Get Help Now
If you are in need of social services or mental health or addiction treatment services, call the following numbers. Each number connects to a different county social service office, with information specific to that county.
We strongly suggest you do not call 911 in the Portland area for assistance with a mental health crisis unless you are in a life-threatening emergency or are witnessing a crime.
24 hour crisis line: (503) 655-8585
11211 S.E. 82nd Avenue, Clackamas, Oregon – bus #72 & #71
Walk-in: Mon.-Fri., 10 AM – 8 PM and Sat.-Sun. 10 AM – 7 PM
Crisis line: 360-696-9560 or 1-800-626-8137
24-hour crisis line: 503-988-4888 or 1-800-716-9769
Urgent Walk-In Clinic
2415 SE 43rd Avenue, Portland, Oregon – bus #4 Division
Open 7 AM to 10:30 PM, seven days a week
Crisis line: 503-291-9111
Sorry – we do not give clinical, medical or legal advice, or provide any social services. This page was checked for accuracy on April 10, 2012.
Sometimes people with mental illness and addiction get into serious trouble. Sometimes their friends and family members can help.
Too many persons with active mental illness and addiction commit suicide. It is always the right thing to do to intervene. Here’s how to do it.
If a person has means to harm themselves AND a plan to harm themselves, and they have shared the means and the plan with you, they are AT RISK of suicide.
You have an obligation as a friend or family member to make a decision – is their plan to harm themselves serious? Consider two factors. 1. Do they have a history of harming themselves? 2. What’s their answer to the direct question, “are you serious about harming yourself?”
If you determine they are serious about harming themselves, ask them to call the local crisis hotline. If they are unwilling, you make the call.
- Multnomah Mental Health Crisis Line at 503-988-4888 – 24/7
- Clackamas County at 503-655-8585 – 24/7
- Clark County Washington at 360-696-9560 – 24/7
- Washington County at 503-291-9111 – 24/7
Outside of these areas, call your nearest hospital emergency room – they will give you instructions. National hotlines for suicide do not know about local resources and cannot act in an emergency except to call police.
Police officers are untrained to help suicidal people and often end up killing them or escalating panic so they kill themselves. Police are too often unable to differentiate between talk about suicide and threat to themselves, and therefore are a lethal threat to persons in a mental health crisis. Consider not calling them.
Many people with a diagnosis of mental illness have had hard experiences in hospital emergency rooms and may be reluctant or unwilling to return. Often the urge to suicide comes and goes, and is amplified by drugs or alcohol. Here are a set of alternatives and distractions.
- Stay close at all times. Suicidal people rarely hurt others.
- If you think you need help – get help.
- As you’re able, remove any weapon from the room or house. Throw them out a window if you need to.
- Respect them. They’re doing hard work staying alive and they’re probably terrified.
- Feed them protein. Low blood sugar is your enemy.
- Let them listen to their favorite music with headphones.
- Listen to a comedy recording or simple and absorbing audio book. Listen together.
- Let them take a shower – the cooler the better. Ask them to leave the door open. Tell them the truth – you’re scared too.
- Did they take their meds? Do they have a sedative to take? If not and they’re not drunk, try 100 mg of over-the-counter Benadryl – it has a sedating effect and calms agitation common with schizophrenia.
- Be with other people. This can be stressful to a person who is depressed or manic, but can sometimes calm them. Know the 24 hour restaurants in your area, a hotel or hospital lobby, a fire station or even an all-night gas station.
- Take a walk with them. Wander – don’t march. Let them lead. Uphill is better than downhill. Tire them out.
- Let them sleep if they can.
Learn more at the American Foundation for Suicide Prevention. Remember – plan for crisis.
2. Expected Death
Statistics show persons with diagnosis of mental illness die at a significantly younger age than average, by untreated, under-treated and mistreated physical illness, suicide and homicide. Often these deaths are sudden, but not unexpected.
If your friend or family member is actively dying, they are eligible for hospice services through Medicare. Hospice services provide care and comfort through the dying process. Oregon hospice services are excellent, non-judgmental and provide services where the dying person lives. (Jails, prisons and state hospitals have their own hospice service.) You can find a hospice in your area through the Oregon Hospice Association registry, or ask any nurse. Our opinion? Private for profit hospices are as good or better than hospital-based hospices.
If your friend or family member has died an expected and natural death, do not contact the police or coroner. Instead contact a funeral home to pick up the body and their doctor to sign a death certificate. Funeral homes answer the phone at all hours. Leave a message for the doctor with the name and phone number of the funeral home.
