Portland woman’s struggle with son shows difficulty of getting long-term care for mentally ill

By Maxine Bernstein, The Oregonian – March 19, 2011

Jeri Olson arrived at Multnomah County Circuit Court anxious and tired from a restless night.

“This is the worst day of my life,” she said as she walked to a second-floor courtroom for a civil commitment hearing for her 32-year-old son who suffers from mental illness.

Around a table sat two mental health examiners and a judge, all waiting for the state’s attorney and public defender. At least five witnesses, including Portland police, a psychiatrist and a county mental health investigator gathered in the hall. Olson stepped out to find her son’s attorney.

“Officer (Mike) Stradley said he thinks this is a good thing” Olson said, “but you know what, it’s not his child.”

Olson’s son was a typical kid until age 22, when he was diagnosed with paranoid schizophrenia. He worked as a Benson Hotel valet, took classes at Portland Community College, liked to shoot hoops with friends and swim in the river.

“He was a fun, good-looking guy,” his mom said.

Now he’s reclusive and housebound. Has trouble reading because he can’t concentrate. Talks of hearing 30 voices.

Jeri Olson has worked full-time as an advocate for her 32-year-old son, who has paranoid schizophrenia. Her struggle to find long-term care for him while making sure he stays safe is the experience of many families who have children suffering from a mental illness. At times, her persistence has irritated county or state officials who have been besieged with her calls and e-mails.

Jeri Olson has worked full-time as an advocate for her 32-year-old son, who has paranoid schizophrenia. Her struggle to find long-term care for him while making sure he stays safe is the experience of many families who have children suffering from a mental illness. At times, her persistence has irritated county or state officials who have been besieged with her calls and e-mails.

“He deserves more of a life than this,” said his mother, who has been his full-time caregiver for more than five years, ensuring he takes his medication and eats.

Jeri Olson knows her son needs long-term medical attention. His psychotic outbursts have led to multiple calls to the crisis line, 9-1-1 calls, short stays at local hospitals. She’s tried to keep him hospitalized when he’s delusional and violent, only to be frustrated when he is released days later, no longer deemed a danger.

So the cycle repeats, with mom calling the crisis line and often directed to 9-1-1 for help, putting the burden on police to serve as front-line mental health crisis workers.

Olson’s struggles are like those of so many families who have children with mental illness. They are forced to go to great lengths — in this case even with the help and partnership of police — to get a loved one long-term care. Then they face the ultimate Catch-22: To get help, a person with mental illness must do something criminal or harmful, the very kinds of dangerous acts families are trying to avoid in the first place.

Typically the only option is involuntary commitment, which forces families to relinquish control — a difficult prospect for parents who have been full-time caregivers and advocates for their children, a difficult prospect for parents who have been full time caregivers and advocates for their children.

The numbers of those in crisis, resulting in hospital mental health holds, are staggering.

In Multnomah County alone, there were 3,938 in 2009-10. For those people, the county has 14 full-time investigators who are expected to review within three days of a patient’s arrival whether the person is a danger to himself or others and should be presented for involuntary commitment or released. In an average week, investigators handle 70 to 85 holds.

With that volume, it’s easy to see how police increasingly find themselves confronting dangerous or suicidal suspects, a phenomenon Portland Police Chief Mike Reese has described as “overwhelming.”

Jeri Olson, too, has relied on police but takes an active role in how they interact with her son. When she’s called 9-1-1, she waits at a corner several blocks away to screen the arriving officers.

“I’m not going to let them in my house if they don’t have any compassion and understanding,” Olson said. “When they send out a police officer, then it’s really hit and miss. They’re all supposedly trained in CIT (Crisis Intervention Training), but they’re individual people with their own personalities. Some of them have a lot of compassion, while others don’t really care.”

Olson has even asked for certain officers.

“You have to be really persistent, and take the lead. If you do it enough, you start knowing the cops and you can actually request them. Some of them are so kind, they’ll give you their own personal cell phone.”

Two days after Christmas, Jeri Olson called 9-1-1.

Her son was hearing voices, trashing the house and throwing things out the front door. He smashed an antique family clock, which lay shattered on the front stoop.

Olson ran out of the house, and her son followed, throwing a beer bottle at her. He was now walking down the street.

Olson waited at Northeast 59th and Alameda Street until Officer Stradley arrived and returned with her to her house. There, he patiently sat as she explained her son’s behavior, his side effects from changing medication and mental health history. Stradley, in turn, shared that with officers out looking for him.

Stradley also called Project Respond, which was familiar with Olson and agreed that a hospital hold was appropriate.

Stradley located Olson’s son about four blocks away. He stood bewildered as Stradley tried to talk to him. On the ride to the hospital, he told Stradley that he wanted to go to “another galaxy.” Stradley asked how he planned to do that.

“He told me he would make the police shoot him,” Stradley wrote in his report.

Stradley took Olson’s son to Legacy Emanuel Medical Center.

He called his mother the next day, yelling that he wanted out to buy a gun to kill himself. Two days later, he was released from the psychiatric unit.

“I feel like I’m beating a dead horse. What more do they need?” Olson said. “It makes you irate. It’s like this bad dream that doesn’t stop.”

State mental hospitals
The Oregon State Hospitals in Salem and Portland, have a combined capacity to serve 641 individuals. Approximately 20 percent of the beds are available for individuals who have been civilly committed. The remainder are for individuals who have been forensically committed – found guilty except for insanity or judged unable to aid in their defense
Blue Mountain Recovery Center in Pendleton has the capacity to serve 60 individuals, most who have been civilly committed.

Olson had hoped the county would allow her son to remain hospitalized for up to two weeks to stabilize his medications. However that 14-day diversion for intensive treatment is granted only if a county investigator considers the patient a candidate for involuntary commitment, and the patient and an attorney agree.

