Robbins believes there is safety in numbers, but that extra workers can also trigger anxiety in patients.
"If you have too many people show up, it can feel crowded and threatening, and you may actually precipitate violence," he said. "On the other hand, there are safety reasons you may want to have two or three people along. You have to think through the pluses and minuses."
More than 400 of the 615 people currently under Oregon's Psychiatric Security Review Board jurisdiction live in the community, according to the board. And since 1978, only 2 percent of the more than 1,400 people found guilty by reason of insanity supervised by the board have committed crimes again.
"You would think if someone committed a crime because they were psychotic, that once the psychosis is treated they shouldn't have to spend their life in a facility," said Collins. "At some point, it would make sense that conditional release be considered, assuming there's a way to make sure they stay on treatment that's working."