Psychiatric patient won’t move to hospice

Terminally ill man must remain in State Hospital
By Alan Gustafson

A state board ruled Wednesday that a terminally ill mental patient with AIDS will remain at the Oregon State Hospital and not be released to a community hospice care facility.

The state Psychiatric Security Review Board concluded that the ailing patient, Robert Anderson, can receive hospice care at the state-run psychiatric facility in Salem.

Anderson, 47, bowed his head and slumped in his chair when the board decision was announced. Outside the hearing room, he expressed frustration and anger.

“How can people sit in a room for 20 minutes and pass a death sentence on me?” he said. “How can you look someone in the face and say, ‘We know you’re dying, but you have to stay here.'”

Testimony provided to the review board indicated that doctors have told Anderson that he has less than six months to live.

Anderson dreads the prospect of dying at the state institution, possibly without loved ones at his side.

In seeking a conditional release, he hoped to spend whatever time he has left in a Portland-area facility — closer to his daughter, church and other supporters.

Anderson, who has a long history of mental illness, recently landed in the hospital’s forensic psychiatric 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.

Anderson recently was diagnosed with lymphoma, a form of cancer that often afflicts people who have AIDS.

Given Anderson’s condition, his hopes for moving to a community hospice facility are “racing against the clock,” said Harris Matarazzo, Anderson’s attorney.

“He understands his time on the planet is very limited now,” Matarazzo told the review board.

Under Oregon law, the board can conditionally release patients to live in community facilities. Typically, a conditional release occurs only after a patient makes progress in treatment, receives favorable reports from hospital therapists, is deemed no longer dangerous and has a suitable place to reside in the community.

The state hospital did not support Anderson’s request for a conditional release.

Dr. Satya Chandragiri, a state hospital psychiatrist, told the review board that Anderson is receiving comprehensive medical treatment.

Anderson currently is housed on hospital Ward 35B. Some of the patients living on the medical unit have dementia, along with mental illnesses. Others are physically frail.

Anderson frequently displays irritation, frustration and anger about being held at the hospital, Chandragiri said.

“He’s becoming very hopeless with all the constraints placed on him,” the therapist said.

The review board denied Anderson’s bid for a conditional release after brief, closed-door deliberations.

The board also denied Matarazzo’s request to have Anderson evaluated by a community facility for possible placement at some future date.

agustafs@StatesmanJournal.com or (503) 399-6709

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Addiction-treatment home lets women keep their children

Reyna Belmont
A place to stay a mom

The youngest resident of Her Place, a Marion County transitional home for women in drug and alcohol treatment, happened to be the born on the day the new house’s inhabitants moved in.

“I was so thankful that they’d let me keep her,” said mother Reyna Belmont, 28, as she held her newborn daughter, Kaliana Gabriela Juarez-Salinas, now 3 weeks old.

Belmont and six other women live at Her Place, which held a celebration and open house Wednesday to show its new space. The 3,500-square-foot, one-level home is an improvement from the program’s former home, an aging, two-story house in constant need of repair.

In the new home, each of the six bedrooms was sponsored by donors such as Salem Alliance Church and Salem Hospital’s neonatal intensive-care unit employees, who provided new furnishings, bedding and decor.

“This is Extreme Makeover: Her Place Edition,” said Teri Morgan, the lead counselor.

The home’s living room is used for group treatment sessions. A back playroom for children is staffed during the day.

For women with children, the greatest challenges in seeking treatment are transportation, child care and housing, Morgan said. Her Place provides a safe, supportive environment for the mothers, who also are encouraged to help one another.

“It’s really about getting living skills and getting drug-treatment skills,” Morgan said.

When Belmont came home from the hospital, she was greeted by the new home and furnishings. Belmont, who has been part of Her Place for about four months, had Morgan name her daughter out of gratitude.

“It’s a great place,” she said. “I wouldn’t have my little girl right now.”

A resident can stay at Her Place for as long as 100 days, or more if necessary. Often, the mothers have pending child-welfare and criminal cases. Many are on a waiting list to get into the program.

“When they come in, they’re so broken,” Morgan said.

Often, the women have suffered from domestic violence, trauma or other kinds of abuse, she said. The location of Her Place is unpublished because some of its participants have been victims of domestic abuse.

