Getting Help in Portland, Oregon
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 an addiction or mental illness crisis unless you are in a life-threatening emergency or are witnessing an actual crime.
If you call 911 in Portland, start the conversation by asking for “a member of the Behavioral Health Unit with a crisis worker” to be sent. Most Portland Police officers have, in comparison to surrounding jurisdiction, extensive training about mental illness and addiction, but alerting the 911 operator that 1. you’re calling about a crisis caused by addiction or mental illness frames all further questions, 2. tells the 911 operator you have some understanding about who should respond to this particular crisis.
Local county-based crisis hotlines are far more able to provide you with local resources and referrals, and may be able to “see” information via local databases – which are not available to national 800 or 988 numbers.
Sorry – this organization does not give clinical, medical or legal advice, or provide any direct social services. This page was checked for accuracy on June 2021.
24 hour crisis line: (503) 655-8585
Clackamas County Urgent Mental Health Walk-In Clinic
11211 S.E. 82nd Avenue, Clackamas, Oregon – bus #72 & #71
Walk-in: Mon.-Fri., 9 AM – 7 PM and Sat 10 AM – 7 PM, Closed on Sunday
24-hour crisis line: 360-696-9560 or 1-800-626-8137
This crisis line is operated by Seattle-based Crisis Connections.
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, Monday thru Friday, and 9 AM to 9 PM on Saturday and Sunday.
1225 NE 2nd Avenue, Portland, Oregon – (503) 944-8000
Open 24 / 7 – Psychiatric Emergency Hospital
Crisis Assessment and Treatment Center
30 NE Martin Luther King Jr Blvd, Portland, Oregon
Open 24 / 7
The CATC can only be accessed through referral by the Multnomah County Crisis Line 503-988-4888 or 1-800-716-9769 or a hospital. Patients must be medically “cleared” at an ER prior to admission.
Crisis line: 503-291-9111
Here is Health Share’s list of mental health and addiction providers
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 to your nearest hospital emergency room. National hotlines for suicide do not know about local resources and cannot act in an emergency except to call police.
Why not call 911? The vast majority of police officers are untrained to help suicidal people and too often end up killing them or escalating panic so they harm 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 for help.
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.
- Now is not the time for judging. They’re already doing enough of that. If you’re mad about something, write it down and keep it to yourself.
- Respect them. They’re doing hard work staying alive and they’re probably terrified.
- Feed them protein. Low blood sugar is your enemy. Hydrate with water.
- Do not give them alcohol or non-prescribed drugs (& only give as medically prescribed).
- Do not get creative, like “let’s smoke some pot so you calm down,” or “Let’s go on a road trip.”
- 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.
- Get peer support. If they’re a Vet, get a Vet. If they’re an alcoholic, get an alcoholic. If they’re depressed, get a depressive. Weird, but it works.
- Did they take their meds? Do they have a sedative to take? If not and they’re not drunk, try 25 mg of over-the-counter Benadryl – it has a sedating effect and calms agitation.
- 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.
AFTER A CRISIS:
Thinking about suicide and self-harm is an unfortunate but normal experience of persons experiencing symptoms of depression, anxiety, post-traumatic stress disorder, bipolar disorder, some personality disorders, addictions and alcoholism. It’s a predictable complication over a normal course of illness.
Crisis comes and goes. Over time friends and family members can get tired of the repetition, tired of the perpetual problem, and become acclimated to crisis and no longer vigilant. This is why it’s terribly important to break the cycle of crisis by getting good medical help and engaging more helpers.
After a suicidal crisis, or during periods of ongoing suicidal thoughts, it helps when the person can express those feelings. Making the topic off-limits does not help. An exaggerated, horrified response does not help. What helps is availability, willingness to listen, and being yourself — don’t try to be a therapist, be a friend.
Talk about suicide in a calm, normal way, treating it as something real, that exists, that might happen, but which you both hope will not. Safe, calm talk diffuses pain and suffering.
Here’s a good sample conversation:
“I was thinking of killing myself last night.”
“Whew, that scares me. You must have been really scared.”
“Yes I was. I’m feeling a little better now. But I am still sad.”
“Well it just quit raining, so let’s go for a walk and you can tell me about it.”
Talking about suicide is super-hard work. Try to stay focused on being mildly curious, to not make their experience about YOU, to be open-minded about terrifying stuff and not get scared or apathetic or hurt or withdraw. Say your mantra. If you know someone who is suicidal, or you have teenagers, you need a mantra. Plan for yourself in their crisis; stay fed and hydrated, practice breathing, catnap when you can.
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.
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 prescriber. 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 Matthew Kimball, Indigent Defense Coordinator, at (360) 397-2256 or matthew.kimball @ clark.wa.gov
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 OMB 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 – and that process of discovery can be painful, jail health staff 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 sufficient. 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.
Chronic homelessness is a political and policy 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 and personal level – they are all useless in resolving your immediate problem.
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. Talk with the case manager involved. Your simple engagement and interest will shoot you to the top of their priority list.
