When people are charged with a crime, they have a constitutional right to aid in their own defense. But when they’re too mentally unfit to do so, where do they go?
In September 2019, Eugene Weekly published “The Broken System,” an investigation into Lane County and Eugene Municipal Court’s dramatically increased reliance on the Oregon State Hospital (OSH) for aid-and-assist treatment, an overburdened system that fails to provide effective treatment for Oregon’s mentally ill and often homeless population.
The city and county have nowhere else to send defendants, but OSH does not have enough beds to house everyone, which means defendants are often kept in jail longer than federal courts say is legal. EW reported that the Eugene Municipal Court has sent at least 76 people to OSH since 2014 for low-level crimes, often without a mental health assessment — far more than had been previously reported.
EW also revealed that, since 2013, Lane County increased the number of defendants sent to the state hospital by 238 percent. Other Oregon courts statewide have increased the number of defendants they send to OSH by 55 percent.
After the story was published, EW reached out to some of the people we spoke to before as well as other local officials — county commissioners, city councilors, the mayor of Eugene and the Lane County Sheriff — for their responses.
EW asked whether city and county officials knew the extent of the problems before the story came out, and why they thought the number of defendants sent to OSH had increased so much.
We also asked what they thought worked well about aid-and-assist, and what they thought could be improved. Finally, we asked about possible solutions for lowering the rate of people sent to the state hospital and the potential of a new 24-hour crisis center.
EW reached out to Eugene’s city officials but received few responses.
Mayor Lucy Vinis emailed a written statement and later followed up with a phone interview. But Eugene city councilors Betty Taylor and Greg Evans were the only council members to answer EW’s questions.
City councilors Emily Semple, Jennifer Yeh, Alan Zelenka, Mike Clark, Claire Syrett and Chris Pryor did not respond to EW’s questions despite multiple calls and emails over a two-week period requesting a response.
Vinis says in an emailed statement that she is “concerned with the limitations of our services for people struggling with drug addiction and mental illness that are either causal or contributing to their presence in the court system.”
In a follow-up phone interview, Vinis says the aid-and-assist system is too complex for her to speak about with any expertise. She says she met with Eugene Municipal Court’s acting presiding judge, and she learned that the court is working under multiple constraints, such as its capacity and the inability to meet the demand for housing and mental health services.
“I think it’s apparent to everyone in the community that we need additional services, particularly for people who are homeless,” Vinis says. “But we know that our state is at the rock bottom in terms of the support for mental health and addiction services. Many of those people who are not found fit to stand trial need those more robust mental health and addiction services.”
Putting those solutions in place is difficult due to funding. “It’s all about money,” Vinis says, adding that Lane County Behavioral Health, which oversees in-community treatment for aid-and-assist patients, is underfunded.
“We as a community do know how to stabilize people who are homeless. We do it every day,” Vinis says, pointing to nonprofits like ShelterCare, where she once worked. “We can’t do it at the level and at the rate to meet the need. And that is the same with mental health and addiction services.”
Taylor says in an email that Eugene Municipal Court’s sending people to the state hospital seems like a “good idea for people who need to live in an institution — better than on the street.” Taylor, who announced in December that she would not run for re-election in 2020, said in a follow-up email that meeting with the presiding judge, who updated the council on the Municipal Court in a council work session in November, did not change her views, but that she would only know if she had the time and authority to attend all court proceedings.
“If we had a performance auditor, we might learn more,” Taylor says.
Evans, the other councilor to respond, says in an interview with EW that he is unaware of any specific program to lower aid-and-assist admissions to the state hospital, but that there has been an increase in mental health issues and drug addiction among the homeless population in Eugene.
He adds in a follow-up email that Lane County oversees health and human services, not the city.
Evans says he believes the Eugene Municipal Court would rather see defendants assessed for mental illness than see them jailed, but right now, there is nowhere else to send them.
“All of those facilities are full,” he says.
Lane County is trying to improve its ability to serve people with mental health issues and is doing the best they can with its limited resources, Evans says.
“The problem,” he says, “is that there’s not enough money, there’s not enough budget to go around. We need more money from the state to be able to improve what we’re doing with aid-and-assist.”
The goal is not fining or incarcerating people with mental health issues, Evans says — it’s more humane and less expensive.
“The city has limited resources and the county has limited resources,” he says. “So, we’re trying to work together where we can to make sure that treatment and other strategies for people are available and they’re more robust.”
Officials in Eugene and Lane County have been looking for ways to collaborate and address these problems, Evans says.
“We’re just right now not making the progress that we want to make,” he says. But he says he expects to see improvements in the next year or so, as more money becomes available, such as revenue from the payroll tax.
Semple wrote in an email that she would be available to speak with EW after taking some time to reflect on the questions. “I need to do some contemplation and research to effectively answer your questions,” she says. She never responded to EW’s follow-up emails and phone calls.
Likewise, Yeh says she did not have time to respond to the questions. After EW extended the deadline, she still did not respond to requests for a response.
The other city councilors — Zelenka, Clark, Syrett and Pryor — never responded to EW at all despite multiple emails and calls.
