HILLSBORO – The state official who oversees Oregon’s public psychiatric hospital said Wednesday the facility has become “the world’s most expensive homeless shelter.”

His remarks came in the context of a court hearing raising hard questions about ways the state manages resources to help those suffering from mental illness.

About 60 percent of defendants admitted to the state mental hospital in Salem were homeless prior to their arrest, Patrick Allen, the Oregon Health Authority director, said in court testimony Wednesday. Those defendants were sent to the Oregon State Hospital to get treatment for the illnesses that prevent them from aiding in their defense at trial.

That figure, apparently disclosed publicly for the first time during Allen’s testimony, underscores the ties between Oregon’s homelessness, drug addiction and mental health crises and the increasing number of mentally ill defendants winding through the state’s courts, jails and psychiatric hospital.

“Homelessness is the big defining piece of this,” Allen told The Oregonian/OregonLive following his testimony. “That’s what’s driving this crisis.”

Treatment at the state hospital costs $1,324 per day for each patient.

“We’re paying for the world’s most expensive homeless shelter,” Allen said.

He gave testimony in an unprecedented Washington County Circuit Court hearing on whether the Oregon Health Authority should be held in contempt for violating court orders to treat or assess four defendants, three of whom are still held in the Washington County Jail.

The orders, issued by Judge D. Charles Bailey, were not followed within the judge’s seven-day deadline. Those deadlines are based on a 16-year-old federal court ruling requiring the hospital quickly admit defendants to avoid unnecessarily long stays in jail.

An investigation published in February by The Oregonian/OregonLive found the state frequently violates the deadlines, leaving defendants to languish in jail in violation of their constitutional rights.

In a hearing earlier this month, attorneys for the state said officials have “no solution” for the violations.

[Read our investigation: Mentally ill languish in Oregon jails, in breach of federal court order]

Allen and Derek Wehr, the state hospital’s deputy superintendent, testified Wednesday that hospital managers want to admit all defendants quickly, but cannot because the facility is at capacity. It currently is treating 516 patients, 264 of them there to be readied for trial; 53 defendants are on an entry waitlist.

Two assistant attorneys general argued on behalf of the state that although Bailey’s orders had not been followed, the violations were not “willful,” so a contempt finding was inappropriate.

Attorneys for the four defendants, led by Amanda Thibeault, argued that the state’s lack of funding for bed space was no excuse to violate defendants’ rights. The state has known for many years that it must provide beds for all defendants ordered to the state hospital, Thibeault argued, and had in fact chosen not to prioritize its funds to make those beds available.

Bailey did not make a ruling Wednesday and said it may take him several weeks to issue one.

After the hearing, Allen told The Oregonian/OregonLive that his agency has scrambled to address the high number of mentally ill defendants but has limited powers. Allen said the Oregon Health Authority has no say over law enforcement decisions to make arrests or file charges, a part of what he characterized as a system that at times criminalizes mental illness.

He said, however, that the Health Authority spends about $15 million annually on community-based treatment programs for defendants in need of trial fitness treatment. That frees up space at the in-patient state hospital, he said.

State spending on stepped-down community-based treatment has increased in recent years, though spending on institutionalized care is much higher. In 2018, the state spent about $110 million on in-patient trial fitness treatment, according to figures provided by the Oregon State Hospital.

-- Gordon R. Friedman

GFriedman@Oregonian.com