Mental Health Association of Portland

From the Portland Tribune, September 17 2009

Interesting, how one building can mean so many different things to so many people.

Cascadia Behavioral Healthcare reopened its Garlington Center on North Martin Luther King Boulevard Friday amid a great deal of rejoicing. A ribbon was cut, speeches were made by notables, including an ex-mayor and a variety of leaders in the Portland black community. But not everyone present was celebrating the same thing.

Derald Walker was celebrating financial progress and also the way a disaster opened room for new community connections. Cascadia’s chief executive officer, Walker came to the nonprofit in 2008, shortly after the financial meltdown that very nearly closed Multnomah County’s largest provider of mental health services. It took a $2.5 million state and county line of credit to save Cascadia.


But the Garlington’s Center’s particular disaster was near total destruction from a fire in October 2008. The fire’s cause has not yet been determined, but many members of the Garlington community are convinced an arsonist was involved.


Walker said it cost $2.2 million to rebuild Garlington, nearly all of it covered by the building’s insurance policy. Of more concern is the ongoing operating cost for the center, an estimated $1.3 million.


Walker didn’t say keeping Garlington open on a sustainable basis will be easy, not with Cascadia still paying off $2.3 million worth of loans.


“Running publicly funded health care is not for the faint of heart,” he said. But on Friday, at least, Walker said the future for Cascadia looked brighter.

“We survived last year and we’ve come out a lot stronger,” he said. “I think we’ll be fine.”

New clinic space

The new Garlington Center represents substance for Jill Ginsburg, and relief. A family physician who started the North by Northeast Community Health Center three year ago in a tiny building on North Williams Avenue, Ginsburg has watched her free clinic patients line up outside on Thursday evenings, and sometimes wait in their cars.

Some of those people who had come to North by Northeast for the only health care available to them had to be turned away, sent to other safety net clinics. Ginsburg simply had no room.

Ginsburg has room now, at the Garlington Center. Her new clinic space is four times the size of the old, with four treatment rooms instead of two, a waiting area that can seat 20, and even a break room for volunteers.

Was there some sort of break room in the old North by Northeast clinic?

“Are you kidding?” Ginsburg asks. “We had a treatment area in a hallway behind the curtain. We’re growing up and (Garlington Center) is a beautiful place for our patients.”

Youth resource center

Proud as she has been of the Sexual and Gender Minority Youth Resource Center for which she serves as program director, Favor Ellis has recognized the center has not been as diverse as its name implies.

The Cascadia-financed center, based in Southeast Portland for 11 years, has been the only organization in Portland with the aim of providing a supportive environment for lesbian, gay, bisexual and transgender youths.

But nearly all those youths were white.

And that is the primary reason the center has moved its offices and hangout space into the new Garlington Center.

“Queer identified African American youth in Northeast Portland may have felt like SMYRC was a resource for white youth,” Ellis said, adding that non-heterosexual black youths may not have felt welcome in Southeast Portland. “It may have been scary for them,” she said.

In the new Garlington Center building, the minority youth resource center may truly be able to bring in minority youths, Ellis said. Outreach has begun to predominately black organizations and churches in North and Northeast Portland. The message, Ellis said, is that gays, lesbian and transgender youths of all races are at increased risk for suicide, drugs, alcoholism, teen pregnancy and as victims of violence.
Reopening is a tribute

Maggielean President also attended Friday’s opening ceremony at the Garlington Center. President, a Northeast Portland resident who has been a Cascadia client since 1999, attends group therapy twice a week, so she’s happy to have Garlington back. But the real significance of the reopening for President was what she calls “paying tribute.”

Garlington Center is named after John Garlington, a black minister and social activist who died in a car accident 13 years ago. Reopening the center keeps Garlington’s memory alive, according to President.

“Whoever did this did us a favor by setting this place on fire,” President said. “The favor is that this place is looking better that it was at first.”

More triumphs

Nobody understands the daily struggle to overcome life’s obstacles better than those who suffer prolonged mental illness. Ryan Hamit took the fire personally.

“I’ve seen programs come, stay a while and go. I’ve seen staff leave. I’ve seen a lot,” said Ryan Hamit, who lives in the Pearl District but for years has received a variety of mental health services at Garlington, nearly an hour away by public transit. Hamit serves on the Garlington consumer council, which lobbied county officials to save Garlington during Cascadia’s financial crisis.

“It’s like an extended family to me,” Hamit said, explaining why he travels cross-town.

The fire, to Hamit, was another obstacle in a series of obstacles faced by Garlington and the people who need its services.

“It’s hard when there’s always somebody out there trying to cut us down,” he said.

For Hamit, last Friday’s reopening was just one more in a long line of triumphs.

