Mental Health Association of Portland

By Maxine Bernstein, The Oregonian, Thursday, January 26, 2012

The Associated Press
A Portland police officer investigates the police-involved shooting on the roof of a downtown parking garage.

The officer-involved shooting, which will be reviewed by a Multnomah County grand jury, has already raised questions among some in the rank-and-file and in the mental health community as to whether the bureau would be better suited returning to its old model of having a Crisis Intervention Team of specialized officers available at moment’s notice for such calls. They’d be on patrol, scattered through the three shifts in each of the precincts.

Morgan had called 9-1-1 at 3:17 a.m. Wednesday, saying he had committed a robbery at knifepoint and was going to jump off a downtown parking garage. An officer and sergeant in the bureau located Morgan. They called for police negotiators and Project Respond mental health workers to help talk the man down. But before the assistance arrived, the officer and sergeant started to talk to Morgan atop the garage.

Police have not said whether the two officers walked up to the man or where they were standing during the conversation.

Within 15 minutes, both officers fired multiple shots at Morgan when they said he pointed a black handgun at them, according to police. The gun turned out to be a fake.

Police would not say if the sergeant and officer had been interviewed.

In a news release on Wednesday’s shooting, the Police Bureau noted that officers had called for Project Respond and officers from the bureau’s Crisis Negotiation Team, formerly known as the Hostage Negotiation Team. But the shooting occurred before they got to the scene.

“All Portland Police Bureau officers are trained in Crisis Intervention; however, CNT and Project Respond bring additional experience and equipment,” the release said. “Both Project Respond and CNT are on a call-out basis and are 25-30 minutes away at a minimum.”

Even if a Project Respond crisis worker had arrived, he or she likely wouldn’t have been able to approach the scene since police had information that Morgan may have been armed, said Jay Ausland, Project Respond director.

In 2007, Portland police switched from a voluntary crisis intervention training program for a select group of officers, led by an officer or sergeant, to mandatory training for all officers. The switch came after the controversial 2006 death in police custody of James P. Chasse Jr., who suffered from paranoid schizophrenia. He was tackled by police and died from blunt force trauma to the chest.

Retired Sgt. Karl McDade, who was Portland’s first Crisis Intervention Team coordinator, argues that the old approach is more effective. “Yes, they would respond much quicker and be pretty well trained. It might turn out better. I think the odds are that it would.”

But McDade said, in these situations, “There’s no guarantee that anything you do is going to turn out well. When someone points something that legitimately looks like a gun, you don’t have much of a choice, other than find cover and back off.”

Advocates of the former CIT model say all officers don’t have the judgment, maturity level, experience or interest that makes crisis intervention training effective.

But Chief Mike Reese disagrees. He’s defended the current approach, saying the mandatory crisis intervention training for all officers lays a needed foundation for the entire force. He has argued that the mandatory training, coupled with the bureau’s one-car mobile crisis unit – which pairs an officer with a Project Respond worker — and the bureau’s negotiation team, which helps on calls involving armed or suicidal people, provides an innovative “layered” approach.

“Reverting to only a few officers having specialized mental health training would be a step in the wrong direction,” said police spokesman Sgt. Pete Simpson on Thursday.

Central Precinct’s mobile crisis car was not operating early Wednesday. Its hours are 7 a.m. to 5 p.m., Wednesday through Saturday.

From The Oregonian, June 8, 1999 – not elsewhere online

THE CITY LINKS WITH THE WHITE HOUSE FOR A CONFERENCE BROADCAST LIVE TO 6,000 SITES NATIONWIDE

Sandy Hayden suddenly sat up in her threadbare easy chair and focused on the television.

It was January, and President [Bill] Clinton had just announced plans for a White House Conference on Mental Health in his State of the Union speech.

Hayden, 46, thought immediately that the conference should include people like herself — people who live with mental illness.

She didn’t realize that Oregon’s reputation for innovative mental health services would mean that the conference would come to her.

On Monday, Hayden sat in the front row of the Providence Portland Medical Center amphitheater, one of three sites in the nation chosen for a live satellite feed of the Mental Health Conference. She was one of only 120 people invited to the Portland site to observe the first such White House event.

The administration’s stated goal: to attack stigmas, identify treatments and recognize efforts to improve the lives of the 50 million Americans with mental illness and their families.

The conference linked with Portland, Flint, Mich., and Atlanta, giving each city a chance to showcase innovative mental health programs. It was also beamed to 6,000 sites across the nation, including more than 20 in Oregon, from Baker City to the Oregon State Hospital in Salem.

Tipper Gore, wife of the vice president, moderated the conference. She set the tone by talking about her own experiences with depression after her son was struck by a car and nearly died in 1989.