Some of the participants also are in Circuit Judge Pamela Abernethy’s Fostering Attachment, an alternative court program that focuses on reuniting families in child-welfare cases, and are involved with Family Building Blocks, a Mid-Valley relief nursery.

Abernethy, who spoke at Wednesday’s event, said she wished Her Place could be replicated throughout the community.

“This is the place where moms go home with their babies,” she said.

Her Place graduate Susie Greenlee, 27, of Salem told the audience that she once was told during an early evaluation that she was never fit to be a parent.

Nearly two years later, she has custody of her 2-year-old daughter, Elizabeth, a job and her own home.

“It was like a complete 180,” Greenlee said.

Her Place has been a Marion County program for at least 20 years, said Trish Davis, the clinical supervisor of the county’s drug-and-alcohol treatment programs.

The impetus for the new home was the management changeover of the program. Her Place’s former provider, Portland-based Cascadia Behavioral Healthcare, went through financial struggles in 2008.

At that time, Marion County health officials began restructuring its drug-and-alcohol treatment programs. In July, Marion County took over management of Her Place.

Her Place resident Helen Rice, 24, recently was reunited with her young daughter Sabrina, who returned to her custody one week ago.

Rice, who will celebrate her daughter’s first birthday today, said she wants to return to study addiction services at Chemeketa Community College.

“My daughter is my life, and I love her,” Rice said. “I can’t take care of her loaded.”

rliao@StatesmanJournal.com or (503) 589-6941

Advocates want investigation into state hospital patient’s death

By Michelle Cole, The Oregonian

SALEM — A 42-year-old patient at the Oregon State Hospital was found dead in his bed Saturday night, prompting mental health advocates to call for an investigation amid reports that the man was dead for several hours before staff noticed.

A hospital official confirmed that a patient on 50F, a medium security ward, was discovered dead in his room at 7:40 p.m. Saturday.

The patient was identified as Moises Perez, who had been found guilty but insane for assault and attempted murder. He was sent to the Oregon State Hospital in 1995 and was to remain under the jurisdiction of the state Psychiatric Security Review Board until 2034.

On Tuesday Disability Rights Oregon and MindFreedom, two organizations that lobby for the mentally ill, demanded an investigation into the circumstances surrounding Perez’s death.

Patients interviewed by advocates and The Oregonian said Perez had complained of chest pains. They said he ate breakfast, but did not show up for lunch. Staff distributed dinner trays to rooms on the ward between 5 and 6 p.m., but hospital officials would not say specifically whether Perez got a tray or ate any food.

He shared a room with three other patients and was found when staff dispensed nighttime medications.

“We’ve gathered enough information that makes us think that there’s probable cause to believe there was abuse or neglect,” said Robert Joondeph, executive director for Disability Rights Oregon.

“This was a guy who was pretty significantly disabled,” Joondeph said. “Apparently the one thing he did was, he was a good eater — so when he didn’t show up for lunch something was up and if he didn’t eat his dinner something was really up.”

David Oaks, director of Eugene-based MindFreedom International, described the circumstances as “suspicious.”

A preliminary investigation by the Oregon State Police found no evidence of a crime.

“The Marion County medical examiner advised our investigator that the death was considered natural causes,” said Lt. Gregg Hastings, Oregon State Police spokesman.

State police have forwarded their report to the Marion County district attorney. Hastings said that report would not be released publicly until the district attorney completes his review.

Oregon State Hospital spokeswoman Patricia Feeny said the patient had medical issues. But she declined to discuss the specifics of his case or when staff recorded their last contact with him alive.

Instead, Feeny cited medical confidentiality laws and an ongoing internal investigation by hospital officials. The results of that investigation will be forwarded to an independent commission on hospital accreditation, she said.

The Office of Investigations and Training inside the Oregon Department of Human Services is also investigating, which is routine in such cases.

Oregon’s state mental hospital has a well-chronicled history of troubles. In 2008, the U.S. Justice Department released a report detailing abysmal conditions and staffing shortages at the hospital that not only hindered patients’ recovery but threatened the safety of both patients and staff.

Federal investigators returned this summer to check on the hospital’s progress.

