Oregon State Hospital lacks enough beds to serve the people who need them, a Marion County grand jury concluded after a six-month investigation into the Salem psychiatric facility.
The grand jury released its 19 findings on Wednesday, Sept. 30, capping an inquiry that District Attorney Paige Clarkson convened in March under Oregon Revised Statute 132.440. Jurors held 13 sessions, heard more than 47 hours of testimony from approximately 40 witnesses and toured the hospital campus, according to KYKN.
The findings cover patient experience, safety, staffing and leadership, the hospital's patient population, the use of seclusion and what the grand jury called an overall "conflict of purpose" at the 600-patient facility.
At the center of the report: the hospital cannot simultaneously meet the needs of Oregonians requiring hospitalization for competency restoration, those committed after being found guilty except for insanity, and those committed under civil commitment laws.
"The hospital continues to fall short in its crucial obligation to our communities and our most vulnerable Oregonians," Clarkson said in a statement accompanying the report. She called for increased capacity, improved staff safety, a stronger focus on civil commitment over criminal justice involvement, and "dependable leadership that creates a culture where this is all possible."
Witnesses included current and former hospital employees, medical providers, hospital management, union representatives, forensic evaluators, a former patient, a patient's mother, Marion County Sheriff's Office personnel, a circuit court judge and community partners, according to the Marion County DA's Office.
Senior Deputy District Attorney David Wilson, Deputy District Attorney Evelyn Centeno and specially deputized Washington County Deputy District Attorney Joel Peterson oversaw the proceedings. Wilson handles Oregon State Hospital prosecutions for Marion County. Centeno serves as the county's behavioral health prosecutor.
No response from Oregon State Hospital or the Oregon Health Authority to the grand jury's findings appeared in public records as of Sept. 30.
The report follows a series of leadership changes at the hospital. The Oregon Health Authority removed newly hired Superintendent Sean Murphy in August after roughly one month on the job.
Jim Diegel resumed the interim superintendent role, and OHA said in an Aug. 12 statement it would restart its search for a permanent leader. The hospital has cycled through top administrators since 2020.
On Sept. 23, OregonLive reported that an anonymous nurse sent a seven-page letter to OHA Interim Director Fariborz Pakseresht accusing hospital leaders of fostering a culture of silence and retaliation.
More than 25 current and former employees told OregonLive that concerns about retaliation persist. The hospital was out of compliance with federal quality standards and at risk of losing Medicaid and Medicare funding for stretches of 2022, 2023 and 2024, OregonLive reported.
The Marion County DA's Office conducted a similar grand jury inquiry into MacLaren Youth Correctional Facility in Woodburn in 2025.
Clarkson, who is not seeking reelection, said she hopes the findings will guide state leaders and lawmakers as they shape policy. The full report is available on the Marion County DA's Office website. No legislative hearing or formal deadline for action on the findings has been announced.
