The county’s deflection program is based on people addicted to drugs, making logical, well thought out decisions about their addiction. It is a complete misunderstanding of what addiction is all about….the biggest mistake we made as a community was not electing Sharon Meieran as county chair…she understood the problem in 2017
Exactly - every time we are lucky enough to be presented with an actual intelligent adult, with practical understanding of issues and perhaps the lived experience outside of government to actually do something about them, the self proclaimed “progressive” voting block decides to elect the complete opposite. On some level you begin to wonder if people here relish living in complete dysfunction.
This is EXACTLY the point I made to her in person, from my own lived experience, at this meeting. Her entire position relies on addicts choosing to get sober of their own accord, which as you described is not how addiction works.
It’s almost like our entire government has been incompetent and/or corrupt for several years now, leading to rampant deterioration of every basic service a city requires to maintain semblance of order. Maybe voters will someday get a clue.
Also, down with JVP, Moyer, and the rest of the county - what a swamp of bad ideas and horrible fiscal decisions.
"Although that loophole is widely known, County Chair Jessica Vega Pederson refuses to bring the issue before the commission, Moyer said."
More finger pointing for our elected officials. Moyer ran for office claiming she'd stand up to county chair Jessica Vega Pederson, but now she's content just to run away from Pederson. Partnership for Progress has publishing scathing critiques of the County's failing deflection center since early May, but now that momentum is building to change the program, Moyer has jumped on the outrage bandwagon. She's outraged but can't do anything, except for the inconvenient fact that at least two other County Commissioners have expressed outrage, as well. So why can't 3, maybe 4, County Commissioners make changes to a county program? Because apparently it's easier to point fingers than roll up your sleeves and actually make a difference.
Same thing goes for Moyer's reluctance to use the expanded authority recently granted by the state legislature to temporarily commit people living on our streets with serious mental illness. Moyer points her finger at the state hospital system, and claims $90,000 per person is too expensive. Except she conveniently forgets that the county is the local mental health authority, and much of that price tag is for people and services that the county already contracts for.
Then there's of course the deflection center where we're paying $132,743 for each referral (not treatment, just referral). Moyer can't do anything about that because...Jessica Vega Pederson won't let her. But $90,000 to stabilize someone suffering from psychosis on our streets? Well, that's just too expensive, and someone else should do something about it, sometime.
There is light at the end of the tunnel, just no consensus on what to do to start focusing on treatment for those with psychosis and on recovery for those with addiction. Once we can do that housing the people living on the streets with those conditions becomes feasible. Until then, we are not only wasting money but we are eroding our affordable housing stock, as Central City Concern’s study illustrates. Why do we think asking addicts what they need will get them cured? Why are we not asking the many people who have successfully recovered? If we create the possibility of a 30 day maximum expedited detox/recovery assessment civil commitment for those addicted to drugs and use this time to get them clean, better understand their problem, assign them peer support, assist them in developing their own recovery plan and arrange sober housing with support to be released to, we give them a fair shot at recovery without the burden of a criminal record and the negative impact on our housing stock. If the relapse, which many will, repeat, this time without the medically assisted withdrawal followed by sober housing with wraparound services. This is how most addicts recover. With this, most will not need prison time like I did. And the money? What about a loan from the preschool for all fund and use it to staff the 250 unused dorm beds at Inverness Jail? Be resourceful.
This is definitely a very complex problem. There is the combination of mental health and addiction issues in play. As a medical student I did my psychiatry rotation at Dammasch State Hospital. I don't think I encountered a single patient that would qualify for residential transition or eventual discharge despite intensive management and medication therapy, including electro-convulsive therapy. At yet, we closed and raised that facility. You could say this was part of a different approach to mental illness, to transition it to community care. But while John F. Kennedy may have proposed that, and Ronald Reagan implemented it there were no resources (read: Money) devoted to the needed outpatient services that might have allowed some (but not all) of the seriously mentally ill people at Dammasch to transition to community care. And guess what: there has been NO investment in mental health services since. Everyone just wants to make it disappear. But it cannot. So I don't have a solution, other than this country spends a lot of money on useless healthcare administration, third party payment, etc. But we are not addressing the core issue for people who are seriously mentally ill. So big surprise: They are on our streets. You get what you are willing to fund. If you want to produce tax policy and federal legislation that redistributes wealth upward then this is the result.
