Coos County, OR. — An Oregon county commissioner is raising concerns that state mental health policies create financial incentives to move people with serious mental illness into the criminal justice system rather than into treatment.
“I want to be clear as I go into this article, which will be critical, that my critiques are not of the line staff, not of the medical professionals, and no one between the ranks of CNA to Doctor,” the commissioner said. “These folks strive every day to make do in a broken system.”
The commissioner emphasized that the criticism is directed at leadership and long-standing policy decisions. “My critiques are of leadership, and some of those being across multiple administrations given the length of Oregon’s ongoing mental health crisis,” he said. “The issues at hand belong to persons of higher decision making authority… But, without the acknowledgement of what’s broken we will struggle to repair it.”
According to the commissioner, state policy has increasingly prioritized cost containment over treatment. “I believe there is a component of policy within Oregon’s mental health system where the deferment of liabilities is overtaking humane policy,” he said.
Citing publicly available data, the commissioner compared the cost of treatment to incarceration. Referencing a 2025 OPB article, he said the average cost of a civil commitment bed is “around $1,777.78 per day,” while an Oregon Department of Corrections fact sheet lists the daily cost of an adult in custody at “$173.88 per day.”
“Running those numbers, a bed in prison versus in care saves the state around $1,603.90 per day per person,” the commissioner said.
He also pointed to how costs are allocated between state and local governments. “The cost to the state only applies under the criminal justice system if the individual commits a crime which yields a sentence exceeding one year,” he said. “If the crime is sentenced at a year or less then the individual is lodged in county jail where the cost is fully borne by the local government.”
Based on those factors, the commissioner concluded, “We can see that the state has a financial incentive to criminalize mental illness.”
He said the approach has produced consequences for the state itself. “As of the start of December, the Oregon State Hospital has paid roughly $1.4 million in contempt fines since June,” he said, attributing the fines to “a lack of capacity to process even those mentally ill who yet need to stand trial.”
The commissioner said this has intensified disputes between the state and counties, particularly over the CFAA agreement. “In this agreement, overflow from the state hospital will become the responsibility of counties,” he said.
He noted that while state officials have said contempt fines cannot be passed on to counties because of a federal ruling, “the other hand of the state is actively appealing that ruling so that it can pass fines along.” He also pointed to contract language changes, saying, “Additionally, the new contract removes, ‘subject to availability of funds.’”
The commissioner said the issue is not new. “While the issue of the state criminalizing mental illness to avoid footing the bill for care is a long-standing one,” he said, “we can see present leadership continuing efforts to do the same.”
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