Fighting for People with Mental Illness
Landmark Federal Mental Health Law
More than 30 years ago, Congress took an extraordinary step to protect the civil rights of people with mental illness. It passed a law that created watchdog programs in every U.S. state and territory to address horrid conditions in local mental hospitals, jails, and prisons.
President Reagan signed the Protection and Advocacy for Individuals with Mental Illness (PAIMI) Act into law in 1985. Across the country, Protection & Advocacy organizations like Disability Rights Oregon expanded to shine a light on conditions inside of these institutions that were previously shielded from public view.
In 1986, Disability Rights Oregon hired Bob Joondeph to create its PAIMI Program. Bob later went on to lead Disability Rights Oregon for decades.
Overcrowded, Understaffed State Psychiatric Hospitals
The first thing we did was to regularly visit Oregon’s three state hospitals: Oregon State Hospital, Dammasch State Hospital, and Eastern Oregon State Hospital. All three were chronically overcrowded and understaffed.
In my first meeting with the superintendent of Dammasch, he complained that his facility did not have “rubber walls” that could simply expand to take everyone sent there. In all three hospitals, the lights were kept off during the day to keep patients calm. The first goal of treatment was for the patient to admit that they had an illness that made them incapable of living a normal life. Seclusion, restraint, and forced medication were commonplace, patient grievance processes were ignored, and TV and smoking were the dominant patient activities. Discharge for patients who had become “institutionalized” was rarely available.
Fighting for Humane Conditions and Swifter Discharge
In the years since then, Disability Rights Oregon filed (and the state settled) four lawsuits describing unconstitutional conditions in the hospitals, issued an investigative report about five preventable deaths at Dammasch, and worked with the U.S. Department of Justice to challenge conditions of care and the long waits for discharge that patients had to endure. Disability Rights Oregon made sure that patient rights were honored, that hospital grievance processes and abuse investigations actually occurred, that medical services were available to patients, and that discharge occurred when it was medically appropriate.
None of the three state hospitals remains standing.
Oregon State Hospital first closed its Child and Adolescent Unit. It was ultimately rebuilt as a modern facility. Dammasch was closed and the money used to create group homes for patients who were institutionalized. Eastern Oregon was closed and partially replaced by a new facility in Junction City.
The Fight is Far From Over
But investment in community-based housing and supports has not kept pace with the needs of Oregonians. As a result, jails and prisons have become the home of many people with behavioral health diagnoses and the entryway to state hospitals. Skyrocketing housing and healthcare costs have pushed many people to live on the street.
Efforts to bring mental health services to more children have not kept pace with the need, resulting in children waiting in emergency rooms and motels for over-burdened foster care beds.
Our investigatory reports have brought to light shocking conditions in both adult and youth jails. The findings have reverberated across the state and become a catalyst for lasting change.
Disability Rights Oregon is not backing away from the challenge of decriminalizing mental illness. Jails must stop serving as a “dumping ground” for people in mental health crisis.
Together, we must transform the system—to promote community-based services rather than incarceration and emphasize successful community supports for those leaving incarceration.