The pols are busy finger-pointing, debating "policies," clutching their pearls--but no one will face the essential truth. As long as humans have been on the planet, if they have incentives to do something, they will do it.
The strange, twisted subset of humans who live on the streets and knowingly shoot and snort substances that they know will kill them has been given a whole menu of incentives to continue to live in Portland.
Remove the incentives and suddenly somewhere else looks better. That's why the Gresham side of the Springwater Corridor is clean.
This is something Ms. Moyer doesn't understand. "Why" is another question which probably has to do with her incentives to return value to her supporters.
Lots of good comments. I hope there is a growing consensus. The State has studied this to for years with numerous advisory committees and reports costing millions to inform us it will take billions to solve but there remains no good data, especially for people living on the Street. Central City Concerns’ newly released study gives us a glimpse of some data and some repercussions, but there is still no consensus on how best to get people into treatment and what steps to take when they are there. We can’t even try a low cost pilot to test ideas out using existing staff and infrastructure.
This account of Commissioner Moyer is misleading.. First off, nothing is collapsing about the mental health care that has been provided by many in different venues. Secondly, the reason people are not going to the hospital has nothing to do with what is going on at the state hospital. The state hospital problems, for which it is being sued, has to do with people with legal charges who have taken up almost all of the patient population. They are being evaluated for competency to stand trial and whether they qualify for an insanity defense. They are there, usually transferred from the jail, at the direction of the court which wants to be reassured of their competency, or to make them competent through treatment. The future might include closing the state hospitals entirely which often lead to lengthy hospitalization that is detrimental to patient's functionality and create great suffering. The current protracted competency evaluations and treatment of incompetency is a problem needing a fresh set of eyes. Best to have the competency evals done at the jail, treatment for incompetency in the jail as well which is often medication based. If after two weeks people can't be made competent, then try them with additional state support and consideration at sentencing. The competency movement has become an industry that keeps growing and expanding, in part fuels by defense attorneys who have little evidence supporting their client's innocence, along with criminals who know how to fake symptoms, but primarily by the tremendous number of people with severe mental health disorders who end up committing crimes.
The reason people are in and out of local psychiatric units in three days has to do with poor laws and policy. The cost problems can be solved and allow for more extended treatment. Like I have written before there needs to be a fundamental restructuring of the civil commitment process and law. HB2005 is somewhat in the right direction, but administratively burdensome. Probably much saving could be found by basing judges in hospitals, getting civil commitment determinations with 12 hours of hospital care, establishing a substituted judgement consent process for committed patients who often obstruct their care, and limiting commitment to six weeks max. Community based general hospital psychiatric units are better than free standing psychiatric hospitals because of the very high occurrence of physical illness in this population, the need for psychiatric care for many who are hospitalized with physical problems as well, and also because of the proximity to communities. Sending these patients off to the state hospital miles and miles away, excludes them, and although with exceptions, often leads to prolonged stays in institutions that try patients' composure and civility, given the high rates of violence and bizarre behavior.
The city is doing a lot to try and be of assistance to those with severe mental disorders and sometimes succeeding. We need to streamline and organize our outpatient services, but build the missing component, which is functional, effective, practical, humane, and near immediate hospitalization capability for those who have severe mental illness that negatively impacts the safety, civility, or beauty of the public square, or negatively impacts their families, or in those whose illness is so severe, it would be inhumane to fail to intervene to prevent them from "rotting with their rights on"
There is no time like the present. Let's start now.
