The Oregon State Hospital is nearly full. Members of the military have been called in to care for patients in need of 24-hour on-site nursing and psychiatric care. What led to the crisis unfolding before our eyes?

Our mental health system is meant to provide a range of care. Tragically, we have not yet built a key piece of this system: treatment services that people can access in the community.

People are surging into the level of care that’s meant as a last resort — our state psychiatric hospital — and stressing it. This is a natural and foreseeable consequence of not building the other essential part of the system.

In less than 10 years, the aid and assist population — people who do not have the mental capacity to stand trial because they are unable to help their attorney defend them in court— has more than tripled. As a portion of the OSH’s overall patient caseload, the percentage of aid and assist patients climbed from 11% in 2012 to 69% in 2021.

People who could have been treated in the community are ending up at OSH. Because OSH is the most restrictive, least cost-effective part of our system, the human and financial tolls of this practice are enormous. People do better when they can access treatment in their community. Subjecting individuals to unnecessary segregation and institutionalization is unconscionable.

We solve this by providing people housing, support and the treatment they need where they live.

K.C. Lewis

Disability Rights of Oregon

Portland