In Oregon, the path to mandated treatment for severe mental illness has shifted from civil commitment to the criminal justice system. This has led to a decline in civil commitments and an increase in the proportion of beds occupied by criminal patients in state psychiatric hospitals. As a result, long-term mental health care is often only available to those who have committed a serious crime, leaving those with acute mental illness cycling in and out of ill-equipped community-based options. Advocates argue that this system waits for individuals to commit a crime before providing treatment, and that care should not be predicated on the idea that there must be a victim.