My state started the first Psychiatric Security Review Board in America in the late 70s. There are now three, one here, one in AZ, and one in CT. The PSRB's job is to supervise all Oregonians who have asserted the insanity defense and who are not currently residents of the Oregon State Hospital. Currently, that is around 700 people or so. It's way too long a story to tell here, but basically, the system works like this. A person's Guilty Except For Insanity pleading is accepted by the court (too much to go into here). They then either go straight to OSH for some period of time or, they go to some kind of housing (as determined by the PSRB) and are immediately put under the supervision of the board. A murder GEI conviction would go to the hospital and, say, a first-time offender Burglary II conviction might go to a supported housing setting, as they were deemed appropriate for by the board. Every case is different.

Sentences for these cases are whatever the MAXIMUM would have been had the person been simply found guilty. This results in mentally ill Oregonians serving roughly twice the time their non-mentally ill counterparts who merely plead or are found guilty do. I believe this is unconstitutional, since it sentences mentally ill persons disproportionately higher than non-mentally ill persons for the exact same offense, but noone has yet sued over it. Because of this sentencing disparity, a good number of people have elected to plead guilty rather than GEI, putting yet another profoundly mentally ill person at the mercy of the prison system.

Discharges from the hospital are pretty much entirely up to the treatment team. The PSRB itself ultimately writes the discharge order, but the doctors really are the ones making the call. If someone isn't totally ready to leave, they ain't leavin'.

Once out of the hospital, most patients go to either a residential treatment facility (RTF, for nonviolent offenders) or a secure residential treatment facility (SRTF) for violent offenders. Either way, the patient then works his or her way through successively lower levels of care until ultimately, they may be allowed to live independently. This can take years and years.

Patients living in the community and under board supervision are without question the most highly monitored person in our state. Being on any kind of post-prison supervision is a walk through the rose garden compared to what is required of PSRB supervisees. Weekly therapy and shrink appts. Severe restrictions on travel. Sometimes daily group attendance for awhile after discharge. Strict med compliance. Obviously, no drugs or alcohol. It is an almost overwhelming burden for some. Noncompliance with any part of the regimen may be a swift kick in the pants and a return to the hospital.

For years, the PSRB has justified its onerous approach by claiming its recidivism rate was less than 2%. And that was true, for those still under its supervision. However, ProPublica recently conducted its own investigation of the PSRB and they found that, once discharged from the board, that recidivism rate is actually 35% (compared to just over 50% for people coming out of prison). This, plus a recent tragedy involving someone discharged from the PSRB have put a lot of heat on the legislature and the board and there is now talk of modifying the statutes so that a GEI pleading would require lifetime PSRB supervision. If that happens, I expect both the ACLU and Disability Rights Oregon to sue. But we shall see.

Anyhow, this is how our supposedly super-progressive state does it. Seems to me it's not all that progressive. But what do I know.

I am currently finishing writing a book about the PSRB. It should be done sometime after the first of the year. Now, I just need to find an agent...