A man lying on the sidewalk said, 'help me'

A series of unhelpful, inappropriate, wasteful official responses ensued

I am speaking as a retired banker, felon and ex-con, recovered heroin addict, downtown Portland resident for 20 years and a liberal Democrat. And a white man.

While walking my dog the other night in downtown, I encountered a Black man lying on the sidewalk near a streetcar stop screaming “help me.” His belongings were scattered around him.

I engaged with him, and he asked for an ambulance, telling me he was suicidal. He showed me his wrist, which he told me he had cut. There were a few drops of blood on the sidewalk, but I could see his cuts were superficial.

But I called 911 just in case. I asked them to dispatch Portland Street Response (PSR). After about five minutes of questioning, the dispatcher sent PS3s (Public Safety Support Specialists) and an ambulance because I had not witnessed him cut his wrists and could not assure the dispatcher he was not wielding a knife. This was despite my assurances that he was not violent, there was no knife in sight and he was obviously angling for a visit to the emergency room.

We do need better options for the many people living unsheltered on our streets, but it is also the use of the limited resources we do have that is so frustrating. Living where I do, it is a rare day when I don’t witness at least on encounter like the one that night.

The dispatcher protocol is very unhelpful and requires a long list of often repeated questions and a complete lack of the situational awareness of the caller. It discourages use. As a result, calls are often not made, and when they are, they can take first responders away from much more urgent duties. The ambulances transport those they don’t need to transport to hospitals and are ill-equipped to help while at the same time damaging the efficiency of our health care and public safety system. If we are going to fund Portland Street Response, use it. If not, spend more money on mental illness residential treatment and quit complaining about the Portland Police Bureau showing up.

I have several observations from my four years as an advocate for behavioral health treatment in Multnomah County and Oregon.

• Treatment for addiction and mental health often needs to be jump-started against the will of the addict or the person with mental illness. This does not necessarily need to involve jail, prison or even police. It can be in the form of a short-term (under 30 days) civil commitment—not to warehouse, but to assess, plan and start an individualized treatment process for people suffering from an illness they often can’t even acknowledge they have.

• Prison is not conducive to rehabilitation. The longer the term and the harder the prison environment, the more likely rehabilitation will be unsuccessful. It just hardens and institutionalizes the individual. Prison is also expensive, which is why there was a bipartisan effort to end the three-strikes law. Punishment is expensive. Use it judiciously.

• Oregon and Multnomah County have systematically set up a system of laws, advisory groups, behavioral health staff and guiding principles that are explicitly against prosecution, jail, prison or anything that smacks of coercion or accountability for behavioral health illness and crimes related to it. This is especially true for those who identify as LGBTQ+ or minority racial or ethnic groups. It is reflected in the empty beds at Inverness “Jail,” the lack of adequate public defenders, the quick release of addicts arrested for open use and the county’s deflection system. It is visible in my conversations with city and county staff, who have elevated minority rights to such a degree that the best any white man can be is a recovering racist or homophobe lacking lived experience. Hardly conducive to mutual respect and acceptance or problem solving.

• We also need to recognize that it is the people of the state, city and county who fund and use tax-funded services. Oregon is a progressive state with a tax structure to match. No consumption tax, like Washington and California. Artificial Intelligence says that nationally 60% are net consumers of taxes (receiving in benefits more than they pay in taxes) and 40% are net payers. In Oregon it is closer to 80% and 20%. Marginalized groups are underrepresented in that 20%, but that does not mean we can ignore their priorities, such as ending homelessness, treating behavioral health illnesses effectively and restoring livability and public safety. Those are legitimate needs for all.

It seems obvious that unless we can agree to efficiently solve the problems the net payers want to address, we will have declining revenues to solve any of our problems.