The county was more responsive to our questions.
“The criminal justice system is not well designed truly to be the mechanism for helping people that struggle with mental illness,” Lane County Sheriff Cliff Harrold says in an interview with EW. He says it’s not just a local or statewide problem; it’s countrywide and even worldwide.
“I don’t think the judges currently have a lot of options when they see these folks in their courtroom. They’re really bound by the law,” Harrold says.
He says that when judges believe a defendant can’t stand trial, their only option is the aid-and-assist system, “which truly isn’t mental health treatment. It’s more like school.”
Harrold says the Lane County Circuit Court has developed a mental health court diversion program, and Lane County Behavioral Health is working to build a more robust community restoration program, where aid-and-assist defendants are treated locally rather than being sent to the state hospital.
Lane County Jail Captain Clint Riley says that defendants often get trapped in a loop because the state hospital says they do not need hospital level of care — but there’s nowhere for them to go in the community.
“The state hospital’s saying they’ve become the biggest homeless shelter in the entire state, and then the jails, we’re saying we’re becoming the biggest mental health facility in the county,” he says.
Riley says he wasn’t surprised to learn how many people the Municipal Court has sent to the state hospital because, while these people are usually charged with low-level crimes like trespassing, they are some of the most difficult and resource-intensive to house due to addiction and mental illness.
Harrold and Riley say they have made investments into mental health at the jail with their healthcare provider and in-jail programs like the mental health unit, but they also attend a county-wide summit every month, where people from the city and county governments, as well as local healthcare nonprofits and for-profit companies, meet to find ways to collaborate.
Lane County needs a place that police can take people for treatment rather than jail, Harrold says, as well as a way to divert someone from jail to treatment once it’s clear the defendant doesn’t have the capacity to stand trial.
That place could be a 24-hour crisis center — a place where police can take people who need treatment for short-term care rather than taking them to jail.
EW reported that Lane County allocated $1 million to spur its development in the 2020 budget. Lane County spokesperson Devon Ashbridge says in an email that the county expects an update on the crisis center to come in January.
That isn’t enough to build a crisis center, Lane County Commissioner Pat Farr says in an interview with EW. “But it does get us a commitment,” Farr says, “and it moves us down the path toward creating a permanent crisis center.”
He says Lane County is studying how other counties in Oregon are implementing crisis centers. “We’re behind on this. Now, we’re ahead of 32 other counties, but we’re behind on it in that we don’t have one,” Farr says. “People are being taken to jail who need to be taken to treatment.”
East Lane County Commissioner Heather Buch says in an email that using the state hospital to hold people charged with low-level crimes is not the best use of the county’s limited resources, and jail has become the “default emergency shelter.”
Buch says that the county needs to use less expensive alternatives like the Frequent User System Engagement program, which identifies people who frequent emergency rooms, courts and jails, and coordinates efforts to get them into stable housing.
She says the MLK Commons, which will provide 51 permanent supportive housing for chronically homeless people when it is completed in fall 2020, along with the creation of a crisis center, will also help break the cycle.
“We need a good variety and the right combination of unconventional programs like this, heavy on access to shelter and housing, to right this ship,” Buch says. “It is not only the ethical thing to do but also the fiscally responsible thing to do.”
On behalf of the county, spokesperson Ashbridge sent an emailed statement, and Lane County Commissioners Jay Bozievich, Joe Berney and Pete Sorenson did not have anything to add.
Ashbridge calls the issue “multi-faceted” and says the issue dates back to the 1960s, when the current aid-and-assist system was developed. She says the county began working with the Oregon Health Authority in 2013 to decrease commitments to the state hospital, reduce time spent in jail and build infrastructure for treatment in the community.
“This said, we still face challenges in getting the system adequately funded by the state. It does not reflect what most mental health professionals would consider best practice today,” Ashbridge continues. “It is, however, the program we must work within until a statewide solution is implemented.”
She says the most effective response may be a complete overhaul, but Lane County does not have the authority or the funding to do so.
Ashbridge also adds that, while the county makes recommendations, it has no authority over decisions made by either the circuit or Municipal Court.
Ashbridge says the criteria to get people into mental health services have become more strict, and jail is not the best place for people to receive mental health services, so people are sent to the state hospital “with the hope that they get the services that they need.”
She added that the county is facilitating discussions to find ways to get people help without sending them to the state hospital. She also noted that when people on Medicaid are jailed, their benefits are suspended and their health care costs are paid by the state.
Preventing people from ending up in crisis and eventually in jail, as well as improving community treatment and collaboration between public safety agencies, is important, Ashbridge says.
But funding is a challenge for the county on many issues, she adds — not just mental health treatment.
“Of course, funding is necessary to make meaningful progress on many of these improvements,” Ashbridge says. “Adequate funding is a challenge in relation to many issues in our community.”
This story was developed as part of the Catalyst Journalism Project at the University of Oregon School of Journalism and Communication. Catalyst brings together investigative reporting and solutions journalism to spark action and response to Oregon’s most perplexing issues. To learn more visit Journalism.UOregon.edu/Catalyst or follow the project on Twitter @UO_catalyst.