The descriptive epidemiology of unnatural deaths in Oregon's state institutions: a 25-year (1963-1987) study. IV. The reduction of unnatural death rates during 1988-1992 in three facilities as a result of planned changes.

This paper documents the most recent five-year (1988-1992) analysis of unnatural deaths in Oregon's state mental and correctional institutions. The current findings are compared with those of the preceding five years (1983-1987) within the context of the long term trend in unnatural death rates for the previous 25 years. The unnatural death rates for the institutional clients are also compared with those for the noninstitutionalized citizens of Marion County, Oregon. There are two major findings in these 1988-1992 data: (a) There have been highly significant reductions in unnatural death rates in Oregon State Hospital and in the Forensic Psychiatric Program, which the authors believe are largely due to the implementation of planned changes to reduce the previously very high suicide rates in these two facilities; and (b) There was a dramatic reduction (to zero) of unnatural deaths at the Fairview Training Center. The authors also believe that this was attainable mostly because of large-scale improvements made at that facility, by the Department of Human Resources and the Oregon Legislature, just before and during the present study time frame. Changes in these three facilities which led to the improvement in unnatural death rates of clients are discussed.