If your friend or family member is elderly or ill, consider a gift membership @ $35 a year to the Funeral Consumers Alliance of Oregon. Membership provides a variety of funeral options at the best prices.
If a death has been messy, consider professional cleaners. Here are some local service providers. Homeowners should contact their insurance agent; policies typically cover fire, water and damage. Priority Bio Cleaning, Critical Care BioRecovery, ServiceMaster.
3. Death at the Hand of Others
An unexpected death must be reported to the police. Call 911. Cooperate with the police, coroner and the district attorney’s office.
Sadly death for persons with mental illness sometimes comes at the hands of hospital staff, police officers, jail deputies, prison guards and other institutional representatives. Law enforcement in Oregon does not provide equal justice for these persons and private attorneys can be employed to defend your friend or family member.
Here’s a short list of law firms we’ve worked with or know well by reputation as advocates for persons with mental illness harmed by institutions. Call, make an appointment for a consultation, bring evidence.
- Portland Law Collective – Portland.
- Rosenthal, Greene & Devlin – Portland. Represented the family of James Jahar Perez.
- Creighton & Rose – Portland. Represented the family of James Chasse, Adalberto Flores-Haro and others.
- The Spence Law Firm – Wyoming. Represented the family of Fouad Kaady v Clackamas County
- Larry Peterson & Michael Cox – Washington County. Represents the family of Lukus Glenn.
- Kafoury & McDougal – Portland.
- Marianne Dugan – Eugene.
If you’re contacted by the media about the death or injury of your friend or family member, you are not obligated to speak to them. Instead, ask them to speak to your attorney, or simply excuse yourself and hang up the phone. If you need additional advice about media matters, contact this organization.
If your friend or family member is in jail you can contact the jail for information about their status. Don’t expect the deputy you speak with knows anything more than the rules of the institution and the information on their computer screen. What’s helpful for them to know is what medications your friend or family member takes and the name of their prescribing doctor. The jail can also tell you about bail and court appearances.
Your friend or family member will be represented by a state-funded attorney for their initial hearing. If they’re unable to pay for an attorney a public defender will be assigned their case. It’s a waste of money to get a private attorney in at this point. You can help their public defender by providing your contact information to them.
- Clackamas County Indigent Defense – 503-655-8451
- Multnomah County Metropolitan Public Defender – 503-225-9100
- Washington County Metropolitan Public Defender – 503-726-7900
- Clark County Ann Christian, Indigent Defense Coordinator, at (360) 397-2256 or email@example.com
Jails provide necessary medical treatment, including psychiatric medication. If your friend or family member will be there for a while, contact the jail psychiatric nurse. (There is a MD or DO associated with jails but they do little more than wave their APA card over a stack of weekly prescriptions.) The nurses can improve treatment of your friend or family member by knowing their medical and medication history. Tell them what has worked in the past. Until they know what works, they will typically over-medicate to sedate an agitated person.
About confidentiality. This is a little dance made into systemic and burdensome bureaucracy by lawyers and lawyer-types which is easy to resolve. Ask the jail nurse to present a waiver of confidentiality to your friend or family member with your name on it. If your friend or family member signs it, the nurse can share information about your friend or family member with you. Before this can occur, information can only flow ONE WAY, from you to the nurse (or administrator or deputy). For the most part this is okay. You want them to know your friend or family member’s medical history, whereas it’s not usually essential that you know their immediate status. Each institution has their own, slightly different, waiver of confidentiality. Get your friend or family member to sign it.
DOWNLOAD – The Oregon State Hospital Waiver of Confidentiality, 2012
When persons who are have a diagnosis of mental illness become homeless it’s typically the result of a cascade of problems. Which to solve first? Here are two truths we learned the hard way. 1. There is no one-way to solve homelessness. 2. You may not be able to help.
Homelessness is a political decision made by state legislators, county commissioners, city commissioners, housing bureaucrats and private agency administrators. Confronted, they whimper about budget cuts and decisions of others. At the practical level – they are all useless.
There are significant barriers to getting housing – for anyone. Add mental illness and getting re-housed is almost impossible. The best way to stop an individual’s homelessness is to keep them housed. House cleaners, rent subsidies, respite (sometimes available for agency clients, typically at a cheap hotel), are tools to be used.
You can’t cause someone to be housed if they don’t want to be housed. There are people who, for a variety of seemingly insane reasons, refuse help and housing. It may be out of your control. Here’s what you can do – be patient and don’t give up.