More than a dozen speakers told their stories, from Mike Wallace of TV’s “60 Minutes,” who has battled depression, to a young man with schizophrenia, to the mother of a mentally ill boy and volunteers in mental health programs.

“Mental illness is not just something that happens to other people,” Gore said. “This is the last great stigma of the 20th century that we need to make sure ends here and now.”

The president, first lady Hillary Rodham Clinton and Vice President Al Gore used the conference to announce a dizzying list of public policy proposals: to provide parity, improve treatment, bolster research and expand community responses to help people with mental illnesses.

President Clinton announced his intention that all federal employees’ insurance coverage put mental health services on a par with physical health treatments.

“As a nation founded on the principles of equality, it is high time that our health plans treat all Americans equally,” Clinton said to applause from the Washington, D.C., audience at Howard University.

Oregon was chosen as a live link because of such initiatives as the Portland Police Bureau’s Crisis Intervention Team, which has trained 100 officers to work with people with mental illness to de-escalate crisis situations.

Portland Police Sgt. Karl McDade stood as he addressed Vice President Gore, saying: “Every night in this country on a street corner somewhere, there is a dangerous dance that goes on between an untreated, mentally ill person in a crisis, destitute, homeless, who is frightened, and a young policeman who is probably not trained (for the situation and) who is frightened, too.”

Hosted by Providence

Portland’s link-up was hosted by Providence Portland Medical Center, home to the Crisis Triage Center . The center, a public-private partnership, provides the only 24-hour emergency care for people with mental illnesses in the Portland area.

The Oregon Health Plan also helped the state secure involvement in the conference. The plan covers diagnosis and treatment for physical and mental illnesses equally.

Yet, despite Oregon’s innovations, the state’s private insurance companies still limit coverage for mental illness. A bill to reverse that is in the Oregon Legislature. Senate leaders have yet to give it a hearing.

Hayden says the failure to get private insurance to adequately cover mental health impedes her return to the productive life she led before she became ill.

Hayden, who has a master’s degree in physical education and a bachelor’s in psychology, had wanted to teach fitness as a motivational tool. She co-authored a book on the topic. She worked as a reporter while trying to write her doctoral dissertation in Georgia in the early 1980s.

Hiding the anger

But writing became a struggle. She forced herself to sit at her computer for hours, but she couldn’t concentrate.

She fought to hide the anger that welled up in her at work. She had always given more than 200 percent to her job. Now she felt the steam knocked out of her. She felt she had to quit. That was 1984. She hasn’t held a job since.

Ten years later in Oregon, her doctor diagnosed her with bipolar disorder. He said the illness is characterized by extreme mood swings, from intense energy and agitation to profound depression. For Hayden, knowing what was wrong with her was a relief. Finally, she said, “he had my story.”

She eventually found a blend of four drugs that help her manage mood swings..

Managing her own medication has helped Hayden regain her energy and sense of control.

She joined a state advocacy group run by people with mental illnesses. She became interested again in motivating others.

Now she would like to work part time. But she would risk making too much money to qualify for the Oregon Health Plan. Because private insurance won’t cover her therapy and medications, she needs the Health Plan to survive.

A new Oregon program that lets people with disabilities return to work and keep their public health coverage may help her. But Hayden wants private insurance companies held accountable.

In the meantime, she remains in public housing in a Northwest Portland high-rise, where the noise from neighbors and the light from the street keeps her awake.

Learning about the White House conference galvanized Hayden.

She started networking with other mental health consumers and their organizations. She wound up with three invitations to the Portland site for the White House conference.

Sitting in the audience Monday amid mental health specialists, state and local leaders, consumers and other advocates, Hayden smiled. For years, she felt she could tell no one about her diagnosis. Now she listened as people throughout the country told their stories to a national audience.

“If the wave you can sense from this can be cast farther and taken up by other portions of the country,” she said, “it will be absolutely wonderful.”

From The Oregonian, November 14, 1996

You can count Barb Sander among the tame and typical who have passed through the Hooper Detox Center.

Tame because Sander who was treated for alcohol and drugs when she frequented Hooper in the early through mid-1980s, is a contrast to the sometimes more volatile heroin addicts now treated at the center on Portland’s eastside.

Typical because Sander, with 11-plus years of clean and sober living, is a Hooper success story.

Ed Blackburn, director of Hooper since 1992, says the center’s detoxification program completion rate is 80 percent for alcohol and cocaine addicts and 65 percent for heroin addicts. He says that’s a higher success rate than similar programs elsewhere.

Sander doesn’t doubt it.

“For me, personally,” she said, “I think Hooper played an integral part. Hooper was able to kind of steer me.”

And thousands more.

Tens of thousands more, Blackburn says.

