Street roots., August 07, 2009, Page 13, Image 13

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Street roots
13
Education * Dialogue * Independence
Compassion, good guidance, the bedrock of new center
BY MICHAEL HOPCROFT
AND JASON RENAUD
C O N T R IB U T IN G C O L U M N IS T S
n July 2 the Multnomah County
Commission voted to fund and build
a new facility to help persons who
are acutely mentally ill.
In 2001, during a generational redesign of
Multnomah County’s mental health system,
a variety of
providers, former
patients, referring
.C O M R fG D P
aKCIKKS:
community
« UK OU(
members, and
■
BAB a n t
The M ental Health
Association o f Portland
The Mental Health
Association o f Portland is a
nonprofit advisory
organization that supports
advocacy efforts on issues
around mental health.
Information about their
work is available atwww.
mentalhealthportland.org '
SX ded
to close a similar
! ■ ■ ■ ■ ■ ■ ■ ■ facility — the Crisis
Triage Center, or
CTC.
The CTC was a 24-hour psychiatric clinic
attached to Providence Hospital, which
planned to provide immediate treatment for
anyone. It specialized in being a third choicé
for police, the first two’being doing nothing
or making an arrest. The CTC started
unpredictably and badly with the tragic
death of Emily Comeaux, a person with
needs beyond the comprehension of the
CTC staff.
Prospective patients, sick and in crisis, •
who were coached , to seek services at the
CTC regularly waited hours before seeinga
clinician. Sick children were kept in the
same waiting room as adult patients. The
costof care was high and rising. Some
patients and clinicians chronically overused
the CTC, clogging the service for others.
Patients were put on psychiatric holds '
unnecessarily, given the wrong medicine, or
complained their concerns were dismissed,
and critical j
M ejia
Poot, Providence Hospital and Multnomah
County, both pointing fingers at each other,
quit the contract and closed the CTC.
A re-design was proposed. The newly
formed Cascadia would operate five walk in
clinics which would be open 24 hours,
staffed with able-bodied clinicians, and
located in all five quadrants of the city.
Anyone could walk in and get help in a few
minutes.The costs would be lower because
the clinics were uncoupled from a hospital.
The clinics opened with much media
fanfare, but within a few weeks, bureaucrats
were thinking of how to save money. If
services could be reduced, costs could be
eû t Cascadia closed one clinic after another,
leaving eventually only one that was not
open 24 hours, and services were only
available to certain people.
The Closure of the CTC added a hard-to- <
measure burden on a variety of services and
individuals which had no coordinated way of
comparing experience and recognizing an
additional set of responsibilities. We’d
estimate the cost of not having this service
is in the tens of millions of dollars per year.
So we applaud that the county leadership
recognizes this new facility-is an important
component of the continuum of county
services.
Naming the facility
The name and how this facility is referred
to. áre extremely important. The facility
should not be called or generally referred to
as the “mental health crisis center” or any
parallel term focusing attention on “illness”
or “crisis” or “assessment” or ’“mental” or
“psychiatric.” Professionals might object,
but they’re not the ones coming for
treatment
We suggest the facility be named after
someone in our community who is both
deceased and would hâve made use of the
facility. Emily-Comeaux woùld be an
excellent choice.
... Peers are important _
I Pe.er outreach workers should staff the
front door o f the facility 24/7. Peers have an
education and orientation to recovery which
is impossible to generate in a professional -
though some professionals aré in recovery
themselves and sòme are good at faking i t
Their value is to act as a human segue, a
intimate problem-solver, a minder, a role
model, a constant conduit And for persons
contemplating the difficult changes required
to gain sanity and sobriety, there is value in
having a relationship with someone who is
not a professional.
There also needs to be an oversight
committee for the new facility that reports
to the county chair. This coihmittee should
be made up entirely of persons who would
be likely users of the facility.
'
Understanding trauma
Just about everything we presumed was <
true about mental illness in 1996, when
Emily Comeaux commited suicide in the
CTC waiting room, we now think is wrong.
In 1996 we looked back at the prior decade
with the same skepticism.
