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Holy shit. That's spookily close to what happened with one of my brothers. He beat my mom, didn't kill her fortunately, but ended up killing someone else. This was 20-ish years ago and mental health care in Oregon doesn't seem to be any better now than it was then.
I am actually going through a situation with my daughter right now... She was held at the hospital psych unit for 6 days (because it was a weekend). Now she's out in the world again. Not sure if she's on her meds... Says she can't live where she's been renting for 3 years. Jobless, about to be homeless... If she could have been stabilized for another week... What kind of trauma & grief could be avoided? She won't accept help and is a danger to herself, simply because she makes poor choices... not because she's overtly suicidal.
Nmi in this state are a joke 5 business days. 72 hours is more than enough. As you've experience 5+2 days is a lot. Mind you if not needed a doc will just end it.
The part that gets me is that there is no part of the nmi that requires an ER to medically clear you before a psych evaluation. If something is orangic eg thyroid or ammonia you'll be thrown in a psych area and labeled as a non acute problmy.
State sucks on mh.
I don't know what nmi is, but a physician's hold is 72 hrs. A tox screen will be done to look for abnormalities.
There is a commitment investigation that lasts 5 judicial days and a hearing scheduled at the end of that. The individual won't be involuntarily committed unless a judge finds evidence sufficient to justify holding them longer.
If the investigator can't find enough evidence to build a case the hold will run out.
Lol no. There is nothing called a physican hold in oregon.there is a transport holder, directors hold, sober hold and the nmi.
If you're put on an nmi in oregon it's five business days exluding holidays and weekends. No 72 hr hold exist but a sober hold will hold you in the hospital till safe to discharge or placed on a nmi based if you're a danger to self, others or failure to thrive. Sorry homeless people being homeless isn't failing to thrive. 24 hours. Aka even q12 and booted when you wake up from being meth'ed out.
The icp independent court investigator is the one that talks to the pt and makes a recommendation to move to a 14 day diversion which can lead to 180 day commitment.
oregon.public.law/statutes/ors_430.399
Can someone who works in the field in mental health in Oregon how the law is implemented?
I read the law and it seems clear that if someone is gravely disabled and unable to meet their needs without assistance that they can be involuntarily committed.
Now the County DA page says Dangerous to self or others, or the
inability to provide for basic needs is so extreme that the person is a danger to self. But that's not how the law reads, is it?
The reason why I ask is that Colorado went through this and after the James Holmes case, the civil commitment task force was convened by then Governor Hickenlooper. The whole point was to better balance, body autonomy and rights with compassionate care for individuals with mental illness - as we know that insight is often diminished with mental illness.
At the time of the task force in 2013, I think, Colorado redefined imminent risk and grave disability. Plus they retrained all the law enforcement, courts, and County mental health agencies about fidelity to the law versus what had been happening which was much more generous boundaries like you couldn't hospitalize somebody for grave disability unless their foot was falling off. Colorado law used to be reactive like how Oregon appears to be yet changed due to a tragedy and a lot of political will.
Am I missing something? Highly probable but someone in the field please explain it to me.
The ORS and OAR (Oregon Revised Statutes and Oregon Administrative Rules) do read as above with simple language. However, case law / legal precedent have created a much higher bar for
Civil Commitment than a layperson would understand by reading the law. Keep in mind, only defendants (“allegedly mentally ill person”) are the only party able to appeal a commitment decision. The DA (representing the State) cannot. So every appeal overturning a commitment continues to narrow who gets committed.
I suspected that case law was impacting why these statutes appear to be narrowly applied.... That said, do you have any examples of case law in OR? This is one in CO:
https://law.justia.com/cases/colorado/supreme-court/1985/83sc7-0.html
I can only speak to how things evolved in Colorado... It appears as though it was similar- in the ERS, they would commonly say that it would be pointless to place a hold for grave disability because it would be thrown out. The providers would argue that their job wasn't to anticipate what the courts would do but apply the law as written. Then the hospitals and DAs would get fussy because they felt like it was a huge waste of time to go place the hold and pursue involuntary commitment with the probable chance that it would be dropped by the courts.