If your friend or family member uses drugs or alcohol, is in the Portland area AND wants to make the effort to be clean and sober and be housed, the best gateway to end homelessness is through Hooper Detox, a program of Central City Concern. Open at 7 AM everyday for new admissions, this inpatient clinic provides comprehensive detoxification from both alcohol and drugs. On day three or four each patient will be offered a meeting with a social worker to talk about ongoing treatments. Hooper is at 1535 North Williams Avenue, under an apartment building called The Madrona. Call 503-238-2067 for more information.
Addiction treatment is mostly unsuccessful for persons who are homeless, or who live with those who use and drink. Some Alcohol and Drug Free Housing is available through agencies like Central City Concern, and Oxford Houses almost always have available beds for clean and sober and engaged in recovery persons who can pay some rent (like $300 a month).
READ – directory of Oregon Oxford Houses from May 2012. Call each house for up to date information.
Many persons with mental illness and opiate addiction are funneled toward methadone maintenance. Persons on methadone are routinely discriminated against – and perhaps for good reason. This ‘harm-reduction model’ (where the harm reduced is the identified patient) in comparison to other abstinance-based treatments is cynical and abusive. Don’t accept it. If you’re friend or family member is already dosing and wants to to quit, we suggest contacting the offices of the following medical doctors and ask about a titration schedule. You’ll have to jump through hoops.
- Rachel Solotaroff, MD – (503) 228-7134
- Tom Welch, M.D. (503) 292-4382
- Nick Gideonse, M.D. (503) 418-3967
- Jeff Young, M.D. (503) 216-2028
- Paul Leung, M.D. OHSU (503) 494-6162
The large community mental health agencies own housing which they rent to clients and have relationships with regional and county public housing agencies, such as the Housing Authority of Portland (which has recently re-branded itself as Home Forward). Resources are extremely limited; some sorts of housing have years-long waiting lists. For the past decade Portland has lost more low-income housing than it has created.
To access housing through a community mental health treatment center, a person must be a client in good standing – engaged in treatment services.
If your friend or family member is estranged from the community mental health system, they’ll likely need a array of coordinated services. Start by calling the largest community mental health clinic in your area. Ask for the housing director. Ask them who their craftiest social worker is. Call that person and pick their brain. This is a friend you need. If you get a dead-end, switch to another agency or even another town. You need a friend who can advise you about what works and what doesn’t work. When you get one, listen to them and send them a nice piece of cake. Black belt social workers all eat cake.
The agencies which have some skill in providing housing include -
- Cascadia Behavioral Healthcare, Jim Hlava is housing director – 503-238-0769
- Central City Concern, Rachael Post is housing director – 503-525-8483
- Lifeworks NW, UNKNOWN is housing director – 503-645-9010
- Luke Dorf, Mona Knapp Interim Executive Director of Services, 503-726-3690
Don’t just accept anything offered. There are a number of buildings run by public agencies which are terrible, humiliating, infested or dangerous, including Innovative Housing’s The Clifford, co-managed by Luke Dorf, the Biltmore, managed by Central City Concern, Pisgah House, managed by Cascadia. Check them out before accepting them. The emergency shelters in Portland are all filled with persons who are drinking and using drugs. Sometimes agencies will offer cheap rooms in ugly downtown hotels such as the Steward Hotel or the Home Hotel. These are pitfalls for persons trying to resolve homelessness. Ask the person offering – would you send one of your family members there to live?
In Portland, the clearest path for a willing person is through the Cascadia Behavioral Healthcare Urgent Walk-in Clinic. They provide mental health services for adults, children, and families; walk-ins welcome. 7 AM -10:00 PM seven days a week at 2415 SE 43rd Avenue – take Bus #4 Division .
Central City Concern’s Old Town Recovery Center provides mental health and primary care services in a fancy new building 33 NW Broadway in downtown Portland. Call 503-228-7134 for an appointment.
The CCC Community Engagement Program works specifically with people who are homeless, have mental illness and a multiplicity of problems to be solved. Call 503-226-4060 for more information. Read more about the CEP program here.
6. Civil Commitment
You can launch a civil commitment investigation by the County of your friend or family member if you feel they are a danger to themselves or others, or if they’re unable to care for themselves. Unarguable evidence of these criteria are important, such as history of mental illness, walking in traffic, verbal or written threats of violence, acts of violence, bizarre behavior, not taking life-sustaining medications. Your initial testimony must be unequivocal. The evidence criteria for a five-day legal hold, or ‘notice of mental illness’ is ‘probable cause’. The evidence criteria for a six-month civil commitment is ‘clear and convincing’.
