Oregon's mental health system fails all of us
Resistance to coercion as a tool for maintaining public order brings predictable results
In a previous column, I examined the failures in the police response to the Jonathan Grall case and the Portland Police Bureau’s neglect to meaningfully address those mistakes. Even more alarming, however, are the failures of Oregon’s mental health system—and the uncomfortable reality that, despite glowing headlines, state policy choices are making future tragedies more likely, not less.
In her reporting on the Grall case, reporter Maxine Bernstein of The Oregonian shared a parent’s praise for the loosening civil commitment standards from legislation signed by Gov. Tina Kotek last year. Even more recently, the paper praised the state’s “slow but steady progress” in expanding treatment capacity while warning that federal policies and economic circumstances could put that progress at risk. https://www.oregonlive.com/politics/2026/01/oregons-slow-but-steady-progress-adding-substance-use-treatment-beds-is-at-risk.html
That optimism is misplaced.
While policies of the Trump Administration are poor, Oregon’s most serious failures are self-inflicted and homegrown. The changes being celebrated amount to fool’s gold for two fundamental reasons.
First, Oregon refuses to expand the number of secure, in-custody mental health beds—beds where people can be detained and required to undergo treatment when they pose a danger to themselves or others. Those beds are chronically full. Expanding civil commitment standards without expanding secure in-custody capacity is not reform; it is performative politics.
That shortage is not accidental. When Oregon built its current state hospital more than a decade ago, policymakers deliberately limited the number of secure in-custody beds. That decision has never been meaningfully reported or revisited. This remains true despite an Oregon Health Authority study—ordered by Kotek herself and released two years ago—concluding that Oregon needs nearly 3,000 additional behavioral health beds, including a substantial number of additional secure, in-custody beds. https://www.oregon.gov/oha/HSD/AMH/DataReports/Behavioral-Health-Residential-Facility-Study-June-2024.pdf
At the time it was released, legislators and mental health officials praised the study. Since then, the state has added some residential and treatment beds. The report made clear, however, that the state needed many more secure in-custody treatment beds. That omission is not a technical oversight; it is a policy choice. And it renders claims of “progress” deeply misleading.
Second, the same legislation that expanded civil commitment standards also imposed new restrictions on detaining mentally ill individuals who commit crimes. Sections 43 through 53 of House Bill 2005 (2025) https://olis.oregonlegislature.gov/liz/2025R1/Downloads/MeasureDocument/HB2005/C-Engrossed place strict time limits on how long defendants who are unable to aid and assist in their defense may be held in criminal justice facilities—even where those facilities can provide appropriate mental health treatment.
The real-world consequence of all this is obvious and predictable: More mentally ill individuals who have committed crimes, including violent crimes, will be released back into the community. The civil commitment system will not be able to absorb them because the Oregon State Hospital will remain full. Police will be left cycling the same people through repeated encounters until, as in the Grall case, someone is killed.
This raises a blunt question: Why are state leaders not taking the needed action?
The answer lies in a political reality that is rarely acknowledged publicly. Oregon’s governing class is hostile to coercion as a tool for maintaining public order—even when the alternative is preventable violence. And much of the state’s media doesn’t seem to recognize it.
The pattern is unmistakable:
Repealing mandatory sentences for violent juvenile offenders;
Cutting in-custody sentences under a repeat property offender measure passed by Oregon voters;
Sharply constraining police responses to violent riots;
Enacting statutes that codified now-discarded federal court limits on criminal enforcement of public camping.
These are not isolated decisions. I could go on. They reflect a coherent ideological preference—and one with consequences.
Much of the governing class does recognize that the days when it could pardon violent criminals at will, cut funding for the police openly, advocate for the non-prosecution of certain crimes and so forth are over. However, as with some governing classes that are overthrown, it has adopted insurgency tactics even though it is still in power: Public defenders are permitted to determine their own caseloads, and certain crimes can’t be prosecuted as a result, re-criminalized drug crimes are “deflected” to facilities with no consequences for the failure to participate. And so it is with the mental health system.
In a democracy, elected leaders are entitled to make these choices. What they are not entitled to do is obscure their true goals or evade responsibility when these choices produce predictable harm. And they are not entitled to hide their motives and intentions.
There will be more Jonathan Grall cases as a direct result of these policies and more deaths like Jonathan Bennett, the innocent pedestrian whom Grall stabbed to death under the delusion that he was a threat. Police will again be blamed for outcomes in which they should not have to be the last line of defense. This is the future unless Oregonians demand otherwise.
 | A guest post by
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From your lips to God's ears . . .