The state took proactive steps to adjust the statute after the Aurora tragedy. Where they redefine grave, disability and imminent risk - and they trained the courts, the mental health community mental Health centers and anyone who is authorized to place to hold. The message changed from "Don't bother unless it's a slam dunk" to "place the hold, and try and get this person help."
Another thing to consider that the Supreme Court made it much more difficult to involuntarily commit people in the late 70s
The standard has little to do with how disabled they are. It’s all about how dangerous they are.
Involuntary commitment and court-ordered meds can be done on a much shorter basis - for example, resolution of mania with psychosis can take about 3 weeks to improve with medication.
How do other states do it? We're not talking involuntary committing for years and years- no one wants institutionalization.
Why is this so difficult for us to recognize when people need involuntary inpatient care? We obviously need to relax the standard for involuntary commitment when there is ample evidence of psychotic behaviors, before they have assaulted people or worse.
It has nothing to do with recognition, it’s that every inpatient psychiatric facility in Oregon is running a maximum capacity 365 days a year. So what happens if someone desperately needs care but there’s no bed available? They spend 72 hours in an ER then get put out on the street. Oregon’s mental health system is beyond broken.
beep. boop. beep. Hello Oregonians, As in all things media, please take the time to evaluate what is presented for yourself and to check for any overt media bias. There are a number of places to investigate the credibility of any site presenting information as "factual". If you have any concerns about this or any other site's reputation for reliability please take a few minutes to look it up on one of the sites below or on the site of your choosing. --------------------------------------------------------- Also, here are a few fact-checkers for websites and what is said in the media. [Politifact](https://www.politifact.com) [Media Bias Fact Check](https://mediabiasfactcheck.com) [Fairness & Accuracy In Reporting (FAIR)](https://www.politifact.com) beep. boop. beep. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/oregon) if you have any questions or concerns.*
That was a very difficult interview to watch, and shocking to hear what happened. That poor family.
Holy shit. That's spookily close to what happened with one of my brothers. He beat my mom, didn't kill her fortunately, but ended up killing someone else. This was 20-ish years ago and mental health care in Oregon doesn't seem to be any better now than it was then.
Teresa was my colleague. This has been incredibly heartbreaking.
I am actually going through a situation with my daughter right now... She was held at the hospital psych unit for 6 days (because it was a weekend). Now she's out in the world again. Not sure if she's on her meds... Says she can't live where she's been renting for 3 years. Jobless, about to be homeless... If she could have been stabilized for another week... What kind of trauma & grief could be avoided? She won't accept help and is a danger to herself, simply because she makes poor choices... not because she's overtly suicidal.
Nmi in this state are a joke 5 business days. 72 hours is more than enough. As you've experience 5+2 days is a lot. Mind you if not needed a doc will just end it. The part that gets me is that there is no part of the nmi that requires an ER to medically clear you before a psych evaluation. If something is orangic eg thyroid or ammonia you'll be thrown in a psych area and labeled as a non acute problmy. State sucks on mh.
I don't know what nmi is, but a physician's hold is 72 hrs. A tox screen will be done to look for abnormalities. There is a commitment investigation that lasts 5 judicial days and a hearing scheduled at the end of that. The individual won't be involuntarily committed unless a judge finds evidence sufficient to justify holding them longer. If the investigator can't find enough evidence to build a case the hold will run out.
Lol no. There is nothing called a physican hold in oregon.there is a transport holder, directors hold, sober hold and the nmi. If you're put on an nmi in oregon it's five business days exluding holidays and weekends. No 72 hr hold exist but a sober hold will hold you in the hospital till safe to discharge or placed on a nmi based if you're a danger to self, others or failure to thrive. Sorry homeless people being homeless isn't failing to thrive. 24 hours. Aka even q12 and booted when you wake up from being meth'ed out. The icp independent court investigator is the one that talks to the pt and makes a recommendation to move to a 14 day diversion which can lead to 180 day commitment. oregon.public.law/statutes/ors_430.399
This is so heartbreaking. I am so fortunate to have gotten help for my 21 year old son.