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 is likely out of your control. Here’s what you can do – be patient and don’t give up. A time will come when you can help. Be available and ready.
Because of service cuts by the City of Portland, this paragraph needs to be revised. Detox services may no longer be available through Central City Concern. 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. Call 503-238-2067 for more information.
Addiction treatment is often unsuccessful for persons who are homeless, or those who live with others 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 nationwide – HIGHLY RECOMMENDED. This directory is up to date. If you are sober, employed and need housing – there are over 200 Oxford Houses in the Portland Metro area and dozens have a room available for you now – no waiting list. Look at this directory, find a house near where you want to be, and give them a call. Average rent is $300-$400 per month.
Use of buprenorphine has been marketed to politicians, healthcare administrators, and the medical and public health communities as a fix-all for opiate addiction. It is not. It is one strategy to reduce cravings and not to addiction as a whole. There are alternatives to buprenorphine, may be equally successful yet are un-marketed strategies, under-utilized because they can’t be patented or trademarked, such as acupuncture, meditation, structured exercise, and group involvement. But – buprenorphine does reduce cravings and we do recommend you talk with a physician or psychiatric nurse practitioner about it. However buprenorphine itself is an opioid and can be addictive. We urge considerable caution and that all conversations between patient and physician about buprenorphine be moving as rapidly as possible toward no use of buprenorphine or any other addictive medications. The goal is to be drug free. Many medical providers don’t believe in or trust recovery from addiction – even those who study addiction and work with addicts – and so they advise longer use of the drug. It’s a balance no one can advise you about without knowing details of the problem. As a newly recovering addict we suggest you talk with other people in recovery about alternative, non-medicine pathways to sobriety.
The medication acamprosate appears to be effective at reducing cravings for alcohol. It is not an addictive substance.
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, Sean Hubert is housing director – 503-525-8483
- Lifeworks NW, ask for the housing director – 503-645-9010
- Luke Dorf, ask for Executive Director of Services, 503-726-3690
- NW Housing Alternatives, ask for Julia Doty, (503) 654-1007
- NW Pilot Project – specializing in elders, (503) 227-5605
Don’t accept just 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 “wet,” 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? Would you spend a night there yourself?
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.
Civil Commitment is the legal process that can result in a person being hospitalized involuntarily. The process is a bit complicated. There are several ways that a case can be initiated.
If you feel that your family member or friend is a danger to themselves or others, or if you feel that they are unable to care for themselves, you can contact the Multnomah county Crisis line at 503-988-4888. Request that Project Respond “go out” and make contact with the individual. Note: if staff of Project Respond are not familiar with your family member or friend, they will bring a police escort.
The Project Respond staff and/or the police may interview you and others about observations and experiences that are related to the individual’s mental health. For example, observations and information 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 statements must be unequivocal. The information you provide may be used to initiate a legal hold in the hospital. or a ‘notice of mental illness’. The basis for issuing a Notice of Mental Illness is ‘probable cause’. The evidence criteria for a six-month civil commitment is ‘clear and convincing’.
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.’ A “two party hold” is much less common than a hold initiated by a medical professional. 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 email@example.com. 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 either a Notice of Mental Illness or a two-party hold is written, a county investigator is assigned and has three legal days to decide whether a hearing is warranted.
NMI can be initiated by any medical doctor, medical director of a clinic, or, most commonly, a physician at the emergency room. . 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. Often an ambulance is called to accomplish the transport of a person to the emergency room or other medical facility. 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 Providence St. Vincents and Milwaukie (for our elders), Tuality Health – now called Hillsboro Medical Center, Providence Hospital, Unity Center, and the Veteran’s Administration Medical Center. Telecare operates two non-hospital facilities for people with mental illness, one in Gresham and the other at the Crisis Triage and Assessment Center (CATC).
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 an informal attempt to balance illness, a chronic lack of information, and civil liberties. The court clerk or a jail deputy can point to 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 – agency 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.
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 types of hospitals in Oregon – private and public. Some private hospitals have psychiatric units, which are located in various places around the state. The public hospital is the Oregon State Hospital. It has sites in Salem and Junction City.
Patients may choose to stay at a private hospital on a voluntary basis, or they may be held for some time at a private or public hospital against their will, which is considered involuntary. Voluntary length of stay averages 7-10 days. Sometimes even much longer depending on specific needs. Involuntary stays can range anywhere between five business days or less, to the full length of a civil commitment- which in Oregon may last up to 180 days from the day a judge signs a commitment order.
Irrespective of whether a patient is voluntary or hospitalized as a result of civil commitment, the overarching goal is to stabilize the patient or restore them to baseline so they can return to the community for continued treatment as necessary. If an involuntary patient is on a court commitment in a private hospital, there is often the push to transfer them to Oregon State Hospital. But since COVID started, transfers have ground to a halt, which means involuntary patients are staying in private hospitals until expiration of the commitment or an appropriate discharge plan is in place.