This won't change until the progressive stranglehold on state government (and on county and local government in the Portland metro area) is broken. Where are the centrist candidates?
What an opportunity for nuance on accountability. As an ex-con, recovered heroin addict, long term resident of Portland's central city and fellow retiree, Norm and I agree on much related to mental illness. Last night, I asked for PSR to be sent to help a black man lying on the sidewalk screaming "help me". with his belongings scattered around him. I engaged with him, and he asked for an ambulance, telling me he was suicidal. He showed me his wrist, which he hold me he had cut. There were a few drops of blood on the sidewalk, but I could see his cuts were superficial but I called 911, just in case. After about five minutes of questioning, the dispatcher sent PPB (3) and an ambulance because I did not watch him cut his wrists, even though I assured her he was not violent and needed an assessment first.
Norm is absolutely correct about the lack of resources, but it is also the lack us using the limited resources we do have. Living where I do, it is a rare day when I don't witness at least on encounter like last night, but usually during the day and someone has already called for help. If not, I will. Last night there were others around, but this has become so normalized at night, than none that I talked to had already called. The dispatcher protocol is very unhelpful and requires a long list of often repeated questions and a complete lack of the situational awareness of the caller. As a result, the wrong people are often the first responders and the first responders are taken away from much more urgent duties. The Ambulances are transporting those they don't need to to Emergency rooms that can do little to help while at the same time damaging the efficiency of our health care and public safety system. If we are going to fund Portland Street Response, use them. I have several observations coming out of my four years as an advocate for behavioral health treatment.
Treatment for addiction and mental health often needs to be "jump started" against the will of the addict or the person with mental illness. This does not necessarily need to involve jail, prison or even Police. It can be a civil commitment, not to warehouse, but the assess, plan and start an individualized treatment process.
Where a violent crime or serious property or sex/bias or drug distribution crime is involved, punishment should be a consideration with treatment. The emphasis on punishment should relate to the seriousness of the crime.
Prison is not conducive to "rehabilitation". The longer the term and the harder the prison environment, the more likely rehabilitation will be unsuccessful. You just harden and institutionalize the individual. Prison is also expensive, which is why there was a bipartisan effort to get away from the "three strikes" rule. Punishment is expensive. I was sentenced to 2-10 years for possession. I served two in a medium security where I was housed in a dorm with 20 other inmates. We had high fences with barbed wire and gun towers, but no gangs and overt racial animosities. That would earn you a trip to maximum security. After two years I received a one year parole date and was sent to fight wildfires in one of California's many fire camps, run by the Department of Corrections but in coordination with CalFire. In the winter we "raked the forest" (limbed up trees within 200 feet of roadways and cleaned the understory). Sound familiar? There were no fences. Just bed checks. Those that "escaped" went back to maxumum security with years tacked on. All of us had parole dates and were earning a little money and learning a job skill that is even more critical today in all three West Coast states.
Oregon and Multnomah County have systematically set up a system of laws, advisory groups, behavioral health staff and guiding principles that are explicitly anti-prosecution, jail, prison or anything that smacks of coercion or "accountability" for behavioral health illness and crimes related to it. This is especially true for those who identify as LGBTQ+ or minority racial or ethnic groups. Attention to this is appropriate due to discrimination. I have witnessed this process play out under both Brown and Kotek, Hardesty and Schmidt and Kafoury and Pederson. It is reflected in the empty beds at Inverness "jail", the lack of adequate Public Defenders, the quick release of addicts arrested for open use and the County's deflection system. It is visible in my conversations with City and County staff. But, speaking as a recovered addict some coercion and accountability is useful, often essential for recovery irrespective of race, ethnicity, sexual orientation or gender identification. It just has to be aimed at recovery of the individual. As a white man, the best I can be is a "recovering racist", but I try to treat everyone with the respect they deserve. I understand addiction, and that is what we are trying to treat.
We need to recognize that it is the people of the state, City and County who fund and use the services. We are a progressive state with a tax structure to match. No consumption tax like Washington and California. AI says (It makes mistakes) that nationally 60% are net consumers of taxes (receive in benefits more than they pay in taxes) and 40% are net payers. A progressive tax structure is beneficial in creating more equity among people, but it also depends on how efficiently we use the money net payers provide to solve the problems of the state. I do not believe net payers would be moving out of our state if we were efficiently solving the three issues that the people want; reduction in homelessness, job creation (and population growth) and public safety. Behavioral health is an integral part of each. To me, it is obvious that unless we can agree to efficiently solve the problems the net payers want to address, we will have declining revenues to solve any problem.