What’s been true forever is compassion is
a good guide. What we have learned in the
past decade is there are a large number of
people who may or may not have mental
illness, but who act like it largely because
they have been traumatized somehow and
that trauma has been ignored or diminished
by their community;
This is from a note Emily Comeaux left
for her daughter:
“Now you listen real close to this. I DID
NOT GIVE UP. I fought with every ounce 6f
strength Thad, you saw me fight, watched the
battle many years. I ’m not gone, you just can’t
talk io me for a while; Baby, I know this is ,
going to hurt real bad but I also know I raised
a fighter with a loud voice to shoutfhat the
system is wrong. I am doing this to help
others.”
We suggest the entire'staff of the agency
that manages the facility, and those who sit
on an oversight committee, or are staff of
the county who provide fiscal or political
oversight, receive training about trauma.
A crisis facility, if properly run and
staffed, is a vital part of the mental health
system. It is our hope that this facility will,
in fact, be done right.
Portland was a place to rest - and renew street activism
BY LEO RHODES
plan to end homelessnes. I’ve also started
homelessness. In addition to the shelters,
to write a book about tent city 4.
SHARKhas two tent cities (I helped start
So after all that, I had come to Portland
one);
a
housing
for
work
program
called
have been in Portland since about the
to rest and visit a friend I hadn’t seen in
first week" of March. I came from Seattle, SHARE H, and storage lockers. :
years. Then I saw all the homeless people
SHARE is self-managed with very little
Wash., where I started my advocacy on
out on the streets and heard about the sit-lie ,
homelessness specifically for shelters and staff. It’s sister organization, WHEEL -
ordinance. I thought to myself, this is crazy.
(Women’s,
Housing,
Equality,
Enhancement,
tent cities. But I have also spoken up for
I had to remind myself that I wasn’t going to
League) is made up of homeless and
other causes dealing with homelessness.
get
involved. I came to Portland to rest.
formerly
homeless
women
dealing
with
In Seattle, December 2001» I was in a
I heard"that they were going to have a
related issues. ,
shelter, under a bridge. The shelter folks
hearing on the sit/lie ordinance. So I
Through my association with SHARE and
were looking for an indoor space. Through
thought I’d go down and check it o u t But
WHEEL in Seattle, I spoke to elected
an ally (Bob “Uncle Bob” Santos), we got a
officials, church congregations, high schools, not get involved, I’ll just show support
space with the Port of Seattle. A billion- -
? When I got to City Hall, there weren’t
grade schools, neighborhoods, radio and
dollar industry gave homeless people space
that
many people there. And even less
television
reporters,
and
so
on.
I
have
for two weeks. When the .two weeks were
signed up to speak. So I signed up. One 7
worked to prevent shelters from being
up, we went to thank the Port of Seattle
closed, and to keep a low-income apartment. thing led to another, and now I’m back in ,
commissioners. Three quarters through my
the fight on homelessness.
complex from beingdemolished.Ispoke on
speech a commissioner motioned that they,
The way I see this fight is that it’s not
behalf
of
SHARE
about
its
indoor
shelters
would give us 30 more days. It was
about fame, it is not about fortune, and it’s ;
and tent cities. I was SHARE’S treasurer. '
unanimous. I thought, “Wow, people are |
not about getting awards? It is about getting
I helped starta Native American indoor
listening.”
the job done, getting the homeless in asafe,
shelter for homeless native Americans
The shelter is called “Safe Haven.” It’s .
secure place. ’
(Chief
Seattle
Club),
worked
with
a
social
one of 14 indoor shelters with an
If you want to read my stories, get ready
organization called SHARE (Seattle Housing justice group called L.E.L.O, trying to get
for a roller coaster ride. If you’re in for the |
low-income and homeless people on a
and Resource Effort). Share is an
construction job, and was one of two
long haul - e-mails, rallies and/or direct
organization homeless and formerly, ,
homeless people on King County’s 10-year
action— well then, let’s make history!
homeless people trying to resolve
£
C O N T R IB U T IN G W R IT E R . ■
I
Leo Rhodes is a street . . .
activist and homeless '
advocate. He is also a
vendor with Street Roots ~
and a regular conributer to
the newspaper. .
embrace [muouj diversity
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