About Behavioral and Mental Health
Behavioral and mental health disorders affect everyone, regardless of their race, ethnicity, religion, or economic status. In 2025, a nonprofit group called Mental Health America did a survey on people in the United States. The survey found (links to external website) that:
- More than 23% of adults are experiencing a mental illness
- 5.6% percent of people are experiencing a serious mental illness
- Almost 18% of people — more than 46 million —had a substance use disorder (SUD)
- 30% of Oregonians reported having a mental illness — the highest percentage of any state.
When the state needs to be involved with a person’s mental health care, that involvement can happen in several ways.
Civil Commitment
Civil commitment is when a judge requires someone with a mental illness to do mental health treatment. A judge may require civil commitment if the person has hurt themselves or other people, or if they are at risk for doing these things.
The civil commitment process starts with an investigation by a local community mental health provider (CMHP). The CMHP will recommend the person have a hearing in front of a judge if:
- the person is dangerous to themselves or to other people, or
- the person is unable to take care of their own basic needs.
At the hearing, evidence is presented about the person’s mental health, safety concerns, and whether the person is able to take care of their own basic needs. At the end of the hearing, the judge may require the person to be “committed to involuntary care.” The commitment can last up to 180 days and can include being put in the hospital.
Fitness to Proceed/Aid and Assist
If a person is charged with a crime, they have a right to be able to understand the case against them and help their lawyer with their defense. If the person cannot do these things because of their mental illness, a judge may find that they are not able to go forward with the case. This is called “unable to aid and assist.” A judge may order the person to participate in treatment to help them become able to aid and assist. Treatment services may be provided in the community or at the Oregon State Hospital (OSH).
Guilty Except for Insanity
Guilty except for insanity, known as GEI, is a defense against criminal charges. It’s when the person is fit to proceed with their case but experienced a mental illness at the time they committed the crime. If a judge finds that someone is GEI, the Psychiatric Security Review Board (PSRB) is given legal authority over the person. The PSRB decides where the person should be placed based on the facts of the case.
Treatment Courts
Treatment courts are court programs that address the specific needs of groups. Often, these are probation programs after a person has pled guilty to a crime. These courts use a broad team to provide support to participants. They often include more interaction between judges and participants. Treatment courts focus on adult or juvenile drug treatment, mental health, veterans, and family treatment courts.
Tribal Courts
The United States recognizes 574 Tribes as “domestic dependent nations.” Nine of these are located in Oregon. Each Tribe is a unique nation with its own cultures and customs.
Each has a unique relationship with the federal government, the State of Oregon, and the Oregon courts. Oregon has long embraced the government-to-government relations with each of the federally recognized tribes in Oregon.
Each Tribe structures its courts according to its needs and customs.
Below are links to the websites for each of Oregon’s federally recognized Tribes, and here is a link on the general government-to-government relations in Oregon (links to external website).