Oregon’s Struggle to Address Mental Illness

By Don MacGillivray

The glowing tributes for Oregon are flawed by a few egregious realities. One is Oregon’s lack of care for the mentally ill. 

According to a recent study by Mental Health America, Oregon rates lowest in the US in its care for the mentally ill. Related to this statistic is that Oregon’s ranks second highest in the number of unsheltered homeless people.

According to the National Research Council & Institute of Medicine, up to one in five children living in the US experiences a mental disorder every year. The American Psychiatric Association says 50 percent of mental illness cases begin by the age of 14 and 75 percent before the age of 24. 

Preventative mental treatment must become a standard part of generalized healthcare at an early age. Allowing a child to “grow out of it” risks worsening their condition.

Local high schools are making mental health an important focus. Teachers are encouraging active learning experiences to improve students’ attitudes and behavior with arts and crafts, exercise, music, and activities that promote wellbeing. Good mental health enables accomplishment and requires a supportive learning environment.

Portland’s elected officials and mental health advocates understand that Portland’s mental health system is woefully inefficient and underfunded for disadvantaged residents. The mentally challenged must receive treatment to avoid having a crisis. Both short term and long term options are needed to manage circumstances independently in appropriate surroundings.

Over the last 50 years, the government has been downsizing mental treatment facilities because care for patients was difficult and outpatient treatments were becoming available. 

In 1995 the Dammasch State Hospital in Wilsonville was closed and then in 2008, the Oregon State Hospital in Salem was evaluated by the US Department of Justice, citing poor living conditions and treatment, among the areas that the hospital needed to remedy. 

Psychiatric treatment could be provided by doctors with outpatient services in the community, thereby saving money while improving outcomes, but funding for these services was not forthcoming and many patients were left without acceptable options.

Mental patients not able to care for themselves often become homeless. A lack of suitable housing only contributes to difficulties. If a crisis occurs, it is the police that are likely responders and this can put a mentally ill person in jail or in the hospital emergency room without getting treatment they need. 

In addition, emergency rooms are the most expensive and least effective places to treat mental illness as they are not equipped with personnel, strategies or resources to handle acute mental health situations. Patients are given short term care and remedial treatment options when long term care is needed.

To deal with this situation in 2013, the police department created five Behavioral Health Unit teams composed of an officer and a mental health clinician who are available 9 am-5 pm on weekdays. 

Even so, police officers are first on the scene and must call for the Behavioral Health Unit teams. They get approximately three referrals a day from patrol officers and assist about 500 people a year.

This year, Portland Street Response was created to be an alternate 911 first responder program. It has been a pilot program in the Lents neighborhood, but is expected to go citywide soon. 

It is organized within the Fire Bureau and they are developing the Community Health Assess & Treat (CHAT) program to provide 911 callers with connection to the right resources for non-emergency health issues.

Currently those in need of immediate mental healthcare can go to the Cascadia Behavioral Healthcare Urgent Walk-in Clinic at 4212 SE Division St. It is home to Project Respond mobile crisis services that are available by calling 503.988.4888.

Portland created the Unity Center for Behavioral Health (UCBH) four years ago to help address the local mental health crisis. It provides care in mental and behavioral health emergencies in an environment designed to focus on getting people good care quickly and effectively. 

The UCBH includes an emergency room for mentally ill patients, a staff of psychiatric providers, nurses, social workers, administrators and over 100 beds for patients with urgent needs. 

The Center was a joint effort between Adventist Health, Kaiser Permanente, Oregon Health & Science University and Legacy Health.

Portland is currently building a facility for those in need to use during recovery, the Behavioral Health and Resource Center, scheduled to open in 2022 to care for patients after leaving a hospital emergency room. 

Multnomah County has approved plans for a new 42 bed mental health center and shelter that will cost $26 million. It will provide space for 60 people suffering from mental illness to recover off the streets and 20 beds for transitional housing. The building is located at 333 SW Park Ave.

The National Alliance of Mental Illness (NAMI) is a national grassroots organization that helps with the education and understanding of the issues around mental wellness. They provide resources, education, training and access to services for the mentally ill and their families. 

Our state chapter, NAMI Oregon, offers a toll-free helpline (not a crisis line) open 9 am-5 pm Monday-Friday, at 800.343.6264 to provide assistance for local callers. 

Additional resources and information are available at namior.org.

Oregon’s Struggle to Address Mental Illness

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