On Saturday, hospital officials said ward 50F housed 42 men and was staffed by a registered nurse, one worker who is regularly assigned to the ward and three “floaters” who work wherever they’re needed. Hospital officials say that level of staffing meets minimum requirements and is typical for a weekend swing shift.

State patient who pushed for release hospitalized

Robert Anderson, who has AIDS, moved from OSH to Salem Hospital
By Alan Gustafson

A state hospital mental patient asking to be released from the psychiatric facility because he has AIDS now is in the intensive care unit at Salem Hospital.

Robert Anderson said Thursday from Salem Hospital that he has been diagnosed with pneumonia and lymphoma, a form of cancer that often strikes people who have AIDS. Anderson said he will undergo chemotherapy.

Anderson, 47, was moved Sunday from the Oregon State Hospital to Salem Hospital, officials confirmed Thursday.

When he might return to the state-run psychiatric hospital hasn’t been determined.

“That’s a decision his treatment team would have to make,” said Patricia Feeny, OSH spokeswoman.

Last month, Anderson told the Statesman Journal that he’s terminally ill and doesn’t want to die at the psychiatric hospital. He hopes to persuade state officials to release him from the facility for “humanitarian reasons.”

On Thursday, Anderson said in a telephone interview from Salem Hospital that he would like to receive hospice care at a facility in Portland, where he could be near his daughter.

As Anderson tells it, the state hospital is ill-equipped to provide him with proper treatment. He maintains the crowded, outdated facility has unsanitary conditions, and he says that heightens his vulnerability to infectiousness illnesses.

Anderson’s bid to get out of the state hospital is scheduled to come before the state Psychiatric Security Review Board at a hearing set for Nov. 4. The board monitors hundreds of state hospital 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 occurs after a patient makes progress in psychiatric treatment, receives favorable reports from hospital therapists and has a suitable place to reside in the community.

Anderson, who has a long history of mental illness, recently landed in the 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.

Anderson faces 10 years under the jurisdiction of the PSRB.

But he expects to die long before his term of board supervision expires.

agustafs@StatesmanJournal.com or (503) 399-6709

Reading Your Way To Mental Health

By KEVIN HELLIKER
The Wall Street Journal

A growing number of therapists are recommending something surprising for depressed and anxious patients: Read a book.

The treatment is called bibliotherapy, and it is gaining force from a spate of research showing that some self-help books can measurably improve mental health. In May alone, the journal Behaviour Research and Therapy published two studies demonstrating the effectiveness of bibliotherapy in patients with depression or other mood disorders. The national health system in Britain this year is prescribing self-help books for tens of thousands of people seeking medical attention for mood disorders.

Decades after the emergence of the self-help book, it remains one of publishing’s hottest categories. This year, U.S. revenue for the category will exceed $600 million, a single-digit jump from 2006, says Simba Information, a market research firm in Stamford, Conn.

Yet this category is reminiscent of the market for elixirs, oils and pills before the advent of federal regulation. Despite the growth in research, fewer than 5% of the tens of thousands of self-help books on the market have been subjected to randomized clinical trials. And authors with no scientific credentials are just as likely to hit the jackpot as are renowned physicians. “When the book cover announces that it’s a bestseller, that means nothing,” says John Norcross, a University of Scranton professor of psychology and researcher on the effectiveness of self-help books.

Now, mental-health professionals in the U.K., the U.S. and elsewhere are determined to distinguish the most proven offerings. The aim is to recommend books that have been shown to be successful in published trials conducted by reputable, independent researchers. Trials are conducted much the way drug research is done, comparing patients’ depressive symptoms before and after treatment, compared with patients who didn’t undergo the treatment. For instance numerous clinical trials have shown that “Feeling Good: The New Mood Therapy,” a 1980 tome by Stanford University psychiatrist David Burns, reduces depressive symptoms in large numbers of readers.

In the U.K., where the wait for professional treatment can stretch six months, the national health system has embraced bibliotherapy as the first line of treatment for non-emergency cases. The program varies but in most parts of the country, health officials have approved a list of about 35 books that have been stocked at local libraries. Seekers of non-emergency mental-health services receive a prescription enabling them to check out a book without a library card and for 12 weeks, four times longer than other books.

In a small but significant percentage of cases, bibliotherapy reduces symptoms sufficiently that the sufferers no longer seek additional treatment, says Neil Frude, a Cardiff University psychology professor who helped develop the U.K. program.

