Oregon State Hospital still in contempt of court 1 year later

• The Oregon State Hospital was found in contempt of court on June 6, 2025.
• The hospital was found in contempt for not meeting a requirement to admit aid and assist patients within seven days.
• A new order limiting which defendants can be admitted to the hospital and for how long is expected to bring the state back into compliance sometime this year.

The Oregon State Hospital remains in contempt of court as defendants continue to sit in jail past the seven-day deadline for them to be admitted and has racked up nearly $4.5 million in fines since a federal court order in June 2025.

A new order is expected to bring the state back into compliance by the end of 2026.

For Emily Cooper, the legal director for Disability Rights Oregon, the organization that sued the state more than two decades ago, every additional day of waiting means another day a person with mental illness “could be irreparably harmed.”

At least two people have died waiting to receive treatment for mental health issues a judge has deemed severe enough to prevent them from aiding and assisting in their own legal defense.

Since 2002, the state psychiatric hospital has been ordered to admit people who have been found unable to aid in their own legal defense for competency restoration within seven days.

The state has been out of compliance with that requirement for most of the last eight or so years.

Oregon has been fined nearly $4.5 million for late admissions

Disability Rights Oregon asked U.S. District Court Judge Adrienne Nelson to hold the Oregon Health Authority, which oversees the state hospital, in contempt of court for failing to meet that standard in January 2025.

On June 6, 2025, Nelson did just that, finding Oregon in contempt and ordering fines of $500 per-person for every day an aid and assist patient was waiting longer than a week to be admitted to OSH.

From June 7, 2025, to May 14, 2026, defendants cumulatively waited more than 9,000 days in jail beyond the seven day allowance, averaging about eight additional days each.

OSH reports four weeks of data on the first of each month.

The nearly $4.5 million the state has been fined will be spent in some way on helping people struggling with mental illness, Cooper said.

Those fines are paid from the budgets for the hospital and OHA’s behavioral health division.

The fines have lowered in recent months after spiking in the winter but continue to add hundreds of thousands of dollars to the total bill.

Oregon is expected to be back in compliance this year

Aid and assist patients are admitted to OSH for short stays – 90 days, six months, or a year – depending on the charges. The purpose is to stabilize someone enough that they can, on a basic level, understand what they are being charged with and help their attorney.

Nelson eliminated most extensions to those stays on June 1 by granting a remedial order. People who have committed Measure 11 felonies, serious violent crimes, are now the only aid and assist patients eligible for an extension on their stay at OSH.

The elimination of most extensions, along with limiting what charges can make defendants eligible to be sent to OSH, are designed to open beds for new patients more quickly.

After reviewing data on the prior extensions, Dr. Debra Pinals, who has served as a neutral expert and is now a court monitor on the case, found that in many cases they did not result in the person being restored to competency.

Metropolitan Public Defense and Disability Rights Oregon asked Nelson to issue the order back in March. The request is based on recommendations from Pinals, who has provided a series of reports on the hospital.

Beyond changing the time someone can be in restoration treatment at OSH, the order changes who can be admitted.

People charged with low-level, non-violent felonies and misdemeanors, like resisting arrest or disorderly conduct, will no longer be admitted to the hospital for competency restoration.

The courts will decide where those defendants are directed. Some options include community restoration, civil commitment or dismissing the charges, OSH spokesperson Marsha Sills said.

“The subtext of this is stop charging these people for crimes, when these are really manifestations of mental illness,” Cooper said.

Pinals had found diminishing clinical returns and high costs of treatment for people who “if they’d been convicted, they would have spent a long weekend in jail,” Cooper said.

“The duration of hospitalization may exceed the time an individual would have served if convicted, particularly when sentences are less than 90 days, with the average length of stay for restoration reaching 116.5 days,” Pinals wrote in a March 16 report.

Pinals estimated in March that with the changes to extensions and admissions the state could likely comply with the seven-day admission requirement within two and a half months.

The order is projected to bring the state into compliance by the end of the year.

“It’s forcing the system to think about an alternative rather than forced institutionalization on the state’s dime,” Cooper said of the order.

Remedial order draws criticism

Not everyone is in support of Nelson’s decision.

“The Board of Commissioners is very opposed to the new request from Disability Rights Oregon because they are only considering the interest of the individual who has committed the crime,” Marion County Commissioner Danielle Bethell told the Statesman Journal a few days before the order. “They are not considering the harm or challenge in the community.”

Counties have been stuck and frustrated because the responsibility to provide community-based care falls on them, Bethell said.

“Nobody wants anybody with a mental illness to be stuck in jail and not be able to move through the process of the criminal justice system. Nobody wants that on either side of the ideological divide,” Bethell said.

She highlighted Salem’s REACH, Rapid Engagement, Assessment and Community Health team as one way the community is working to relieve pressure on emergency services that have been responding to mental health crises, “but it’s still inadequate because we don’t have all the stairs of that escalator for that system.”

State leadership, staffing issues challenge Oregon State Hospital

Both Cooper and Bethell pointed to the state’s top leaders and the hospital’s staffing challenges as major issues plaguing progress at OSH.

The hospital’s changing patient population and the pandemic have meant more patients with higher needs, fewer programming options and more pressure on staff, Cooper said.

Four of the eight top OSH executives are interims, including the superintendent and medical and nursing officers.

“I think at the end of the day, what we’ve been concerned about is less about OHA, less about the state hospital, and from a leadership top down,” Cooper said. “Like, from the governor’s office, from the legislature – are you really funding the hospital and the Oregon Health Authority in a way that really allows them to do their jobs?”

The governor and legislature should “walk and chew gum at the same time” by hiring more staff for the hospital while working with local leaders on prevention, Bethell told the Statesman Journal.

“There’s no state law that says they cannot increase capacity and provide better care for individuals that come into the state hospital and a better environment for employees who work in the state hospital,” she said.

Problems with Oregon’s behavioral health system ‘are not fixable overnight,’ court monitor says

Gov. Tina Kotek’s office did not respond to a question about future funding for the hospital, instead pointing to increases in community treatment beds during Kotek’s term.

“I am committed to ensuring Oregonians can access the health care they need, when they need it,” Kotek said in a provided statement. “Together, we are building a system with the capacity to meet the behavioral health needs of Oregonians in the timely fashion they deserve.”

Her administration has helped facilitate the development of 930 new and in-progress residential treatment beds, increasing the state’s capacity by over 30%, spokesperson Hanna Seay Thomas said.

“The Governor has been clear that increased treatment and workforce capacity are essential to having a complete continuum of behavioral healthcare across the state that will serve people better and help to relieve pressure on OSH,” she said.

The most straightforward way to address the intake delays is by adding treatment capacity to help divert people from being admitted to the hospital and provide a place for patients leaving to be discharged, Sills said.

Those projects take time, two to four years on average. The hospital and OHA’s behavioral health division, she said, are working with community programs to make the discharge process better.

Leaders at OHA and OSH were not made available for comment.

While Cooper pointed to the slowly decreasing wait list as a positive sign, Bethell believes things have only gotten “more volatile and negative” since the contempt finding last year.

Hospital leadership and OHA’s behavioral health division meet with Pinals each week, Sills said.

“Despite the lack of compliance with the 7-day admission requirement, in my opinion, at this time OHA is working reasonably and appropriately to address the needs that this Court has required,” Pinals wrote in a March report. “The problems that the behavioral health system is facing are not fixable overnight, but there are many steps that have been taken to help.”

Anastasia Mason covers state government for the Statesman Journal. Reach her at acmason@statesmanjournal.com or 971-208-5615.