others