In the U.S., no official list of bibliotherapy treatments exists. But thousands of mental-health professionals have contributed to a self-help manual that Dr. Norcross — co-author himself of a self-help book, “Changing For Good” — has been updating since 2000. “The Authoritative Guide To Self-Help Resources in Mental Health,” available from many commercial booksellers, ranks more than 1,000 self-help books according to their effectiveness, based on clinical trials and on the clinical experience of professionals.

Bibliotherapy works best on mild to moderate symptoms, and isn’t regarded as a replacement for conventional treatments. A 2003 article in the Journal of Clinical Psychology reviewed the published research on bibliotherapy and concluded that it could successfully treat depression, mild alcohol abuse and anxiety disorders, but was less effective with smoking addiction and severe alcohol abuse.

Most research suggests that bibliotherapy is most effective when used in conjunction with conventional therapy or while waiting for conventional therapy to begin.

Move to relax watch on killer terrifies family’s survivors

Move to relax watch on killer terrifies family’s survivors
State hospital – Officials ask to send a convicted murderer to a small Pendleton facility
Oregon State Hospital
Tyler Smith still is haunted by the day 10 years ago when his uncle stabbed him five times during a rampage through his grandfather’s home in Beavercreek.

Smith, now 24, cringes when he remembers dialing 9-1-1 and reporting that his uncle already had killed his grandfather and was strangling his 10-year-old sister.

When sheriff’s deputies arrived, they pepper-sprayed the out-of-control uncle and shot him three times in the legs before they could subdue him. The last shot blew off his lower left leg; still he hopped into the bathroom, where deputies finally pulled him from the tub, grunting, screaming and declaring himself to be Jesus Christ.

In the decade since, Tyler and his 21-year-old sister, Jaime Smith, have recovered, burying their fears as they made lives for themselves.

Now, both are reliving their terror as Oregon State Hospital officials want to transfer their uncle, convicted murderer Christopher Darrell Persyn, 36, to a smaller, secure residential facility about to open in Pendleton.

Both say Persyn should remain under the highest levels of supervision and care.

“I love my uncle,” said Tyler Smith, who was in a wheelchair for two years following the attack. “But I don’t trust him any farther than I could throw him under water. I already live in pain. I don’t want to live in fear, too.”

Jaime Smith said her uncle’s personal safety also could be at risk.

“He has a mental disease and can’t take care of himself,” she said. “He needs to be in Salem, where he can be taken care of.”

When deputies arrived at the home on Forest Park Road on June 3, 1998, they confronted a scene of horror.

They found 64-year-old Darrell Mitford Persyn already dead, lying in a pool of blood.

Thirteen-year-old Tyler was passed out on the floor from loss of blood. He was rushed by helicopter to OHSU Hospital, but suffered brain damage from lack of oxygen. He was in a coma for 21/2 days.

His sister, Jaime, shaken and bruised, escaped her uncle’s grip only by promising to pray.

“He wouldn’t let go of my neck until I promised to say the Hail Mary — which I did not know — so I made something up,” she said. “That seemed to suffice, at least long enough to get away.”

In the following months, Persyn pleaded guilty-but-insane to killing his father and assaulting his niece and nephew. He was sentenced to a life of supervision under the state Psychiatric Security Review Board and has been living in the Oregon State Hospital in Salem.

Hospital officials say Persyn has shown sufficient progress that he no longer needs daily psychiatric supervision. They have filed a motion to have Persyn transferred to Pendleton House, a 16-client residential facility expected to open around Jan. 1.

The motion will be heard Monday by a three-member panel of the five-member review board.

Mary Clare Buckley, the review board’s executive director, said the panel’s decision will be made on a preponderance of evidence and must be unanimous, or it will be referred to the entire board.

Buckley said the new facility will be secure, with more than 30 staff members. The main difference is that psychiatric care and evaluation will be more limited.

“The hospital staff believes the Pendleton House probably will be a more calming and therapeutic environment,” Buckley said.

Prosecutors and police are against the move.

Gregory D. Horner, Clackamas County chief deputy district attorney, said Persyn belongs under maximum supervision.

“We don’t believe that the proposed state-run local facility would provide the necessary level of security,” Horner said.