To launch an investigation, call the Multnomah County Crisis Line at 503-988-4888 and request that Project Respond ‘go out’ and make contact with your friend or family member. Note: if staff of Project Respond are not familiar with your friend or family member already they will have a police escort.
You can also call the County civil commitment investigator’s office for the County your friend or family member is in and ask to start a ‘two-party hold.’ Police can also initiate an investigation. We do not recommend contacting Portland area police directly about persons with mental illness unless there is imminent danger.
- Multnomah County civil commitment office – Bill Osborne, phone 503-988-5464 Ext. 28565 Fax 503-988-3926 firstname.lastname@example.org. More information here.
- Clackamas County civil commitment office – Phone 503-655-8401, 998 Library Court in Oregon City. More information here.
- Washington County civil commitment office – Kendra Henley, Civil Commitment Coordinator 503-846-4736 Fax: 503-846-8287
- Clark County civil commitment office – Vanessa Gaston, Vanessa.Gaston@clark.wa.gov Phone (360) 397-2130 Fax (360) 397-2490. State of Washington makes it’s commitment forms available online here.
Only physicians can write a ‘notice of mental illness’. Agents such as Project Respond, or the police, write a ‘temporary transport hold’ that facilitate a person’s being brought to an hospital emergency room for evaluation, but the receiving emergency room physician decides whether a ‘notice of mental illness’ is warranted. If a two-party hold is written, a county investigator is assigned and has three legal days to decide whether a hearing is warranted.
Persons can also be civilly committed by the medical director of their clinic, a physician at an emergency room, or a police officer. If a person has any history of violence or is relatively unknown to a responsible clinician, it’s likely they will call police to witness the civil hold – especially if the hold takes place in public. Typically when police are brought into a civil commitment situation by a clinician things go smoothly.
Persons are held for a civil commitment hearing at local private hospitals in secure wards. The hospitals with psychiatric wards in the Portland area include St Vincent’s, Good Samaritan, Emanuel, Adventist, Tuality, Meridian Park, Mt. Hood, OHSU, Providence, and the Veteran’s Administration Medical Center.
Your county court clerk can tell you the date, time and place of any scheduled court appearance – including civil commitment hearings. Plan to attend your friend or family member’s hearing. These hearings are brief – often less than two hours – and informal attempt to balance illness, a chronic lack of information, and civil liberties. The court clerk or a jail deputy can point your friend or family member’s attorney. You can talk with them outside of the courtroom about your friend or family member. Their services are provided free, and they are more expert than a privately-paid attorney. The more information they have, the better outcome will occur. You may also want to speak with the assistant district attorney. These attorneys may ask you to testify – for or against your friend or family member. Consider your relationship with your friend or family member will continue beyond this trial and your testimony could impact that relationship for a long time.
If your friend or family member has made a positive connection with a staffer at a community mental health agency this is a good opportunity for them to be useful. Call them and ask them to attend. It’s likely they do not know about the hearing – CMHC staffers are by recruitment and nature incurious, overworked and under-trained. It’s also likely they’ve never attended a civil commitment hearing. Educate them.
READ – Oregon Revised Statue, Chapter 426 — Persons With Mental Illness; Sexually Dangerous Persons. Here’s a slightly easier to read version which is somewhat less offensive.
READ – Mental Commitments: the judicial function – a case perspective, by Arthur LaFrance. This long essay describes LaFrance’s experience as a civil commitment judge in Multnomah County.
The criteria for commitment is proof of a mental disorder AND that as a result of that mental disorder a person is proven to be dangerous to self, dangerous to others, or is unable to care for his or her basic personal needs such as is required for his or her health and safety. If a person is committed they return to the hospital from where they came. Though commitments are for a maximum of six months, it is the decision of the hospital psychiatrist how much of that time is necessary. It isn’t unusual to have folks discharged within a month or two. Most people are not transferred to the state hospital.
If the judge determines your friend or family member is not a danger to themselves or others, they are immediately freed – sometimes in pajamas and without money, keys, a phone, etc.
All civil commitments are reviewed by an administrative judge, typically an attorney hired by the state with little or no training in mental health, every 180 days. Reviews are held in the locked facility; witnesses are the identified patient’s medical providers. The medical director of a facility, acting as the State’s proxy or ‘mental health authority’ can release a person at any time. Typically this decision is based on managed symptoms, safe housing, and engagement with a treatment plan.
