OREGON STATE HOSPITAL EVOLUTION OF AN INSTITUTION

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1 KATHERINE TACKER. MD Assistant Professor. Dept of Psychiatry. OHSU OHSU Academic Chief of Psychiatry at Oregon State Hospital OREGON STATE HOSPITAL EVOLUTION OF AN INSTITUTION JUNE MALCOLM AQUINAS. Peer Recovery Specialist MIKE DURAN. MAHPS President BRANT JOHNSON. Crisis Intervention Coordinator

2 Disclosures I have no financial conflicts of interest to disclose

3 Learning Objectives Describe a century of the major successes and challenges in Oregon's longest running operational psychiatric hospital. Describe the current role Oregon State Hospital has in serving the healthcare needs of Oregon citizens. Discuss and begin to identify ways Oregon State Hospital can be an optimal partner in Oregon's mental health community per the perspective of community providers.

4 Formulating Oregon State Hospital

5 Removing the Blindfolds

6 A complex history that informs our future

7 Taking Our Own Social History SOCIAL HISTORY BUILD ON STRENGTHS TRAUMA INFORMED

8 Segregating the Insane

9 Private Hospital Care in Portland

10 Oregon State Insane Asylum

11 Nothing is certain, except death, taxes and staffing issues.

12 Tragedy Unfolds

13 The Mystery Solved

14 A Lasting Trauma

15 Lessons as Silver Linings

16 A growing institution without room for its own

17 Efforts to Decentralize

18 Memorial Circle

19 A Decaying Hospital

20 Politics and Media on Tour

21 Psychiatric Security Review Board You all heard their doctor say that they want to release these people. But you are not a hospital. You are there to keep people in this state safe.

22 OSH Mission Statement Oregon State Hospital is a psychiatric hospital that inspires hope, promotes safety and supports recovery for all. Our mission is to provide therapeutic evidence-based, patient-centered treatment focusing on recovery and community reintegration, in a safe environment.

23 Evolution of the PSRB comprehensive treatment that acknowledges their offense but also their humanity is how we maintain public safety.

24 Progressive Scrutiny

25 An Evolving Memorial

26 De-constructing the Past

27 A New Era

28 Treating Illness or Treating Dangerousness?

29 Early Forms of Treatment

30 Early Forms of Treatment

31 Lobotomy It is a highly technical surgical procedure severing the nervous pathways from the frontal lobe to other parts of the brain for patients who are suicidal, profoundly depressed, resistive In select cases it is now looked upon as standard procedure. The public has heard of this miraculous procedure and are clammering for this work to be done. A brain surgeon in Portland will be willing to come here and operate for $200 per patient if we can save a few suicides and eliminate a lot of human misery it will be money well spent. received only temporary benefit and at the present time her mental status is the same as prior to surgery. This patient will no doubt always be a hospital case.

32 Eugenics Program

33 Impact of Psychopharmacology

34 Precursors to the Treatment Mall

35 Adventure Camp

36 Community as Therapy

37 One Flew Over the Cuckoo s Nest

38 What it meant in the moment This was the one showing they were most anxious about they cared deeply how the patients would react. Forman said They laughed and they had a good time and they felt like being liberated from themselves.

39 Simply Being Remembered

40 Using the legacy of others to build our own

41 Discussion 1. Do you have reflections and insights to share about Oregon State Hospital s past? OSH PANEL 2. As a citizen of Oregon, how would you define the state hospital today? 3. What features of current state hospital initiatives are you curious to learn about? Peer Recovery Services Trauma Informed Care Safe Together Crisis Prevention, Intervention and De-escalation Collaborative Problem Solving for Adult Population MALCOLM AQUINAS Peer Recovery Specialist MIKE DURAN MAHPS President Ligature Mitigation in a Large Institution Suicide Risk Assessment and Planning LEAN Practices Restructuring Institutional Leadership Medical Educational Initiatives Goals to Increase Research Collaboration 4. What is your hope for where future evolution of the hospital will take us? BRANT JOHNSON Crisis Intervention Coordinator

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