From the Portland Observer, December 2008


In the early 90s, Ryan Hamit had a “bad spell” and ended up in a hospital struggling with a personality disorder. He bounced from various social service agencies and hospitals, encountering counselors that talked down to him and seemed to make problems worse.

Things got better when he started using the Garlington Center, a longtime local mental health provider with multicultural roots, currently operated by Cascadia Behavioral Healthcare.

At Garlington, he found himself better respected by the staff and not talked to as if he was a confused child, like he had at other places. Hamit started to improve.

“I wouldn’t be near as well off if it wasn’t for the Garlington Center,” said Hamit.

But over the past year, Garlington has had its own bad spell. It almost collapsed financially when Cascadia fell into financial turmoil. Then the center had a devastating fire.

Named after the late Rev. John Garlington, an African-American minister who worked closely with the poor, the Garlington Center is one of the most culturally sensitive providers of mental health and substance abuse services in the area. It also connects people with stable housing and jobs.

“These are the folks, where if they don’t have these services, they’re going to be downtown costing the community a lot more money,” said Jim Hlava, Cascadia’s vice president of housing.

Essie Mae Morphis, an African-American client of the center for about 10 years, explained how Garlington has provided her with care that has no parallel in its cultural tactfulness.

“If I couldn’t get my meds I’d be somewhere in a state hospital,” said Morphis of the value she places on Garlington services.

Cascadia’s chief executive officer Derald Walker explained that the center helps people through group therapy, helping them develop a sense of stability, and assisting them in managing their own medication regimen.

Statewide, Cascadia has an operating budget of about $42 million, which comes from a patchwork of state, county, and federal funds, according to Walker. It services about 525 people, he added.

Last summer, the non-profit nearly collapsed financially due to mismanagement. According to reports on Multnomah County’s website, Cascadia was hemorrhaging money due to a faulty billing system (among other problems) that essentially didn’t charge the appropriate sources for services.

In April of this year, Cascadia informed the county that it was on the verge of defaulting on a $2 million line of credit from Capitol Pacific Bank, and was about to go under. The Garlington Center would have expired had it not been for a loud chorus of voices that rose in protest.

Gascadia was saved by a $2.5 million loan comprised of state and county funds. A nationally recognized consulting fire was called in to correct the problems with billing, among others.

According to Walker, Cascadia has implemented many of the firm’s suggestions and is steadily recovering.

“We’re cautiously optimistic,” said David Austin, spokesman for the county’s department of human services, which has worked closely with the Cascadia on its financials. He added that the mental health provider continues to provide an essential service to Portland.

Austin said that Cascadia is taking recommendations from the county and the consulting firm seriously, and appears to be stabilizing. He also pointed out that Cascadia has passed along two of its other clinics to other non-profits, which has been a huge financial relief.

The fire sparked last October in the Garlington Center’s Martin Luther King Jr. Boulevard location extensively damaged the building, a former NIKE factory outlet.

Currently, the center looks as if it’s the aftermath of a war. Its windows are boarded up. Yellow tape lines scorched walls and corridors. The sharp, sour smell of the smoke has marinated the air, and still lingers heavily. The floor of some rooms is pitch black and sprinkled with broken glass.

Since the fire, clients have had to go out of her way to an alternate Cascadia center on Southeast Division Street and 43rd Avenue.

“It’s a hassle,” said Morphis of having to make the trek to the alternate center.

The clinic’s director Tasha Wheatt-Delancy expects to have the MLK facility back up in about six months. Currently there are several trailers outside the building where clients will be served. They are not quite ready, said Wheatt-Delancy. But she’s hoping they’ll be ready soon.

Hlava isn’t sure how much the building repairs will cost.

The fire is considered “suspicious,” and is under investigation by local and federal investigators.

Walker said that Cascadia is taking great care not to allow the tumult facing the organization to interrupt services facing clients.

However, Cascadia’s problems aren’t entirely in the past. Walker said that the state budget cuts could affect the non-profit’s addiction treatment program, but isn’t entirely sure what could happen.

“Making sure we have stable funding is our biggest challenge,” said Walker.

From the Oregonian, October 21 2008

More than 500 mental-health patients will have to go elsewhere for service after a fire destroyed part of a Cascadia Behavioral Healthcare clinic in Northeast Portland last night.

No one was injured by the blaze at Cascadia’s Garlington Center on Northeast Martin Luther King Jr. Blvd., but authorities say it appears to have “suspicious” origins. The cause of the fire that officials say began sometime before 9:52 p.m. is under investigation.

“It’s very important that we get it back up and running,” said Cascadia chief executive Derald Walker. “A lot of the people we serve live in this general area.”

An outcry of public support helped keep the center’s doors open after it nearly shut down this year in the face of severe financial problems at Cascadia.