Such successes are no trivial matter at Hooper, which operates an alcohol and drug detoxification program at 20 N.E. Martin Luther King Jr. Blvd.

So it’s no wonder Hooper detox, officially known as the David P. Hooper Memorial Detoxification Center, will be making a big deal of contributions to the community Tuesday with a 25th anniversary party.

Festivities will begin at 7 p.m. at Lloyd Center Exhibit Hall at Red Lion Hotel, 1000 N.E. Multnomah St.

For Blackburn, Hooper’s 25th birthday is a milestone worthy of pomp and circumstance yet Blackburn is aware the significance of the Hooper event might be lost on the so-what crowd — the many city residents who are unaware of the center and the services it provides.

“There are 100,000 individuals that have received services from the Hooper Center,” he says. “There are tens of thousands of people in the metro area who are affected by Hooper. They’ve either been in Hooper Center or they know someone — family or friends — who have been in Hooper. Those people won’t be saying ‘So what.’”

It’s with good reason that Blackburn comes across equal parts proud parent and protective older sibling when talking about Hooper. He knows there’s a fine line between past successes and current challenges.

All he has to do is refer to admissions records for Hooper’s Chiers, sobering, and medical detoxification programs. Chiers is the Central City Concern Hooper Inebriate Emergency Response Service.

The figures show Hooper has been receiving about 9,000 individuals yearly since 1993. At this rate, Blackburn says glumly, Hooper will admit in the next 10 years as many people — 100,000 — received in its first 25 years.

He says Hooper’s international and national reputation for helping people partly accounts for the high numbers. That’s good news for an organization that relies on word-of-mouth instead of advertising.

Blackburn says Hooper is visited regularly by people specializing in alcohol and drug treatment and government officials from countries in Africa and the Middle East, as well as Canada and Russia.

Among the visitors is Patrick Vanzo, division manager for Alcoholism and Substance Abuse Services for Seattle-King County Department of Public Health.

He said the agency is planning to build a sobering center north of downtown Seattle that is modeled after Hooper.

“They were able to put an affective chemical and medical intervention program in place for minimal cost,” Vanzo said of Hooper.

“I realized we needed to do something very, very similar to what Portland has done if we’re going to make inroads into the chronic public inebriate population. We knew we had to get a service very much like Hooper on line here in Seattle. They are a national model.”

Yet, Blackburn is well aware reputation alone isn’t fueling Hooper’s admissions’ increases. He knows the higher numbers also are the result of a dramatic rise in heroin use over the past five years.

Blackburn says about 60 percent of detoxification program admissions this year — 1,022 — are heroin addicts. That’s a 260 percent increase over five years up from the 284 heroin clients admitted in 1992.

He says most clients are 18- to 25-years-old, and probably started using heroin six months to three years before deciding to seek treatment.

“This epidemic didn’t start in 1992,” Blackburn says.

He says about 30 percent of heroin clients are women, for which there are only 18 beds in the voluntary detoxification program.

“We’re turning women away,” Blackburn says.

He says Hooper turns away about 15 people a day. “That was not the case three years ago.”

The explosion in heroin addictions has impacted Hooper greatly’ he says, amounting to an additional per year load of 738 clients, 19,000 blood pressure tests, 15,000 meals and 12,000 medications.

“So logistically, it just comes at us,” Blackburn says. “They also prevent new challenges for us in terms of managing and intervening the withdrawal of the disease.”

Because heroin is an illegal drug, simply obtaining it means breaking the law. Therefore, Blackburn says, clients are “more criminally involved” than those suffering from alcohol

He says combating the heroin tide has required Hooper to retrain staff and search for new medical approaches.

Still, not everyone is toasting Hooper Center or cheering Chiers. It is the program that puts a van on the streets of Portland to cruise the city and pick up people who are passed out on the streets because of drinking or drugs, or who are too drunk or drugged to care for themselves.

Nor are they thrilled about the sobering station, a 4,000 square-foot space on the first floor of Hooper Center where people are taken until the effects of drinking or drugs wears off. It has large and small common space and individual concrete-walled holding cells.

The word on the street within some circles of homeless people is that the tactics employed by the Chiers van and workers at the sobering station approach brutality.

Blackburn says that’s because people picked up by the Chiers van — an average of 3,000 a year — and taken to Hooper’s sobering station often “resent having their inebriation process interrupted.”

But the sobering station isn’t a jail, Blackburn emphasizes, saying its purpose is to provide a safe place for people until the effects of their drinking and drugs wear off.

“The sobering station has saved a lot of lives,” Blackburn says.

Thus, he makes no apologies about the sobering station being a “bare-bones, concrete-area;” after all, the people taken there often are a drunken mess and sick.

Blackburn says people who are combative when they arrive at the sobering station are placed in a holding cell to calm down.

