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The Salem Statesman Journal published this guest opinion on Sept. 27, 2003. State-hospital life improves By Bob Nikkel, MSW For decades, Salem-area residents have driven past the Oregon State Hospital on Center Street NE, with its park-like campus and its classic buildings from an earlier era. The hospital is a prominent feature in the Salem landscape, but not in the lives of most Salem residents. Having a friend or family member in the hospital was a much more common occurrence 50 years ago. If trends from the 1950s had continued, Oregon State Hospital would now have about 10,000 patients (compared with the about 750 it actually has). Several years back, when a patient died at the hospital, a colleague who reviewed her history learned that she had arrived in 1927! She lived her entire adult life on the campus. Today, that would be rare. With the state hospital in the news, here's a look at what's happening in mental health treatment, and in those buildings arranged along Center Street NE. Medicines have improved. There's greater public understanding of mental illness. Treatment programs, specialized apartments and other resources are available in communities. These trends have opened the door to community living for people who once would have been committed long term to an institution. At the same time, the state hospital has improved the care of those who do require ongoing institutional treatment, including growing numbers of patients from the criminal justice system. In its report last month, the president's New Freedom Commission on Mental Health said that actual psychiatric practice in public programs can trail medical science by up to 15-20 years. This is not the case at Oregon's state hospital. Consider: ---The hospital was one of the nation's first to use the full range of new medicines brought on the market since 1990. ---Security and safety have improved in the past decade. ---We're strengthening links to the Oregon Health and Science University medical school. ---We've developed extensive vocational programs. All of this fits with what is called the "recovery model," which says most psychiatric patients should be able to get well and return to their communities. The presidential commission recommends this approach. A member of that commission serves on an expert committee that is determining how to make this good hospital better. The committee will look at how to further modernize treatment, and how to attract more clinicians to a hospital that now has vacancies for five physicians and 26 nurses. Filling vacancies is a challenge. But despite difficulties such as lower pay than that available elsewhere, we have highly dedicated physicians, nurses and direct-care staff. They choose to work in the state hospital because they want to help people with the most challenging mental-health problems. Like the rest of our state's mental health system --- and like all of government --- the state hospital faces the difficult task of meeting rising demands with limited dollars. But as we focus on improvement, you can expect more news about how the hospital, as part of the state's broader mental health system, is improving Oregonians' lives. Bob Nikkel of Salem is administrator of the Office of Mental Health and Addiction Services in the Oregon Department of Human Services. He may be contacted at robert.e.nickel@state.or.us |
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