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THE DAILY ASTORIAN • TUESDAY, JULY 31, 2018
Center: Offers residential treatment and crisis care
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or forced medication if they
become aggressive.
The type of patients who
would most likely qualify
would be people who are sui-
cidal or psychotic and are not
safe at home, but are not vio-
lent enough to trigger care at a
psychiatric hospital.
Baker estimates secure
beds would cost an extra
$200,000 for staff and secu-
rity enhancements. “Are there
enough of those folks to jus-
tify what the increased costs
would be?” she asked.
Alarm
The commitment to have
secure beds at the crisis respite
center grew out of alarm.
Warrenton and Astoria,
alerted by law enforcement
about the risk of potentially
violent patients, demanded
the security improvements
weeks before the respite cen-
ter was expected to open on
Marlin Avenue in April 2016.
Rich Mays, the interim
county manager, brokered
the agreement for four secure
beds with the Caring for Clat-
sop Coalition, the partner-
ship between Clatsop County,
Greater Oregon Behav-
ioral Health Inc., Columbia
Memorial Hospital and Provi-
dence Seaside Hospital on the
respite center.
Administrators at Clatsop
Behavioral Healthcare, who
at the time were under pres-
sure over management and
quality of care issues, reluc-
tantly went along. But top
administrators resigned from
the county mental health
agency before the respite cen-
ter eventually opened that
July, leaving Baker — the
agency’s new director — and
Cameron Moore — the new
county manager — to fulfill
the promise.
“Generally, I would say
I’m satisfied with where we
are with CBH,” Moore said.
“I think we’ve come a tre-
mendously long way from
two years ago.”
After heavy losses and a
bailout, the county and the
other partners in the respite
center made finding a sus-
tainable financial model the
priority.
“There is a timeline and a
plan for when and how we can
get to secure beds, but, again,
we want to make sure we
don’t do that in a way that cre-
ates any financial problems,”
Moore said.
Broken promise
Warrenton Mayor Henry
Balensifer said the respite
center has had some success
in relieving pressure on hospi-
tals and the county jail, but he
sees the lack of secure beds as
a broken promise.
The mayor was upset
after a young woman walked
away from the respite cen-
ter in March and a few days
later was arrested for killing
her dog. Warrenton police had
taken the woman to Columbia
Memorial Hospital in Asto-
ria several times in the days
before the dog’s death, and
her fiance had also appealed
for help.
“The county has failed to
deliver on a promise,” Bal-
ensifer said. “They can dance
around the issue and say, well,
we did or we didn’t, or we
thought we would or what-
ever. I don’t care. Everybody
was on that page.”
District Attorney Josh
Marquis, who has been crit-
ical of the county’s men-
tal health system, has also
pressed for quicker action on
secure beds.
“We certainly had hoped
there would be at least a cou-
ple of ‘secure’ beds but we
are hoping that there will be
soon,” he said in an email.
“We clearly do not have
enough jail space and even
less secure housing for people
with mental issues involved in
criminal behavior that might
not be appropriate for a jail
but still need to be held until
they are medically stabilized.
“We had hoped over a year
ago that when the respite cen-
ter opened we would have
that, but I know Clatsop
Behavioral Health is doing
what they can to meet the cri-
sis needs of the community.
Without an adequate local jail,
this will continue to be a crit-
ical need.”
Balensifer has suggested
the county consider a detox
component at the new jail
proposed for the former
North Coast Youth Correc-
tional Facility in Warrenton.
The mayor — who has not yet
taken a position on the $20
million bond for the jail that
voters will decide in Novem-
ber — said detox could help
with people whose behavioral
problems are more rooted in
drug and alcohol abuse than
mental illness.
Astoria Mayor Arline
LaMear said she is grateful a
new project for the homeless
at a former Uniontown board-
ing house could have a hand-
ful of detox beds.
Columbia
Memorial,
meanwhile, is looking at a
larger room to screen patients
in mental health crisis as part
of a $4 million expansion of
the emergency department in
2019. The room could be in a
quieter part of the emergency
department than the small
multipurpose room the hospi-
tal uses now, and could have
some security.
“Even though we don’t pro-
vide psychiatric services here,
still we know that patients are
going to come here needing
help,” said Trece Gurrad, the
hospital’s vice president of
patient care services.
Episodes
Many of the people Clat-
sop Behavioral Healthcare
and police encounter have
drug or alcohol problems that
can influence mental health.
The county’s lack of detox
and substance-abuse treat-
ment options for people on
the Oregon Health Plan — the
state’s version of Medicaid —
can place burdens on the cri-
sis respite center, hospitals
and the jail.
“Alcohol and drugs are a
fantastically effective way of
dealing with emotional pain
and hopelessness, but they
also have a horrible impact on
one’s mental health,” Baker
said.
Baker and others under-
stand that police often get
frustrated when they have to
repeatedly respond to emer-
gency calls involving a person
who appears to be in mental
health crisis, yet gets released
from the hospital or walks
away from the respite center.
“If the police were just
going to drop somebody off, I
can’t hold on to them if there
is a possibility that it’s sub-
stances that are fueling their
crisis,” Baker said. “I can’t
take away their civil liberties
based on substance use.”
The respite center, which
is financed by Medicaid, may
be preventing some of the epi-
sodes that used to routinely
play out in hospital emer-
gency rooms.
At Columbia Memorial,
behavioral health visits were
down 23 percent last year,
according to Gurrad, while the
average length of stay fell by
17 percent. The hospital also
saw a decline in the number
of behavioral health patients
who transferred to a higher
level of psychiatric care.
Baker is lifted by some of
the respite center’s individual
successes — getting people
in crisis back on their medi-
cations, into their own apart-
ments, or stable enough to
hold jobs.
“Is it completely serv-
ing the needs of the system?
I would say there’s a question
mark there,” she said. “Are
we serving people really well
and getting good outcomes
with our clients? Yeah, that
we’re doing.”
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