The people who run the sobering station aren’t equipped with weapons. Rather, Blackburn says, they rely on training that has taught them to calm unruly clients by talking to them. However, should that approach prove futile, sobering station staff is trained in applying “non-aggressive” physical restraint holds as a last resort.

Their work impresses Chuck Currie, coordinator of Burnside Advocates Group, an advocacy organization for homeless people.

“I think Chiers is particularly a good program,” he said. “I’ve seen them treat homeless people with nothing but respect.”

Portland Police Bureau Sgt. Karl McDade, who worked downtown for five of his 18 years on the street, said the people picked up by Chiers lessen the load for police.

“Those would have been people we would have had to pick up and take there,” he said, referring to the sobering station. “We call them oftentimes to assists.”

McDade knows the nightly challenges awaiting Chiers, having driven the van as a volunteer for a year.

“Basically, the Chiers people are the only friends these alcoholics have,” he said. “And it’s somewhat dangerous. They get assaulted by people. They’re waking up someone and they’ll get up swinging. That’s not unusual. It’s a tough job.”

During their stay, Blackburn says, clients are monitored for seizures and withdrawal symptoms and their intoxication level and medical problems are evaluated People are kept warm — the temper temperature is about 74 degrees — and fed soup.

The law allows the sobering station to keep people up to 48 hours, though Blackburn says most are released within five hours.

“People on the outside often look at these people as less than human,” he adds.

“We don’t. We look at them as prisoner of a disease. And we know what kind of behavior that can produce. Some of those people get sober, and when they get sober, they often come back and thank us for saving their lives.”

By Robert Landauer – editorial columnist for The Oregonian, April 18, 1996. Not available elsewhere online.

“Police shootings in August 1994 of two mentally disturbed women in less than a week shocked and appalled Portland and Gresham.”

“The cream of the crop.”

The phrase is common, but both the source and the subject are surprising.

The praise comes from Margaret Taylor. She is executive director of the Salem-based Oregon Alliance for the Mentally Ill. She is talking about Portland-area police, mostly in the Portland Police Bureau.

The change of perception is startling. Police shootings in August 1994 of two mentally disturbed women in less than a week shocked and appalled Portland and Gresham.

But the tragedies should not have surprised them.

Oregon has been downsizing its mental -health-care institutions and underfunding community-based alternatives for years. It had just closed its regional psychiatric hospital in Wilsonville, Dammasch State Hospital.

“The last resort” is what doctors, judges, police and advocates for the mentally ill called Dammasch. The pun was marginally cruel, bitterly ironic — and chillingly apt.

“We would see them in the sobering station, and they had just gotten off the bus with prescriptions from Dammasch,” recalled Ed Blackburn, director of Central City Concern’s Hooper Detoxification Center in Northeast Portland.

Calls for police intervention mounted as the population of the seriously mentally ill on the streets rose.

The killings of the two women were a peak, a summit. But not a triumph.

Gendarmes feared they were becoming forced draftees for police-assisted suicides. Most disliked being cast as head-thumping, guns-and-guts, “Robocop” stereotypes.

Portland police responded creatively. Sgt. Karl McDade and Carol Sweet of the bureau researched and helped develop a Crisis Intervention Team. It was operational and plugged into the 9-1-1 emergency system a year after the two deaths.

The idea is to get 90 to 100 officers — three to four every day on every shift in each precinct — who have been trained to identify the mentally disturbed and deal safely and sensitively with them.

The bureau is two-thirds of the way toward its goal, says Capt. David Butzer, who leads the Family Services Division. He makes another point worth appreciating:

“These are all volunteers, no extra pay, and we’ve asked far too few people (to handle) the needs, demands and great stresses.”

The effort is noticed:

Jack Wolinski, director of the Alliance for the Mentally Ill of Multnomah County: “During the training period, consumers talked to these police officers and were telling them what was going on in their minds during the psychotic episodes. The police discovered that the mentally ill person was very frightened and confused. Even if there was a weapon, it was for self-protection, not to inflict harm. . . . The dialogue taught them to be patient, and the crisis could be resolved in a peaceful manner.”

Howard Klink, deputy director of Multnomah County’s Department of Community and Family Services: “I would absolutely support the idea that there is a sea change in both law enforcement people’s understanding and their concern for mentally ill people on the street.”

Police understand “the inappropriateness and inhumaneness of putting these people in jails.”

Mike McCracken, executive director, Association of Community Mental Health Programs, also sees changes occurring: “Police are taking a leadership role in advocating for better services in jails, better diversion processes and community networks of services. Police and sheriffs are not Bubbas. They do not want the mentally ill to have to suffer in an inappropriate setting.”

Beyond our own shortcomings — but close to our vulnerabilities — is where compassion and pragmatism meet.