In Oregon, people who are accused of crimes but found unable to participate in their own trial because of mental illness are supposed to be sent to the Oregon State Hospital until they are ready to “aid and assist” in their own defense. Advocates say jail is a dangerous place for people with mental illnesses, but even before the pandemic, “aid and assist” patients often faced long waits in jail for space at the hospital. Staffing shortages and other challenges have made the problem even worse. Sally Reid’s son Phillip is currently at the Oregon State Hospital under “aid and assist” after spending over a month in jail in Astoria. He has also spent time at the psychiatric hospital for civil commitments. Reid tells us how these commitments have affected her family.
The following transcript was created by a computer and edited by a vounteer.
Dave Miller: This is Think Out Loud on OPB. I’m Dave Miller. In Oregon, people who are accused of crimes but found unable to participate in their own defense because of mental illness are supposed to be sent to the Oregon State Hospital. The idea is that they’ll be provided enough treatment so that they can “aid and assist” in their own trials. But even before the pandemic, “aid and assist” patients often faced long waits in jail for space at the hospital, despite the fact that advocates say jail is a dangerous place for people with mental illness. Staffing shortages and plenty of other challenges have made the problem even worse.
Sally Reid’s son, Phillip, is currently at the Oregon State Hospital under “aid and assist”. That’s after he was in jail in Astoria from April to June. This isn’t Phillip’s first stay at the state hospital. He’s been civilly committed there six times. Sally Reid joins us to talk about the intersection of criminal justice and mental illness in Oregon and how all of this has affected her family. Sally Reid, welcome.
Sally Reid: Thank you for having us on the program today.
Miller: What was Phillip like as a young kid?
Reid: He was quite the entertainer. He always had a smile on his face, was very energetic, very intelligent, excelled in anything he did, active in sports, theater. Just a happy go lucky kid. Like I said, just had a lot of friends, was just very active in school, his education et cetera, et cetera, just a fun person to know.
Miller: When did his symptoms first appear?
Reid: They started appearing when he was around 16, 17. And at that time, I thought it really was due to experimentation with drugs, which most teenagers unfortunately go through, but he was having symptoms of seeing things that were not there and hearing voices. And so I did take him to a psychiatrist and he was labeled with a mental health illness.
Miller: Was there a specific point when you realized that this was going to fundamentally change his and your lives forever? That this wasn’t a minor diagnosis or a temporary diagnosis?
Reid: I know when I first heard the diagnosis, it scared me to death and I did a lot of research. But he was prescribed some medication. He seemed to respond to the medication and then actually went off as an adult, when he turned 18 and he did actually do regular jobs and worked and traveled the United States as well as the country. But then it really wasn’t until he turned 25 that he had a situation where he got fired from the job and then just spiraled down into this deep dark hole. And I really believe it was trauma induced, that brought on the new situation, and quite honestly, I had no idea of what our journey was going to look like over the next 13 years. He’s now 40, actually 15 years because it took us three years to actually get him help, because he was in denial of his current state of mind and didn’t want to go to treatment, didn’t want to take medication. And it took a civil commitment to get him into his first commitment to the state hospital.
Miller: When he was 26, 27. Can you remind us how civil commitment works, what it is?
Reid: It’s actually a situation where he was taken to the hospital and put on a hold for five days and an evaluation was done, if he was going to be able to make it on his own basically. And then what typically happens is someone signs a two party petition and in his situation, the county actually started the civil commitment process, he goes in front of a judge and at that time it was Judge Cole and I testified to his symptoms and there were court evaluators in the courtroom and the bottom line decision whether or not he was competent was up to the judge and I remember very clearly that day, I was quite honestly shocked about the way they brought him into the courtroom because they actually had him in shackles and handcuffs and here I’m thinking, my son’s not doing well. He’s already traumatized by being taken to a hospital and put on a hold and now they’re bringing him like he’s a criminal and he was scared to death. He told me later, he said he was afraid to even move. But anyway, the bottom line that day was he was deemed incompetent and basically given a sentence to go to the state hospital for six months to ‘become competent again’. So basically all their rights are taken away. They have no say in anything, including their treatment.
Miller: Basically, this is involuntary commitment when people are deemed unable to provide for their basic needs like health and safety or if they’re found to be a threat to themselves or others.
Miller: What stands out to you about that first commitment, as I mentioned that there were six civil commitments over the course of the next 15 or so years. What do you remember from just the very first one?