Furious, Olson called Stradley, who called the hospital, reiterating concerns that Olson’s son was intent on killing himself.

But because he was no longer expressing a desire to hurt himself that moment, a Multnomah County investigator released the hold.

“If someone says, ‘I want a suicide by cop,’ and then goes with police voluntarily, that’s not imminently dangerous. That’s someone saying, ‘Come help me,'” said Jean Dentinger who oversees involuntary commitments for the county mental health division. “People can say they’re suicidal; it doesn’t mean they’re going to act on it.”

Stradley alerted dispatchers to provide an immediate two-car police response to any future 9-1-1 calls from Olson, and Olson’s son took a bus home.

Less than two weeks later, police were back.

He was scheduled to meet with his case manager at Cascadia Behavioral Healthcare. Jeri Olson had arranged for a volunteer to pick up her son because she was too afraid to drive him. The morning of the appointment, he cursed at his mother, yelling that she needed to “get the (expletive) out of here.”

So she did.

About an hour later, a neighbor called her cell phone. Olson had given her neighbors cards with her son’s name, diagnosis and symptoms and her cell phone number, should they ever need to call police.

Her son had thrown a clock, dishes, a mug and a vase out the front door. Olson called police at 12:11 p.m. and urged them to hurry, fearful her son might hurt the volunteer scheduled to drive him to his 1 p.m. appointment.

Officer Randy Brandt walked up to the house as Olson’s son walked out for his ride. Brandt decided to follow in case of problems, then went back to the Olson home to learn more about mother and son.

Brandt has since checked in on Olson’s son and established a relationship with him.

Turns out, Brandt, 60, once worked as a psychiatric aide supervisor at the former Dammasch State Hospital.

“It’s something I enjoy, taking more time with mental health issues than most officers probably because of my background,” Brandt said. “Not everybody has the same capacity to strike a rapport with mentally ill people, or to understand what you’re walking into.”

“I just kind of talk to him. See where he’s at. What’s going on in his head. What he’s thinking. Let him know there’s someone interested in him.”

Brandt thinks that attention might stave off police crises down the road.

Olson is grateful.

“Brandt really took a special liking to him, and kept coming back. The sincerity with Officer Brandt is different,” she said. “My son always answers the door, like it’s his friend.”

Still, her son’s voices became constant, and the calls to 9-1-1 more frequent.

A social worker gave her advice she decided to follow, though it hurt to do so: “If you want to help, leave him alone. You’re just holding him up enough so he’s never going to get the help he needs.”

She knew he couldn’t take care of himself, and her mother’s instincts wouldn’t let her kick him out.

So she left the house. And she didn’t answer his calls.

About 48 hours later, she returned to a house littered with beer cans and food cartons, but her son was gone. She called police. “I’m thinking, ‘Is he going to be dead from an OD if I look in his room?”

Brandt arrived.

“It was like he was my guardian angel,” Olson said.

He helped her search the house. They spotted her son’s cell phone. The last number called: 9-1-1.

He’d been taken to Providence Portland Medical Center.

Her son would later tell a county investigator: “I called the crisis line, they weren’t able to help me, so I called 9-1-1 and told them I was suicidal.”

“It truly goes on and on like that,” Olson said.

“You just want your son back. You just want them to have a real life. When he says he’s suicidal, I would be, too.”

And so it’s come to this day, when county mental health officials seek to lock her son in a psychiatric hospital. The catalyst: He struck two staff at Cedar Hills Hospital, where he was transferred from Providence Portland Medical Center.

His mother worries about putting him through a hearing in which he’ll hear doctors and police describe in excruciating detail his problems. An application is pending for Telecare in Gresham, a locked-down 16-bed residential treatment facility for those with severe and persistent mental illness. It’s the only place that provides long-term, secure residential care for the seriously mentally ill that’s a step down from the state mental hospital. All referrals are made through the state’s mental health division; generally half the costs covered by the state, half by Medicaid.

There are few, if any, avenues for voluntary admissions to Telecare, which disturbs Olson.

“I can understand their frustration,” said Jane-Ellen Weidanz, adult mental health services unit manager in the state Addictions and Mental Health Division of Oregon Health Authority. “But the state has limited resources and has to prioritize those resources to those individuals who are at most risk to themselves or others.”

As Olson awaits her son’s commitment hearing, she thinks out loud: “They’re going to win, anyway. They have all the facts, and witnesses that he’s a danger to himself… Why’s it have to come to this extreme?”

She tracks down the state’s attorney hoping for a last-minute alternative. “What can I do instead of putting my son through this torment?” she pleaded. “… I’d rather see him say, ‘OK, I’ll do this.'”

Her insistence appeared to pay off. The deputy district attorney and public defender worked out a deal that her son accepted. He agreed to stipulate to an involuntary commitment for up to 120 days – less than the typical 180-day commitment. His public defender said in court that Olson’s son expected to remain at Cedar Hills Hospital until he could be transferred to Telecare. The judge accepted the 120-day commitment.

“That would be a happy ending if there’s a happy ending to a commitment,” Olson said. “But why do you have to give up your civil rights to get help?”

Yet 11 days later, Olson got notice that her son was considered too aggressive for Telecare, and on March 2 the state sent him to Blue Mountain Recovery Center, a state hospital in Pendleton — 3 1/2 hours from Portland.

Once someone is committed, the state assesses where that patient should go, despite options discussed at the county commitment hearing. “The civil commitment doesn’t give the judge the authority to make that interpretation,” Weidanz said.

So Olson scrambled to get her son to appeal, which he did, but the county denied it, citing no clinical reason to change the state’s referral.

“I am horrified,” Olson said. “That’s not what the agreement was. I would never have done any of this if I knew this was going to happen.”