The county’s deflection program is based on people addicted to drugs, making logical, well thought out decisions about their addiction. It is a complete misunderstanding of what addiction is all about….the biggest mistake we made as a community was not electing Sharon Meieran as county chair…she understood the problem in 2017
Exactly - every time we are lucky enough to be presented with an actual intelligent adult, with practical understanding of issues and perhaps the lived experience outside of government to actually do something about them, the self proclaimed “progressive” voting block decides to elect the complete opposite. On some level you begin to wonder if people here relish living in complete dysfunction.
This is EXACTLY the point I made to her in person, from my own lived experience, at this meeting. Her entire position relies on addicts choosing to get sober of their own accord, which as you described is not how addiction works.
It’s almost like our entire government has been incompetent and/or corrupt for several years now, leading to rampant deterioration of every basic service a city requires to maintain semblance of order. Maybe voters will someday get a clue.
Also, down with JVP, Moyer, and the rest of the county - what a swamp of bad ideas and horrible fiscal decisions.
"Although that loophole is widely known, County Chair Jessica Vega Pederson refuses to bring the issue before the commission, Moyer said."
More finger pointing for our elected officials. Moyer ran for office claiming she'd stand up to county chair Jessica Vega Pederson, but now she's content just to run away from Pederson. Partnership for Progress has publishing scathing critiques of the County's failing deflection center since early May, but now that momentum is building to change the program, Moyer has jumped on the outrage bandwagon. She's outraged but can't do anything, except for the inconvenient fact that at least two other County Commissioners have expressed outrage, as well. So why can't 3, maybe 4, County Commissioners make changes to a county program? Because apparently it's easier to point fingers than roll up your sleeves and actually make a difference.
Same thing goes for Moyer's reluctance to use the expanded authority recently granted by the state legislature to temporarily commit people living on our streets with serious mental illness. Moyer points her finger at the state hospital system, and claims $90,000 per person is too expensive. Except she conveniently forgets that the county is the local mental health authority, and much of that price tag is for people and services that the county already contracts for.
Then there's of course the deflection center where we're paying $132,743 for each referral (not treatment, just referral). Moyer can't do anything about that because...Jessica Vega Pederson won't let her. But $90,000 to stabilize someone suffering from psychosis on our streets? Well, that's just too expensive, and someone else should do something about it, sometime.
Both tragic and pathetic at the same time.
There is light at the end of the tunnel, just no consensus on what to do to start focusing on treatment for those with psychosis and on recovery for those with addiction. Once we can do that housing the people living on the streets with those conditions becomes feasible. Until then, we are not only wasting money but we are eroding our affordable housing stock, as Central City Concern’s study illustrates. Why do we think asking addicts what they need will get them cured? Why are we not asking the many people who have successfully recovered? If we create the possibility of a 30 day maximum expedited detox/recovery assessment civil commitment for those addicted to drugs and use this time to get them clean, better understand their problem, assign them peer support, assist them in developing their own recovery plan and arrange sober housing with support to be released to, we give them a fair shot at recovery without the burden of a criminal record and the negative impact on our housing stock. If the relapse, which many will, repeat, this time without the medically assisted withdrawal followed by sober housing with wraparound services. This is how most addicts recover. With this, most will not need prison time like I did. And the money? What about a loan from the preschool for all fund and use it to staff the 250 unused dorm beds at Inverness Jail? Be resourceful.
I've never heard it put better or more succinctly:
"Why do we think asking addicts what they need will get them cured? Why are we not asking the many people who have successfully recovered?"
This is definitely a very complex problem. There is the combination of mental health and addiction issues in play. As a medical student I did my psychiatry rotation at Dammasch State Hospital. I don't think I encountered a single patient that would qualify for residential transition or eventual discharge despite intensive management and medication therapy, including electro-convulsive therapy. At yet, we closed and raised that facility. You could say this was part of a different approach to mental illness, to transition it to community care. But while John F. Kennedy may have proposed that, and Ronald Reagan implemented it there were no resources (read: Money) devoted to the needed outpatient services that might have allowed some (but not all) of the seriously mentally ill people at Dammasch to transition to community care. And guess what: there has been NO investment in mental health services since. Everyone just wants to make it disappear. But it cannot. So I don't have a solution, other than this country spends a lot of money on useless healthcare administration, third party payment, etc. But we are not addressing the core issue for people who are seriously mentally ill. So big surprise: They are on our streets. You get what you are willing to fund. If you want to produce tax policy and federal legislation that redistributes wealth upward then this is the result.