Reid: It’s really interesting. I ran into Judge Cole many years later, we had similar past after he retired and I remember sitting there with him and having lunch and he said, “Sally, we all hear voices,” and I said, “You are absolutely right,” and I said, “I am so sad that I sat on that stand and said my son was mentally ill,” because I think from that point on, we labeled him and the world has a great way of labeling people today with mental health issues that are really common to all of us. We all have voices from our past that come up in different situations where we’re told we’re not good enough, we hear maybe a teacher or a parent or somebody that really, when they said the words they said, it’s stuck in our soul. And those voices come up every day for all of us and it causes anxiety and depression and a lack of confidence. And that’s really what I think happened with my son, is he lost a job that he loved and it started to spiral down into this deep dark depression that he just could not get out of. And the majority of the commitments were due to him being out in the community and doing acts that weren’t normal for most people and ended up getting him in trouble with the law.
Miller: Was he threatening to himself or to other people? Was that one of the reasons for his being civilly committed so many times?
Reid: It was the threat to others. He had a habit of just saying the wrong things, but if you know Phillip you know, he basically uses his words as his threats, and has never really followed through on any of those actions, but when you tell a police officer you’re going to kill them, those things don’t go over very well. Or he would go down to the governors, to Salem and want to talk to the governor about his ideas and just came across as too aggressive at times. And so he became a public nuisance more or less. And I worked quite honestly behind the scenes a lot with a Beaverton detective and I also worked very closely with the Washington County Sheriff’s Department just to let them know when I knew my son was not doing well and they actually had him in their system. So if anybody did encounter him, they knew that he wasn’t as much of a threat as he said he was. They did watch him because we just don’t know if he would ever step over that line and people have stepped over that line and hurt people.
Miller: What you’re describing is it, if you needed to have close contact with local law enforcement and to have them almost be on board and have everybody there who might encounter him, have a sense for his history and, and believe you, so that they wouldn’t react defensively or perhaps aggressively. If you know, in any given circumstance. To go back to the civil commitments. I mean, this was a real cycle. I imagine there were variations on this theme at different times, but broadly, what was his status when he was released from the hospital? I mean, the point of being in the hospital was to make him better. What was he like each time he would be released?
Reid: The majority of the time he was able to have a two way conversation once he was released because they did medicate him, it was forced, he didn’t have a choice. And the unfortunate thing is they set him up obviously with a provider and he had to go see his psychiatrist weekly or every other week. But he never felt comfortable being on the medication and he always said, “Mom, it’s not working. It doesn’t stop the voices.” He said and they said you know, it will stop the voices. Well it doesn’t, what it did is it ballooned his weight. One way or the other, he just didn’t feel good. It affected his eyesight. He had to do blood draws with the medication they were putting him on to make sure that he wasn’t developing some major medical conditions. I mean the side effects of these antipsychotics are tremendous. And so once he talked to a psychiatrist and asked to lower them or remove them, they usually didn’t listen to him. And that was the one thing that frustrated me the most is they don’t listen to mental health patients. They don’t listen to how the medication is affecting them. And I think that’s so key to keep people, if they truly need medication for the remainder of their life, they need to buy into it. And I think that’s why we have so many people on the streets today that have gone through these systems and they put on these harsh medications that really were not meant for long term. They end up not trusting, they go off their medications and quite honestly, I think he suffers tremendously from withdrawal symptoms because he typically will go off cold turkey. And you just can’t do that with some of these medications. And we’re seeing that with the addictions to OxyContin and some of the other medications that are out there, you just can’t stop. So yes, he’s able to communicate and he seems to be semi-normal, but he’s not my Phillip, if you know what I mean, because he was so drugged up.
Miller: If you’re just tuning in, we’re talking right now with Sally Reid. Her son, Phillip, has lived with serious mental illness for more than 20 years. He is currently at the Oregon State Hospital as what’s known as an “aid and assist” patient, awaiting criminal trial. So let’s skip forward to where we are now, could you tell us the story of what led to the criminal charges?
Reid: Unfortunately, Phillip had been living in the Midwest for a while and when he came back to Oregon, he stayed with myself and my new husband for a short period of time and then, because he wasn’t medicated again, we had to pretty much ask him to leave. He ended up taking a bus to Astoria. I think he wanted to start a new life there away from Washington County where everybody knew him. And one day he had a situation that was very real to him, where he thought this cloud that was coming into Astoria was truly a poisonous cloud. And you have to remember when people are going through this, it is real to them, extremely real. So he wanted to warn the city and he went into a convenience store and asked somebody to call 911 to report it and they wouldn’t, they kicked him out. So he went across the street to the Chamber of Commerce, broke open the door and called 911 to report this cloud coming into the city that he thought was going to harm people. He waited for the police to show up and after the police arrived, they did understand what the situation was, as far as his mental health. They did unfortunately take him to jail basically just to hold him, for the breaking and entering, and the reason he was kept in jail as long as he was and not dismissed was because he wouldn’t say his name to the judge. So the judge apparently has to keep them under a mental health hold in the jail for further evaluation. And so that’s what got him into the situation with the “aid and assist”.