Your friend or family member can appeal a civil commitment with the help of an attorney. Here are some suggestions of experienced and successful appellate attorneys.
- Benjamin Haile, Portland Law Collective – 503-228-1889
- Harris Matarazzo, private practice – 503-226-0306
Disability Rights Oregon produces Mental Health Law in Oregon: A Guide for Individuals with Mental Illness. It’s a general orientation to mental health law, and oodles of other obscure ideas, terms and methods.
There are two kinds of hospitals in Oregon, private and public. Most private hospitals have psychiatric wards. The public hospital is the Oregon State Hospital. It has sites in Pendleton, Salem and Portland. Persons may be held at private hospitals, against their will, for a duration pending a civil commitment trial. If they continue to be held after the trial they may stay a duration at the same private hospital or be transferred to a state hospital or a locked facility, such as Telecare in Portland. Neither the identified patient, you, a politician, judge or an outside physician can alter the treatment plan; your friend or family member has lost their freedom.
Cost of hospitalization is a strong motivation for psychiatric administrators to release persons in their care. Your friend or family member’s insurance will be carefully monitored for the duration by their case manager and releases are likely to coincide just within insurance termination dates.
There are three basic things you can do to help a friend who is in the hospital, visit, send care packages, and let staff know you are watching.
Visiting private hospitals is simple. First, call to ascertain your friend or family member is still at the hospital. To evade ‘confidentiality’ say to the front desk, “I’d like to speak to patient so-and-so.” The clerk will check the record to determine whether that person is admitted to the hospital. If they are, you will be transferred to the clerk of the psychiatric ward (they may have some other clever name for it). If they’re no longer at the hospital the front desk clerk will tell you they are no longer there.
Once you have the clerk of the psychiatric ward on the phone say, “I’m a friend of so-and-so. When would be a good time to visit.” The clerk will get off the line and check the identified patient’s record and perhaps do a visual check. Unless they’re in restraints it’s likely the clerk will return and simply tell you the visiting hours. If there is a problem, give your name and number and ask for the charge nurse to contact you when it would be a good time to visit.
When you visit you may be asked to leave cameras, cell phones, weapons, bags, coats, etc in a locker. You may be asked to sign in and out. Do not give anything to the patient without consulting with staff – you won’t be punished, but your friend or family member will be uncomfortably scrutinized and future visits will be watched. Be friendly to staff. They are watching you for hostility as a rational to disregard you.
Make visits short and if possible often; quantity over quality. The concern of most patients is they have been lost, forgotten or abandoned. But also listen to staff; your visits may agitate your friend or family member and may not be helpful.
To visit your friend or family member at one of the Oregon State Hospital sites, download, complete and mail an Oregon State Hospital visitor application. The application must be approved by your friend or family member. This process typically takes 7-10 days, and longer if your background check turns up something interesting. More information about visiting is here. Questions? Contact Deborah Howard at 503-945-7132.
Telephoning your friend or family member at a state hospital is not simple. Hospital patients can not have cell or private phones (though some have internet access and can use products like Skype). Instead each ward has a telephone which accepts incoming calls. Other patients answer these phones and will often be willing to fetch your friend or family member to your call. Be patient – most of the time this actually works.
Telephoning patients at private hospitals is also not simple. One phone is shared among as many as twenty patients. You must have this number to dial – and you’ll need to get it from your friend or family member – we won’t post them here. Some one will answer and just ask for your friend or family member. Be patient and be pleasant. If you get hung up on just call back.
Care packages are also important. They can include almost anything except the obvious no-nos such as alcohol, drugs, tobacco, weapons, etc. All packages – including letters will be opened in front of staff. Hot sauce, chocolate, music, photos are all good. If your friend or family member will be at the hospital a long time, consider a schedule of care packages so they have something to look forward to.
The Oregon State Hospital has created an excellent family guidebook (really things are SO MUCH better than a decade ago.)
If your friend or family member in the hospital and is unwilling to follow medical orders, Disability Rights Oregon has written the Involuntary Medication Hearing Handbook.
Perhaps the most important thing you can do is the simplest. Call, write or visit your friend or family member’s doctor and / or ward nurse. Make it clear to them that you care about their patient and you will be available to them continuously and for the duration. Many persons at state hospitals – and with mental illness – who have supportive friends and family member can get well. Those without social support tend to do poorly and remain ill. They seem to get less help and are unable to do much with the help they get.