Update: Multnomah County Walk-in Center for SUD and MH

This is an excerpt from an article titled “Multnomah County hopes to create alternative to jail, ERs for mentally ill homeless people” originally published on Oregon Live by Molly Harbarger on 6/10/2019. See the full story here.

Photo courtesy of Motoya Nakamura.

Photo courtesy of Motoya Nakamura.

Homeless people have no place to go that isn’t a clinic, emergency room or jail.

[Multnomah County leaders] want to turn the Bushong & Co. building at 333 S.W. Park Ave. into a walk-in center for the thousands of people in the county who are on the streets and struggling with mental illness and addiction.

County elected and health officials envision a place where people could do laundry, take a shower, use the computer, charge a phone and access mental health services. They also intend to include transitional housing there for people who need somewhere to stabilize their mental health.

The plan will likely take more than a year to realize – not only to design the center but to coordinate with Portland police, health agencies and other crucial players to make it work.

“If you’re at a point where you don’t know where to turn, don’t have a place to go, experiencing mental health issues, you’re living on the street, where right now can you go?” said Commissioner Sharon Meieran, a former emergency room doctor who spearheaded a review of the mental health system that called for more peer-run services and other changes.

“There literally is nowhere,” Meieran said. “You can go to the library.”

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The empty Bushong warehouse is essentially a shell that county workers are assessing with the help of business groups, mental health advocates and others to see if renovations are possible or if it must be torn down and replaced.

…But Multnomah County Chair Deborah Kafoury said the spot and space allow the county to forge something to suit people’s needs instead of trying to retrofit an old office building that doesn’t have enough bathrooms or other crucial amenities.

The final price tag will depend on the design and is expected to be a money-saver in the long-term, county officials said, because it could reduce the number of homeless people in the Oregon State Hospital or jail-- both considered the most expensive places to house people on the streets.

“Having a shell allows us to be creative,” Kafoury said. “This has the potential to make a real strong impact not only on the downtown community but the lives of people who are suffering on the streets.”

The walk-in center’s housing will account for some of the planned beds lost when the county terminated a lease it signed in 2017 with Budget Lodge in Southwest Portland. The county had intended to use the hotel’s 22 single-occupancy rooms for people with mental health or addiction issues but found extensive problems that could pose health risks for anyone staying there.

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County officials expect the walk-in center to take some of the people discharged from the Unity Center for Behavioral Health who are homeless – about a quarter of the center’s patient load.

Many Unity patients shouldn’t be there to begin with, advocates say, but it’s a better alternative to jail or emergency rooms. Unity became the city’s answer to a federal settlement that required the area provide place for people in mental distress to go.

Four Portland hospital systems consolidated their separate mental health facilities into one center that allows people to walk in. But the doors lock behind anyone who admits themselves, which officials now say misses the spirit of the kind of facility Portland needs.

“We really need an environment that doesn’t seem clinical or medical,” said Neal Rotman, who runs the county’s community mental health program.

Rotman has pushed for funding for a walk-in center like this for years. The nonprofit Cascadia Behavioral Health runs a walk-in clinic on Southeast Division, but Rotman said it doesn’t serve a demographic drawn to downtown who might not be ready to see a doctor yet.

The proposed center would allow visitors to choose how much engagement they want. If they just want to use the computer and socialize for a few hours, that’s fine.

But supporters hope the center’s staff members, who are intended to all be people who have dealt with mental health troubles, addiction or homelessness, would build relationships with visitors over time and help connect them to services.

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Portland has few, if any, peer-run mental health services -- a need identified in an third-party overview of the county’s mental health system last year.

Janie Gullickson, now executive director of the Mental Health & Addiction Association of Oregon, said she spurned clinics and places with new furniture and mental health professionals when she was homeless. She didn’t feel welcome, she said.

“I bounced from the street to emergency departments to a lot of psychiatric wards to jail to eventually prison. I did that whole cycle for years,” Gullickson said.

Gullickson’s association provides peer services and is part of a committee to help shape what goes into what’s being called Behavioral Health Resource Center.

She wants a place for people to go that isn’t the same criminal justice revolving door that she experienced. Visitors can work with people who have vetted the services themselves, she said, and make steps toward recovery and housing, even if those steps are small and slow.

“That’s a position that puts them in the driver's seat and in more control of the situation,” Gullickson said. “That’s empowering, instead of continuing to run until the cops catch you.”

Kaity McCraw