Miller: The idea, as I noted in my intro, is that patients at the Oregon State Hospital who are part of the agency’s population, they’re supposed to get enough treatment so that they can take part in their own criminal trials, they can aid and assist in their own defense. Is that happening? Is he getting treatment right now?
Reid: The one thing that’s different this time is the psychiatrist there doesn’t need Phillip’s permission to talk to me and I have to tell you, this psychiatrist he has, with this commitment, is really dedicated to making sure my son is well. I’ve never seen that before. I’ve never had that interaction before under the civil commitment but because of his situation, under an “aid and assist’' they can actually reach out to family members and talk about best solutions for not only Phillip, but for the family. And I’ve actually been very excited about that part because they’ve never included the family in the past and I think it’s a family illness as well as an individual illness because we all suffer. It’s not just Phillip. So anyway, I truly believe that he is getting better help this time, which is really good. I mean the staffing down there is short but the psychiatrist that’s there has been there for I think eight years and we’ve had wonderful conversations on ways to help Phillip, how to help Phillip buy into medication, because I truly think at this point the medication that they’ve given him has damaged his brain. And I really think he’s going to have to be on something for the remainder of his life, which is sad, but it is what it is. Under the “aid and assist”, the one thing I was upset about is he does not have any wraparound services when he walks out of the door, they basically transfer him back to the jail. His case will probably be dismissed and then they send him out back to the street. There’s no services available under the “aid and assist’' where under the civil commitment, there is a total, they’re put on the Oregon health plan, they have all the services they need, they look for housing, they help them with jobs. But under this program, it’s basically they snatch you off the street, put you in jail, take you to the hospital, you’re able to understand your charges, taken back to jail, dismissed back to the street, where the crazy cycle will start again. I actually think he’s getting the help, I’m a little concerned about the med changes and how quickly they change them. But he is listening and he is working. And the other thing that they’re doing is, I kept saying you have to deal with the trauma, you just have to deal with the trauma because they kind of react to how Phillip reacts. If he gets angry, then they upped his meds and I said, you can’t do that. He’s angry because he’s where he’s at, this is his seventh time being there and he doesn’t want this kind of lifestyle. He just doesn’t and you can’t just med him because he’s upset, I’d be upset. So this psychiatrist is really working closely with me about that and they’re actually doing a lot of talk therapy right now with him and gaining his trust which has been huge.
Miller: Given what you and Phillip and your family have been dealing with for almost 25 years now, I don’t imagine you’re looking for a magic solution at this point, but I’m curious what your reasonable hopes are for his and for your future.
Reid: I believe that God still has him alive for a purpose. He’s brilliant. He has a lot of ideas and you look over the years, anybody who has been diagnosed with ‘a mental illness’ has brought some wonderful things to our country and the world and I think we approach mental illness in the wrong way here by putting them aside, telling them they’re disabled for the remainder of their life, telling them they can’t work again. I would like to see my son be a contributor. He wants to be a contributor, he wants to work. But he’s got to get the right program around him and the right housing for him. My hope for my son is that this day and the work that this psychiatrist and one of the other psychologists there get Phillip to understand that he still needs a lot of work on the trauma induced that’s happened to him. So yeah, I would like to see my son work again and have a life
Miller: Sally Reid, thanks very much for sharing your and your family’s story with us today. I really appreciate it.
Reid: You’re welcome.
Miller: Tomorrow on the show, we’re going to hear my recent interview from the Portland Book Festival with the writer and illustrator, Kristen Radtke. Her new book, Seek You is a thoughtful and a thought-provoking exploration of loneliness. Our production staff includes Julie Sabatier, Elizabeth Castillo, Rowley Hernandez and Senior Producer Allison Frost. Nalin Silva engineers the show. Our technical director is Steven Kray and our Executive Producer is Sage Van Wing. If you don’t want to miss any of our shows, you can listen on the NPR-1 app, on Apple Podcast or wherever you like to get your podcasts. There’s also our nightly radio rebroadcast at 8pm. Thanks very much for tuning in to Think Out Loud on OPB and KLCC. I’m Dave Miller. We’ll be back tomorrow.
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