Appropriate discharge plans must consider housing and follow up treatment, including medication management, case management, and possibly therapy. Often patients on civil commitment are stabilized to their baseline far before the end of a court commitment, but the lack of community resources keeps them in the acute care setting for an unnecessary length of time. Even if the patients would no longer meet commitment criteria by this point and want to leave, it is not permissible to discharge them without a plan in place.
Sometimes a discharge plan may include going to a transitional residential facility (TRC) which can last up to 18-months or to a longer term facility. These facilities are often owned by Telecare They may also be discharged home if there’s a reasonable and safe plan in place.
Once a patient has been court committed, the decision to discharge from court commitment is often a coordinated effort between the attending provider, the commitment monitor, the patient’s social worker, the patient, and any family who may be involved in the patient’s care. However, if a patient or family member disagrees, there is not too much to be done. While there are ways to appeal court commitment, the success of which may have some benefit, appeal will not likely lead to release prior to the blessing of the treatment team and commitment monitor.
Phone Calls and Visiting
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 unit 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.
Calling a private hospital to ask about visiting or to talk to a patient can be a challenge. Some staff believe that you cannot disclose whether a patient is in the hospital. This is false unless they have completely opted out of the hospital directory. Nonetheless, it can present a challenge. Don’t give up if you get the response “I’m sorry I can neither confirm or deny the patient is here” Say, “If they are there, give them my number or see if you can get permission from them to put the call through by adding my name to the list.” …Something to that effect.
The truth is that privacy laws don’t have different rules for psychiatric hospitals in terms of directory information (whether a patient is or isn’t in the hospital), but many employees seem to think they do.
Telephoning patients at private hospitals varies. Some places have one or two wall phones which are shared, while others have many cordless phones for patients to use freely. If a unit has a wall phone, you must have this number to dial – and you’ll need to get it from your friend or family member, or the staff. Some one will answer and just ask for your friend or family member. Be patient and be pleasant. If you get hung up on it, just call back.
In places with cordless phones, staff will transfer the call to a cordless phone and bring it to your friend or family member.
If able to visit, please do. But call first and ask to speak to the patient’s nurse to ensure a best time, and that the patient is well enough to accept visitors. Visitation at the state hospital has separate requirements. To visit your friend or family member at one of the Oregon State Hospital sites go here and download the applicable form: Visitation Information and Forms for Oregon State Hospital
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. Questions? Contact Deborah Howard at 503-945-7132.
For information on family services at Oregon State Hospital, including the ability to access the Family Guidebook, visit here: Family Services at Oregon State Hospital
Visiting private hospitals is typically simple. But most are not accepting visitors due to Covid for the time being. Hopefully that will change soon. For now, you can request the social worker set up a visit via Zoom for you and your friend or family member as this may be a possibility.
When visiting in person, it probably makes sense to call first to ensure your friend or family member is interested in having visitors and that they are in a good mind space to do so.
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 – items that have not been checked may pose a serious safety risk. Items that may seem benign to you may actually pose a risk to patients on the unit. Also, if you bring in unsafe items and attempt to obscure them from staff, there is a risk of them not permitting you to visit in the future. Please remember that even if your family member can be safe with certain things, others may not be and the unit must be a safe space for everyone.
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. If the staff says come another time – listen to them.
You can also send care packages. Many hospitals will provide a list which lets you know what patients can or cannot have on the unit. Information for the state hospital is here: Visitation Rules at Oregon State Hospital
Psychiatric units are designed for safety, and it is important to keep the unit free from sharps, ligature risks, and any items that can be used to inflict some measure of harm. A good rule is nothing with metal, glass, or strings (e.g., spiral notebooks or clothing with drawstrings). Drawstrings can be cut out if the patient is OK with it. Even magazines with staples are not permitted, so if you plan to drop off reading material, look for books or magazines bound with glue.
Some places allow you to bring or send food or snacks, as well. For those who are in the hospital for a long time, they understandably get bored of the food and are missing their autonomy to access the food they like. Having a meal from a favorite place can be an amazing thing. Sometimes open container drinks will be confiscated, but closed containers will be transferred to a new cup for your family member. Definitely ask the care team about whether food can be brought in. It may even be best to check with the charge nurse on the unit on the specific day you plan to bring or send food to your friend or family member. Consistency among staff can be problematic.
Communication with the Treatment Team
In the hospital setting, HIPAA is often used as an excuse not to talk to family involved in the patient’s care unless express consent has been given. However, unless a patient expressly forbids the treatment team from involving the patient’s friends or family, the regulatory agency responsible for enforcing the law has explained that it is permissible for the treatment team to involve family for the benefit of the patient in absence of express consent in certain circumstances. If you’re having problems it’s worth a try to present some of the follow information to the care team:
The page has many helpful documents: Information Related to Mental and Behavioral Health, including Opioid Overdose
This document is one of the most helpful: HIPAA Privacy Rule and Sharing Information Related to Mental Health
Please know, however, that if a patient expressly forbids the care team from talking to someone, the staff cannot do so, no matter how sick the patient is, even if the staff believes it to be in the patient’s best interest. Often the staff are working behind the scenes to convince such patients to allow them to make a connection.