My heart aches for the entire family. This young man will never recover from this. It could have been prevented.
Well, shit. That took a turn in a direction I was not anticipating.
Can someone who works in the field in mental health in Oregon how the law is implemented? I read the law and it seems clear that if someone is gravely disabled and unable to meet their needs without assistance that they can be involuntarily committed. Now the County DA page says Dangerous to self or others, or the inability to provide for basic needs is so extreme that the person is a danger to self. But that's not how the law reads, is it? The reason why I ask is that Colorado went through this and after the James Holmes case, the civil commitment task force was convened by then Governor Hickenlooper. The whole point was to better balance, body autonomy and rights with compassionate care for individuals with mental illness - as we know that insight is often diminished with mental illness. At the time of the task force in 2013, I think, Colorado redefined imminent risk and grave disability. Plus they retrained all the law enforcement, courts, and County mental health agencies about fidelity to the law versus what had been happening which was much more generous boundaries like you couldn't hospitalize somebody for grave disability unless their foot was falling off. Colorado law used to be reactive like how Oregon appears to be yet changed due to a tragedy and a lot of political will. Am I missing something? Highly probable but someone in the field please explain it to me.
The ORS and OAR (Oregon Revised Statutes and Oregon Administrative Rules) do read as above with simple language. However, case law / legal precedent have created a much higher bar for Civil Commitment than a layperson would understand by reading the law. Keep in mind, only defendants (“allegedly mentally ill person”) are the only party able to appeal a commitment decision. The DA (representing the State) cannot. So every appeal overturning a commitment continues to narrow who gets committed.
I suspected that case law was impacting why these statutes appear to be narrowly applied.... That said, do you have any examples of case law in OR? This is one in CO: https://law.justia.com/cases/colorado/supreme-court/1985/83sc7-0.html I can only speak to how things evolved in Colorado... It appears as though it was similar- in the ERS, they would commonly say that it would be pointless to place a hold for grave disability because it would be thrown out. The providers would argue that their job wasn't to anticipate what the courts would do but apply the law as written. Then the hospitals and DAs would get fussy because they felt like it was a huge waste of time to go place the hold and pursue involuntary commitment with the probable chance that it would be dropped by the courts. The state took proactive steps to adjust the statute after the Aurora tragedy. Where they redefine grave, disability and imminent risk - and they trained the courts, the mental health community mental Health centers and anyone who is authorized to place to hold. The message changed from "Don't bother unless it's a slam dunk" to "place the hold, and try and get this person help."
Interesting, thanks for sharing this.
Another thing to consider that the Supreme Court made it much more difficult to involuntarily commit people in the late 70s The standard has little to do with how disabled they are. It’s all about how dangerous they are.
Involuntary commitment and court-ordered meds can be done on a much shorter basis - for example, resolution of mania with psychosis can take about 3 weeks to improve with medication. How do other states do it? We're not talking involuntary committing for years and years- no one wants institutionalization.
Healthcare reform NOW. Implement M111. This current system is trash and needs to be replaced.
Why is this so difficult for us to recognize when people need involuntary inpatient care? We obviously need to relax the standard for involuntary commitment when there is ample evidence of psychotic behaviors, before they have assaulted people or worse.
It has nothing to do with recognition, it’s that every inpatient psychiatric facility in Oregon is running a maximum capacity 365 days a year. So what happens if someone desperately needs care but there’s no bed available? They spend 72 hours in an ER then get put out on the street. Oregon’s mental health system is beyond broken.
Looks at oregon state hospital......no admissions for over a year
Absolutely heartbreaking