Psychiatric Survivor Guest Column Challenges Oregon Governor

Guest Opinion

In the March 1 article "Governor picks Salem as site for state hospital," Ted Kulongoski announces: "This initiative represents the most significant opportunity in more than 120 years to improve the quality of mental health care Oregonians receive at our state hospitals."

In this case, however, bigger does not mean better.

What's missing in this comment (and in the article itself) is any mention of the need to help inspire transformation beyond the buildings themselves, which only house the marquee player, anyway. That game winner, of course, is the over-arching treatment orientation itself, meaning how -- not simply in what kind of building -- services are delivered at the Oregon State Hospital.

The spirit of Nurse Ratchet still blows through the grounds of the crumbling institution; and the attitudes and healing skills of state hospital programs and workers may not be crumbling bricks, but are most certainly in need of a good paint job. Still today, the cultures of Salem's neighborhoods and the formerly named Oregon Insane Asylum seem to resist the notion that "mental patients" are people and citizens -- our own sons, brothers, parents, neighbors -- who can and should, given well-met safety and welfare standards, participate fully and richly in community life.

Suppose the state hospital and the community mental-health programs were effective. Wouldn't we see -- as both expected result and criterion -- that more and more people were not going into the state hospital, and even rarely returning?

But this is not the case. The Mental Health Task Force to the Governor ("Blueprint for Recovery," 2004) had as its opening premise that not only Oregon's public mental-health system, but also the nation's, was "fragmented, in disarray, and in need of wholesale transformation."

So what kinds of changes are needed? How can we make sure that the $250 million for 620 beds in a new state hospital in Salem (and $163 million for a 360-bed site in Junction City) do not "make insanity" by simply creating architectural depositories for doing even more poorly-met outcomes than before?

The State Hospital Master Plan Community Workgroup Report (Feb. 21, 2007) insists this is a matter of reordering the values:

"Oregon's mental health services must be developed with values that support individual recovery:

Recovery is possible and is the goal of all mental health services.

Treatment and supports must be consumer-directed.

Services must be evidence-based.

Safe and affordable housing is key to recovery.

Services are cultural and age specific and trauma-informed."

Gov. Ted, please ask the state hospital to weave these values into the blueprints (make them show how, please). One day, then, you will be pleased that not only your state hospitals in Oregon are safe and not dangerously over-crowded, but that they actually work.

And by that I mean, 1. Fewer of us need to go into them, and 2. The care is so good, hardly any return.

[David Romprey of Salem is a member of the Oregon State Hospital Master Plan Community Task Force. He describes himself as a survivor of inpatient treatment for severe mental illness. He has received state and national recognition for working to reform mental-health care. He can be reached at davidromprey@aol.com ]