The pols are busy finger-pointing, debating "policies," clutching their pearls--but no one will face the essential truth. As long as humans have been on the planet, if they have incentives to do something, they will do it.
The strange, twisted subset of humans who live on the streets and knowingly shoot and snort substances that they know will kill them has been given a whole menu of incentives to continue to live in Portland.
Remove the incentives and suddenly somewhere else looks better. That's why the Gresham side of the Springwater Corridor is clean.
This is something Ms. Moyer doesn't understand. "Why" is another question which probably has to do with her incentives to return value to her supporters.
Lots of good comments. I hope there is a growing consensus. The State has studied this to for years with numerous advisory committees and reports costing millions to inform us it will take billions to solve but there remains no good data, especially for people living on the Street. Central City Concerns’ newly released study gives us a glimpse of some data and some repercussions, but there is still no consensus on how best to get people into treatment and what steps to take when they are there. We can’t even try a low cost pilot to test ideas out using existing staff and infrastructure.
This account of Commissioner Moyer is misleading.. First off, nothing is collapsing about the mental health care that has been provided by many in different venues. Secondly, the reason people are not going to the hospital has nothing to do with what is going on at the state hospital. The state hospital problems, for which it is being sued, has to do with people with legal charges who have taken up almost all of the patient population. They are being evaluated for competency to stand trial and whether they qualify for an insanity defense. They are there, usually transferred from the jail, at the direction of the court which wants to be reassured of their competency, or to make them competent through treatment. The future might include closing the state hospitals entirely which often lead to lengthy hospitalization that is detrimental to patient's functionality and create great suffering. The current protracted competency evaluations and treatment of incompetency is a problem needing a fresh set of eyes. Best to have the competency evals done at the jail, treatment for incompetency in the jail as well which is often medication based. If after two weeks people can't be made competent, then try them with additional state support and consideration at sentencing. The competency movement has become an industry that keeps growing and expanding, in part fuels by defense attorneys who have little evidence supporting their client's innocence, along with criminals who know how to fake symptoms, but primarily by the tremendous number of people with severe mental health disorders who end up committing crimes.
The reason people are in and out of local psychiatric units in three days has to do with poor laws and policy. The cost problems can be solved and allow for more extended treatment. Like I have written before there needs to be a fundamental restructuring of the civil commitment process and law. HB2005 is somewhat in the right direction, but administratively burdensome. Probably much saving could be found by basing judges in hospitals, getting civil commitment determinations with 12 hours of hospital care, establishing a substituted judgement consent process for committed patients who often obstruct their care, and limiting commitment to six weeks max. Community based general hospital psychiatric units are better than free standing psychiatric hospitals because of the very high occurrence of physical illness in this population, the need for psychiatric care for many who are hospitalized with physical problems as well, and also because of the proximity to communities. Sending these patients off to the state hospital miles and miles away, excludes them, and although with exceptions, often leads to prolonged stays in institutions that try patients' composure and civility, given the high rates of violence and bizarre behavior.
The city is doing a lot to try and be of assistance to those with severe mental disorders and sometimes succeeding. We need to streamline and organize our outpatient services, but build the missing component, which is functional, effective, practical, humane, and near immediate hospitalization capability for those who have severe mental illness that negatively impacts the safety, civility, or beauty of the public square, or negatively impacts their families, or in those whose illness is so severe, it would be inhumane to fail to intervene to prevent them from "rotting with their rights on"
There is no time like the present. Let's start now.