The center had staff on hand today to help people who showed up for services, and telephoned other patients sending them to Cascadia Plaza about four miles away, Walker said. The Garlington Center served 525 clients, he said.

When the center will again be able to serve patients is unknown. Walker said officials today were still assessing the extent of the damage.

Fire officials estimate $200,000 worth of damage to the structure and an additional $400,000 to the building’s contents.

Walker said that as much as one-third of the building was badly burned, and that smoke damaged other areas. The fire destroyed Cascadia’s main computer, housed at the Garlington Center, but Walker said patient records weren’t lost because the hard copies survived. With the server destroyed, Cascadia cannot use its electronic medical records system and automated billing system until the arrival of a replacement that Walker expected by the week’s end.

The clerical area received the brunt of the damage, Walker said, with computers, copy machines and other business equipment burned in the flames.

“We will take precautions to make sure anyone connected to the Garlington Center who needs services will have a way to get them until it can be repaired,” Multnomah County Board Chairman Ted Wheeler said in a statement. “Given the economic crisis, these are anxious times for everyone. We will make every effort to make sure clients don’t fall through the cracks. Services will not be interrupted.”

EXTRA – NE Portland mental health center fire called ’suspicious’, from KGW.com

From the Multnomah County Mental Health / Cascadia Transition Planning web page.

If you’re receiving updates about the County’s Cascadia Transition Plan via email, please comment below. To date we have not received one.

Cascadia officials continue to work with Multnomah County to make sure that clients receive all needed services. More transitions are occurring as Cascadia looks for ways to reduce its costs.

Cascadia, all other mental health providers, the county, state and community stakeholders will continue to ensure access to quality mental health treatment services within Multnomah County. To that end, we want clients to know that designated services in the memo of understanding with Cascadia, the State of Oregon DHS and Multnomah County have been transitioned or transitions are underway.

The latest changes include:

* LifeWorks assuming full responsibility for the Gresham clinic. The transition will be completed by August 18. Services will continue.

* Central City Concern has begun a comprehensive assessment on the Downtown clinic known as the 12th Street site. The target date for completion of the assessment is the third or fourth week in August.

Cascadia clients will be informed in advance of any changes that may affect them. Continue seeing your provider until you are notified of services being transferred.

All Cascadia intakes have reopened

Intakes are open for all Cascadia locations, including Downtown, Garlington, Plaza and Woodland Park sites. New clients should call the Multnomah County Mental Health Call Center at 503-988-4888 for assistance.

Residential and housing services

Cascadia managers and staff met with county, city and state officials on August 1 to review the mental health provider’s housing resources. These meetings will continue. The plan calls for residents to stay in their current housing.

Future actions

Multnomah County and its state and community partners will continue to closely monitor the financial stability of Cascadia.

Clients who have questions or concerns should call the county’s Mental Health Call Center at 503-988-4888. The Call Center operates 24/7.

From the Oregonian, July 2, 2008 – opinion column by Renee Mitchell

The truth was clearly spoken.

But it might have sounded so familiar that most of the 100 or so folks who attended Monday’s rally to support Northeast Portland’s Garlington Center may have missed it.

Let me recap.

But first, I’ll sprinkle some history on the truth to make it more palatable for those who don’t understand the emotionally charged fuss.

The Garlington Center is the only mental health clinic run by Cascadia Behavioral Healthcare that is on track to be shut down. Its nearly 600 clients would be shoved onto the overloaded caseloads of other mental health programs in the city.

“That is unacceptable,” stated Sen. Avel Gordly, one of the state’s most effective and outspoken champions for the mentally challenged.

So how did we get here, then?

The question was asked so many times Monday that the truth finally spilled from the mouth of Derald Walker, a clinical psychologist who took over Cascadia in April. The Garlington Center’s largely minority, low-income, mentally ill clients, he said, “are not the highest priority.”

That’s why Walker, under pressure from Multnomah County, which is under the state’s thumb to quickly mitigate Cascadia’s financial problems, says he chose the path of least resistance. Who would care?

Monday, he realized he was wrong. The center is the only place in the county where uninsured clients of color also receive help with housing and jobs and access to a culturally familiar staff.

“I got some time clean because of an agency like this,” said Nabeeh Mustafa, who has been clean for 16 years after spending three decades in and out of prison for crimes to support his drug habit. He worked in an intensive case management program for addicts and alcoholics until Cascadia’s Treatment Not Punishment closed this week. “We all got some mental health problems.”

Closing the center makes county leaders gutless hypocrites. County Chairman Ted Wheeler heads the county’s year-old Health Equity Initiative, which, according to its Web site, “works to address the root causes of socioeconomic and racial injustices that lead to health disparities.”

He should already know that various displacements — from the Vanport flood to the Memorial Coliseum to a series of other past and current urban-renewal projects — have all disproportionately squeezed blacks out of a neighborhood that once created a sense of place in a mostly white city.

