Family of murder victim says notification of his release from psychiatric ward might have saved him

The murder of a mentally ill man two days after he was released without notice from Rogue Valley Medical Center’s psychiatric ward raises questions about hospital protocol — and compassion, Jay Safley’s family members said this week.

"I’ll use the word, if nobody else will: They dumped him," said Larry Safley, brother of the 45-year-old Central Point man found stabbed to death early Sunday in a Medford alley.

"They slipped him out as soon as they could. They knew he had nowhere to go and no money. And they also knew he was not stable."

Gary Safley, a longtime Medford pediatrician and Jay Safley’s father, said the situation is an indictment of a local system that abandons the mentally ill and excludes their families from helping.

"To us, it was clearly preventable," he said.

Advertisement

A psychiatrist on RVMC’s 2 North unit said Jay Safley, who suffered from bipolar disorder, was "absolutely not psychotic" when he was released on Sept. 9.

Like all discharged patients, Safley was given a detailed plan for future care, which was not followed, said Dr. Richard Phillips, medical director of psychiatry.

Federal privacy laws prevented hospital staff from notifying family members of Safley’s release without his permission, Phillips said.

He suggested that Safley’s death was the culmination of years of mental illness and addiction.

"You can pass on a blind curve, repeatedly, but eventually there will be an 18-wheeler on the other side," he said. "People have risky behaviors as the result of mental disorders."

A Jackson County grand jury this week indicted Anthony J. Clubb on a single count of murder in connection with Safley’s death, said Beth Heckert, the county’s chief deputy district attorney.

Clubb, 44, a homeless man, also struggles with mental illness, Heckert said. He spent time at the 2 North unit with Safley, family members said.

Clubb is accused of stabbing Safley Sept. 11 after an early-morning dispute.

Safley’s mother, Judy Safley, said a 2 North staff psychiatrist promised on Sept. 6 that Jay Safley would not be released without notification.

When contacted on the afternoon of Sept. 9, however, RVMC staff members said Jay Safley had been discharged hours earlier. He had no money and nowhere to go, his family said.

"Even if he wanted to call us, he couldn’t have remembered the numbers, he was so cognitively impaired," she said. "We didn’t even know where to begin to look for him."

At 6 a.m. Sept. 11, police officers arrived at the Safleys’ home to say their son was dead.

The Safleys and other family members of mentally ill people say the murder illustrates severe flaws in the local acute psychiatric care system.

"I understand bureaucracy, I understand overworked people, I understand human error," Judy Safley said. "I do not understand human indifference."

Pat Acklin, an Ashland woman with a mentally ill family member, echoed charges that patients incapable of caring for themselves are released from 2 North with scant provisions.

"You don’t hand somebody who was psychotic five days ago a piece of paper that says ‘Go to this appointment,’" she said.

Members of both families said officials "hide" behind federal privacy laws — specifically the Health Insurance Portability and Accountability Act, known as HIPAA — depriving clients of needed help.

"It’s happening to people who have no voice," Judy Safley said.

Officials with RVMC and the Jackson County Mental Health Department counter that they’re bound by laws that protect the civil liberties of everyone, including the mentally ill.

Generally, people cannot be held unless they’re an imminent danger to themselves or others, said Hank Collins, county health director.

"There are a number of people who run through this vicious cycle of becoming psychotic to the point of needing us to help them," he said. "Then they’re released and we watch them and they eventually are able to meet the commitment criteria again."

Oregon law allows a person to be held for up to five days without a commitment hearing, or up to 14 days on a psychiatric diversion, if necessary, said David Eisenhaure, county senior mental health investigator.

By all accounts, Jay Safley cycled in and out of the Medford Gospel Mission and 2 North, trying to cope with mental illness, medication and addiction. He had suffered from bipolar disorder since early childhood, although he wasn’t formally diagnosed until several years ago, family members said.

Relatives were unable to care for him at home, despite years of effort and expense, Larry Safley said.

"You just simply couldn’t have him around. You had to put your knives up, you didn’t know what he was going to do."

It’s the role of a compassionate society to care for its most vulnerable members, relatives contend. Gary and Judy Safley have a developmentally disabled daughter who lives in a local group home. They said the contrast between resources for her and resources for their son are dismaying.

"My criticism would be of all of us, of society, and the way we think of mental illness," Gary Safley said. "And once addictions become an issue, we are negative in our treatment."

Jay Safley recently had received care in one of some 80 county foster homes for mentally ill people, but his time there ran out.

That put him back in 2 North, family members said.

Limited bed space contributes to pressure to release patients from the psychiatric unit as soon as they’re stable, Phillips and Eisenhaure agreed.

In the past six months, 399 patients have been admitted to the unit with an average stay of seven days, according to RVMC records. Many clients stay one to two days, while others remain for up to two months.

During that same period, between 35 and 40 mentally ill people were diverted to other Oregon psychiatric hospitals because no beds were available here, Eisenhaure said. Patients are trucked in a secure van, sometimes caged or in restraints.

"They go to Benton County, Coos County, Linn County, wherever there’s a bed," he said.

In the last three years, the number of beds at 2 North has been cut from 25 to 18. Statewide, more than 100 psychiatric spaces have been lost in the same period, Phillips noted.

"We used to be able to keep people longer and there was funding by taxpayers for care of patients," said Phillips, who has practiced medicine in Oregon for 45 years. "Neither is true now."

Budget cuts trimmed mental health services for people receiving benefits from the Oregon Health Plan. That has boosted RVMC’s uncompensated cost for mental health care to between $2.5 million and $3 million annually, records showed.

It hasn’t slowed the flood of clients, however.

"We run full," Phillips said.

The Safley family acknowledged the constraints of space and funding. Still, Judy Safley can’t understand why no one called to say her son was being released.

In fact, he was scheduled for intensive testing this week to more fully determine the extent of his illness.

Jay Safley gave a psychiatrist verbal authorization to release information to his brother and his parents, relatives said.

"I heard him say it on the phone," his mother said. "It’s not a case of expecting miracles. It’s a case of expecting every human being to remain safe."

Phillips said it was "insulting" to suggest that his staff members would release clients without proper screening or compassion.

Some clients, including Jay Safley, are admitted to psychiatric care so frequently they become well-known, he said.

"Jay Safley was beloved by every staff member on this unit," Phillips said. "RVMC bent over backwards for Jay. We went beyond the last mile."

But for the family of the gentle man who earned a law degree and liked to fish, that wasn’t enough. And the Safleys fear that Jay’s fate will be shared by others.

"It is an indictment of the system, maybe," said Judy Safley. "There are hundreds of families in our community suffering the pain of insufficient resources."

Reach reporter JoNel Aleccia at 776-4465, or e-mail jaleccia@mailtribune.com.