A federal judge has found Oregon’s state health agency in contempt of a court order that requires severely mentally ill detainees be swiftly admitted to the state psychiatric hospital.
Starting Saturday, U.S. District Judge Adrienne Nelson will begin calculating a fine of $500 per person, per day for each individual ordered into the care of the Oregon State Hospital left waiting in local jail for more than a week.
The average waiting period for individuals admitted in April 2025 was 20.7 days, according to Nelson’s order. In recent years, at least two mentally ill detainees have died of starvation in Oregon jails while waiting for mental health treatment.
The judge wrote that the delays are a crisis of Oregon’s own making after decades of underinvesting in community care options for mental health. The result, Nelson wrote, is that the criminal justice system has become the only opportunity many have to receive treatment.
“This is simply not what the criminal system was originally intended to do,” she wrote.
In a similar civil rights case, Washington state ultimately paid a $100 million fine for failing to quickly evaluate and treat mentally ill people in jail.
Nelson’s ruling is a blow to the state, which had hoped to avoid costly, punitive damages for violating the constitutional rights of mentally ill people caught up in the criminal justice system.
Amber Shoebridge, a spokesperson for the Oregon Health Authority, which oversees the state hospital, said they’re reviewing the opinion and evaluating next steps.
Disability Rights Oregon, the group that first brought the case in 2002, welcomed the order.
“We’re hopeful swift implementation of the monetary sanctions and remedial measures will kickstart real solutions to fix Oregon’s broken mental health system,” Jake Cornett, executive director and CEO of Disability Rights Oregon, said in a statement.
Nelson’s order also sharply rebuked some of the parties that have participated in the case as friends of the court, or amici. Those include Marion County and a quartet of circuit court judges, which have filed briefs attacking the federal court’s intervention.
They’ve also testified against legislation brought by the Oregon Health Authority meant to help the state resolve the litigation by codifying time limits on stays at the state hospital.
The federal court’s neutral expert has repeatedly said those time limits are best practice and are necessary to ensure flow of patients in and out of the state hospital — and for good stewardship of state funds. It costs roughly $560,000 to treat a single person at the state hospital for a year.
But those limits are controversial. Many district attorneys believe shorter stays at the hospital contribute to recidivism.
“Indeed, the role of many amici in this case has thus far only hindered resolution; these amici seek to be considered ‘friends of the Court’ while actively opposing necessary legislative action and thereby thwarting the Court’s efforts to aid defendants in achieving compliance,“ Nelson wrote in her Friday order.
She did not specifically name the amici she considers unhelpful.
In a separate order, Nelson said all amici must get her approval before filing in the case.
Decades of litigation
Friday’s ruling is the latest development in the lawsuit over the rights of people with symptoms like psychosis or mania who have been arrested but are too unwell to stand trial.
County jails lack the capacity to treat them, and their disruptive behavior means they’re often confined in solitary cells. Metropolitan Public Defender is also a lead plaintiff in the case.
Nelson is the third federal judge in the last 23 years to oversee it.
In 2002, the first federal judge assigned to the case found that leaving mentally ill people in jail with inadequate treatment violated their rights under the U.S. Constitution. He issued a permanent injunction requiring the Oregon State Hospital admit criminal defendants within seven days of a judge ordering treatment for them.
Demand on the state hospital has increased. Since 2018, Oregon has rarely met that seven-day requirement, leading to the case being reopened.
In 2022, U.S. District Court judge Michael Mosman, the second federal judge assigned to the case, imposed limits on stays at the state hospital for criminal defendants undergoing restoration: 90 days for patients charged with misdemeanors, six months for felony charges and a year for violent felonies.
Mosman also imposed new rules designed to limit the use of the hospital for civil commitment, to make beds available more quickly to patients being held in jail. Those intakes are now only for cases where patients had unique medical needs or showed severe aggression.
Those orders have sparked backlash from prosecutors and some circuit court judges, who say they don’t adequately take into account community safety issues. Opponents argue patients discharged from the hospital due to the time limits on treatment are more likely than others to be arrested again later.
After Mosman’s orders, OHA was briefly able to admit defendants from jail to the hospital within seven days, but the state fell out of compliance again last summer.
Judge Nelson took over the case in 2024. She raised the possibility of contempt in a hearing late last year.
Disability Rights Oregon responded by asking Nelson to find the state in contempt and impose fines. At a hearing in March, Disability Rights Oregon attorney Tom Stenson argued that the state health authority was violating the constitutional rights of mentally ill defendants.
Stenson argued that the state had, for years, moved too slowly to fix the central problem dogging the Oregon State Hospital: an underbuilt community mental health treatment system. He also said that a lack of alternative facilities pushes mentally ill people into the criminal justice system in the first place, and makes it harder to transition people ready to be discharged out of the state psychiatric hospital.
OHA “wasted years of mild incremental steps,” he said. “Wait and see is no longer an answer.”
Disability Rights Oregon’s attorneys also argued that the health authority downplayed to state legislators the degree of legal jeopardy the state faces in the case, and had not effectively lobbied for a bill that would impose permanent limits on stays at the hospital.
Attorneys for the state did not dispute that the Oregon Health Authority is out of compliance and has been for much of the past six years. In February, the average wait for admission to the Oregon State Hospital from jail was two weeks, according to state data presented in court.
Instead, the state argued at the trial that it has closely followed the recommendations of a neutral expert appointed in the case four years ago, and is already taking all reasonable steps to address the facility’s capacity issues.
A finding of contempt and fines, they said, could divert focus and funding from that effort.
“That disruption in the system would not lead to compliance faster or more efficiently than allowing the state to continue its work,” said Assistant Attorney General Jill Conbere, during the state’s closing argument in March.
OPB’s Conrad Wilson contributed to this report.