As a result, the black and other minority communities continue to suffer mightily from poverty, health disparities and other environmental stresses, which can exacerbate mental health issues, which, uncontrolled, can spill into homelessness, addiction, violence and crime.

But the Garlington Center has proven to be an important reservoir of hope and self-help models for those drowning in despair. Keep the center open, Gordly pleaded, “so we don’t have any more of the pain.”

Monday, with Gordly’s gentle prodding, Walker acknowledged he made a mistake by suggesting the center’s closure. He stated, emphatically: “We would be willing to take Garlington off the list.”

With Gordly’s insistence, Joanne Fuller, county human services director, also admitted her own negligence in allowing the issue to get this far. She, too, should have known better. But, at this point, correcting the mistake would need permission from Wheeler and Jim Scherzinger, of the Department of Human Services.

Fuller added this directive: “Keep telling us what you want.”

In other words: Wheeler needs to be held accountable to do what he promised: serve those at highest risk. Silence has no place when justice cries for our attention. So when truth hurts, say “ouch.” Loud and proud.

Officials hear plenty from a crowd of 100 who want the Garlington Center to stay open

from the Oregonian, July 1, 2008

Northeast Portland’s Garlington Center, a community cornerstone that serves nearly 600 people with mental illnesses, may avert closure thanks to pressure from a standing-room-only crowd Monday.

The clinic at 3034 N.E. Martin Luther King Jr. Blvd. faces shutdown because of the financial problems of its operator, Cascadia Behavioral Healthcare. The clinic serves mostly neighborhood residents, including many African Americans and other minorities.

Multnomah County, which runs the mental health system, is downsizing Cascadia. Derald Walker, chief executive officer of the nonprofit company, suggested closing the Garlington Center because he thought its clients could get help from clinics elsewhere.

The county accepted this and other suggestions as part of its reorganization of the mental health system. But the collective message from Garlington clients Monday: Don’t do it.

“That I am even here is a testament to Cascadia,” said Adit Hughes, who explained that she has agoraphobia — a fear of being in public places. How could she and other clients be farmed out to other counselors and maintain their fragile stability? she said.

“It’s not just for my stability, it’s for my family’s stability,” said Hughes, who has three children.

Ralph Williams talked about what it’s meant to have a center with a largely African American staff that understands him.

“It’s been a long time since I smoked crack and got in trouble,” Williams said. “This place has been very instrumental in helping me stay focused and on track.”

Ryan Hamit, president of the Garlington client council, and other council members kicked off the 21/2-hour town hall-style meeting with Cascadia’s Walker and the county’s top mental health officials. More than 100 people attended.

Hamit handed Walker a folder of signatures on a petition to keep Garlington open. “It goes on for 40 pages,” he said.

Clients demanded more involvement in decisions. They pushed officials on why they had targeted Garlington. They emphasized that other mental health providers in Northeast Portland are not equipped to absorb all of Garlington’s clients and that the expense of a transition would be better spent to keep Garlington open.

Joanne Fuller, county human services director, said the county had to move quickly in light of Cascadia’s financial crisis and had been unable to get sufficient input from clients. This past spring, the county and state came through with a $2.5 million bailout for Cascadia after a bank called in the company’s loan.

Fuller said the county is committed to serving North and Northeast residents in their community, but must figure out whether Cascadia can continue to be the service provider.

The Garlington situation is complicated because Cascadia is buying the center’s building. If Cascadia were no longer providing the services, clients probably would move to other providers at other locations.

Cascadia’s Walker said that his company wants to keep Garlington open and provide some level of services but must, in partnership with the county, figure out what is viable.

State Sen. Avel Gordly, an independent from Portland, whose district covers parts of Northeast and Southeast Portland, stood several times and pressed officials to commit to keeping Garlington fully operational. Near the meeting’s end, she walked to the front, put her hand on Walker’s arm and looked him in the eyes.

She asked him to acknowledge what he had said to her in a private meeting: that he had not tried to think of a way to keep Garlington viable and had made a mistake in assuming other clinics could care for its clients.

“That’s right,” Walker said.

Then she put her hand on Fuller’s back and asked her to acknowledge that the county should have pushed back on the idea of closing Garlington. Fuller acknowledged that.

“We can’t have any more pain,” Gordly said. “We can work this out.”

“Absolutely,” Walker said.

Fuller said she couldn’t promise that Cascadia could continue to provide the same services at the center, but that she is now committed to looking into how that might be possible.

“We absolutely have to push back,” she said, “and figure out — can we find another solution?”

EXTRA – read how closing the Garlington Center caused an avalanche which collapsed Portland’s mental health system in 1999 in Diane Ponder et al v Employment Department & Garlington Center.