‘Humanitarian’ basis for request is a first for facility
By Alan Gustafson
Fearing that he will die from AIDS at the Oregon State Hospital, an ailing mental patient says he should be released from the Salem psychiatric facility for “humanitarian reasons.”
Robert Anderson, a Navy veteran, said he’s terminally ill and likely to die in a year to 18 months.
As Anderson tells it, he should be placed in a specialized nursing facility or a community-based group home to live out the rest of his life. He’d like to receive hospice care when the time comes.
Anderson, 47, said he hopes to get out of the state hospital through potential legal action or by seeking a conditional release from the state Psychiatric Security Review Board.
Mary Claire Buckley, the executive director of the PSRB, said Anderson’s case may be unique.
In the past, the review board has granted conditional releases for terminally ill patients at least “a couple of times,” Buckley said.”Nobody’s ever come in and said, ‘Can I have a humanitarian release?'” she said.
Anderson’s initial hearing before the review board is scheduled for Nov. 4. That’s his first chance to make his wishes known to the panel.
Anderson recently landed in the state hospital’s forensic program after he was found guilty except for insanity of attempted arson. He reportedly set fire to a Portland duplex early this year. No one was injured.
Arrested in March, Anderson was jailed for more than five months until the criminal case was resolved. He was transported to the state hospital in early August.
As it stands now, Anderson faces 10 years under the jurisdiction of the PSRB. The board monitors hundreds of forensic patients and controls their discharge dates.
Under Oregon law, the board can conditionally release patients to live in community facilities. Typically, a conditional release gets green-lighted only after a patient makes progress in psychiatric treatment, receives favorable reports from hospital therapists, is deemed no longer dangerous and has a suitable place to reside in the community.
Anderson said that terminally ill patients should be granted special consideration.
“I don’t think it’s fair that people get put here under the PSRB and then have to worry about whether or not they’re going to die in this hospital,” he said. “If the board keeps me here, they’ll turn a period of supervision basically into a death sentence.”
If Anderson officially asks the review board to release him, Buckley said, the panel would weigh multiple factors, including his prognosis, reports from hospital therapists, public safety considerations and the availability of a suitable care facility in the community.
“Clearly, if the hospital felt that he could be adequately controlled in a different environment that met both public safety and his medical needs, then I’m sure the board would be open to hearing about that,” she said. “Obviously, the board would need to hear from the hospital in terms of their prognosis and efforts in dealing with this issue.”
Drug abuse leads to HIV
A Statesman Journal review of Anderson’s hospital file, authorized by his consent, found that mental illness and drug abuse have made a shambles of his adult life.
After growing up in a boy’s home in Hershey, Pa., Anderson joined the Navy when he was 17 “because I wanted to see the world.”
His tour of duty took him to Sardinia, Italy, where he worked on a submarine tender for almost two years.
Shortly before he was discharged from the Navy in 1980, Anderson witnessed a grisly tragedy.
“Towards the end of his service Mr. Anderson witnessed an accident on his ship,” wrote a state hospital social worker in a recent report that delved into his background. “A rope somehow beheaded one sailor, cut another in half, and injured the arm of a third individual. Mr. Anderson says that around this time … he began to experience hearing voices and having ‘disjointed” thinking. He characterizes these symptoms as the beginning indicators that he had schizophrenia.”
After his Navy stint, Anderson worked as a fisherman, restaurant chef and construction worker. Work-related injuries and recurring bouts of mental illness prevented him from holding steady employment after he moved to Portland around 1985.
Methamphetamine abuse and crime have taken a heavy toll. In the 1990s, Anderson served three years in federal prison for bank robbery.
He tested HIV-positive about 15 years ago, records show. He reportedly was infected with the virus that causes AIDS when he injected drugs with a contaminated needle.
The U.S. Veterans Administration rates Anderson as 100 percent disabled and provides him with monthly financial support. VA funds help pay for his 20-year-old daughter’s college education.
Through the years, Anderson has been hospitalized about 15 times at the Portland VA Medical Center, records show. But Anderson complains about numerous battles with the VA, citing canceled medical appointments, difficulties in obtaining medications and financial conflicts.
Anderson may be on the hook to pay for part of his state hospital care.
The cost of patient care at OSH is $19,475 per month, according to a “notice of liability” letter Anderson received last month from the Oregon Department of Human Services.
The letter informed him that state hospital patients are liable for the cost of their care, if they can pay.
Hospital care challenged
This is Anderson’s first stay in the hospital’s forensic program, which houses more than 450 patients with histories of mental illness and crime.
He maintains that the crowded, outdated hospital has unsanitary conditions, and he worries that he’s vulnerable to the flu and other infectious illnesses.
“It’s a horrifying situation for somebody like me that basically has no immune system,” he said.
Antiviral medications commonly used to treat patients with HIV/AIDS no longer provide an effective defense against his advancing illness, Anderson said.
“It’s beyond the point where they do any good,” he said. “The disease gets smart and works its way around them. At that point, you could take truckloads of them and they do no good.”
Anderson claims the state hospital is ill-equipped to provide him with proper treatment, including experimental medications for AIDS — drugs that potentially could extend his life.
“The medications that are new and injectable are still in some form of trial stage,” he said. “Because of that they can’t be used here at the state hospital. They will not administer any experimental medications.”
Dr. Michael Duran, supervising forensic psychiatrist at OSH, declined to discuss Anderson’s condition or care, citing patient confidentiality.
Speaking in general about patient care, Duran said: “The hospital certainly will provide what’s medically indicated. Whatever the condition is, we will seek appropriate medical care, meaning that we will refer him to specialists in the area.”
Duran confirmed that Anderson has seen a medical specialist outside the state hospital.
Asked about Anderson’s assertion that the hospital won’t provide him with experimental drugs, Duran said that’s not necessarily true.
“We rely on our medical specialists to help us make decisions in terms of what appropriate medical care is,” he said. “If there were a particular situation where forms of usual therapy had failed and our experts were telling us there are experimental modalities available, we certainly would pursue those avenues.”
Despite such assurances, Anderson said he’s frustrated by his hospital care and desperate to find a way out of the institution. “I’m definitely going to ask a federal judge to step in,” he said Thursday.
agustafs@StatesmanJournal.com or (503) 399-6709