Mental health plan ‘needs…flesh;

From The Oregonian, May 18, 2001

The panel overseeing reform of the Multnomah County mental health system has asked its staff to rewrite a controversial draft proposal by June 6 with more detail and specific numbers.

“It’s a very sturdy skeleton, but it needs a lot of flesh,” acknowledged staff member James Gaynor, author of the draft. After pitching his “action plan” to the Mental Health Coordinating Committee on Wednesday, he readily agreed to come back next month with a much more specific version.

Gaynor called his draft a “rapid departure point” for discussion of “the acute care crisis that is the largest threat to the stability of the system.”

Much of the ensuing two-hour discussion focused on the need for more mobile crisis teams, safe drop-in centers and other services to help keep patients who are having a crisis from needing to stay in a hospital. Council members asked for more detail about how Gaynor’s plan would curb costs, reduce hospitalization and improve care — as it pledges to do.

“There are big questions in here that are not being addressed,” said council member Jim McConnell, the county’s director of Aging and Disability Services.

“I would like to express my disappointment in the lack of details in the plan,” said Marie Dahlstrom, representing the Latino Network of Portland. “How is this going to happen — so we’ll never have another tragedy like what happened with Senor Mejia?”

Jose Santos Victor Mejia Poot, a 29-year-old Mexican national, was fatally shot during an altercation with police last month at BHC-Pacific Gateway Hospital.

“This is the thinking, but this is not the details,” said Dr. Gene Borkan, a psychiatrist. The county’s shortage of services for acutely ill patients has reached “a phenomenal crisis,” he said.

“We have to turn this around — and turn it around quick,” Gaynor agreed.

During the public comment period, 13 people spoke up, many with experience as patients. Most pleaded for prompt action to improve outpatient care and for additional consumer and minority representation on the council.

The 20-member council includes county officials, mental health care providers and patients and family members.

“I’m not here to bash or point fingers, but our community felt excluded from this process,” said Rosemary Celaya-Alston, who chairs the Latino Network for Multnomah County.

“Somehow, systems broke down,” she said in reference to the Mejia case, “and a man died.”