By Gordon R. Friedman

The Oregonian

A federal judge heard arguments Tuesday over the rights of mentally ill people charged with crimes that went to the heart of Oregon’s plagued mental health care system: Who’s in charge and what should be done to make things better?

Chief U.S. District Judge Michael W. Mosman will rule later on the motion seeking to have Oregon held in contempt for violating a longstanding court order meant to ensure such defendants get prompt treatment when a judge deems it necessary. As it stands, dozens of mentally people are detained in county jails in violation of that order and, perhaps, their constitutional rights.

State officials acknowledge their lapses but say they have been unable to admit all those people into the Oregon State Hospital because it has become full as demand for trial fitness treatment rises.

Patrick Allen, director of the hospital’s parent agency, the Oregon Health Authority, testified that officials have worked for years to slow the demand, but it has not abated despite their best efforts.

At times Allen has pinned the problem on other actors including police and prosecutors.

On Tuesday, Allen testified that the state has a “comprehensive plan” to bring it back into compliance with court orders. He provided a laundry list of steps taken: adding hospital beds for defendants, requesting money from the Legislature for stepped-down treatment centers and seeking reform legislation.

Lawyers for advocacy group Disability Rights Oregon and law firm Metropolitan Public Defender said actions taken by Allen and other officials are laudatory but insufficient.

They have failed to uphold defendants’ rights, the attorneys argued, and Mosman should hold the state in contempt, impose fines and even consider appointing an independent monitor.

Mosman gave few clues as to how he will rule. He said it is “a given” that the state has not complied with court orders, but the question is whether officials had taken steps to address the problem or “sat on their hands.”

He wondered aloud whether to impose “contempt or something else” and whether contempt was the “right tool.”

Problems with mental health care are “system-wide,” the judge said, starting with decisions to arrest and charge people as well as a “lack of treatment.” But the situation at hand, where mentally ill people languishing in jails, is “deeply serious,” Mosman said.