DIRECTOR'S DESK | A new report from Disability Rights Oregon finds people seeking help often wind up in jail – we can do better
In a harrowing report on trespass arrests made at six Portland-area hospitals between 2017 and 2018, Disability Rights Oregon has found that 72% of the 142 people arrested were homeless.
Pushed to the margins, struggling with homelessness and behavioral health crises such as mental illness and substance use disorders, people swivel between the emergency rooms and jails. And too frequently, it’s when they’re seeking help and at their most vulnerable that some find themselves handcuffed and transported from a medical setting to behind bars.
Disability Rights Oregon collaborated with the Criminal Justice Reform Clinic at Lewis & Clark Law School to evaluate Portland Police Bureau arrests for trespass over one year period. Of the reviewed arrests, people of color made up 35%.
The highest number of arrests was at Emanuel hospital, followed by Providence, then Oregon Health and Science University Hospital, Unity, Good Samaritan and lastly, Adventist.
The title of the report reads like that of a dystopic novel: “The Unwanteds: Looking for Help, Landing in Jail.”
But this is simply our reality. People who refuse to leave the hospital grounds are coded as “unwanteds;” their crime, trespass.
The emergency, too often, is a lack of housing. And the crime is that people refuse to leave – to be released back into homelessness.
A litany of arrest records described in the report backs this up: She was “arrested because she didn’t have anywhere else to go,” reads one. Another person “frequently seeks hospitals as places of refuge during the cold.”
Avoiding discharge, one patient was described as “stalling.” In another report, a person was described as saying, “I’m not leaving. I’m not going out into the cold.”
One person, promised a “breakfast burrito,” refused to leave without the burrito. Gripped by desperation, people responded with bellicosity and agitation.
This is, of course, is a very expensive way to address homelessness, and looping people through the criminal justice system creates new barriers to housing and employment.
Jail is a terrible place for people struggling with mental health. The “risk of suicide is heightened, solitary confinement is often the default placement for people whose behavior does not conform and mental health crisis is routinely met with force, discipline, lock-down and the use of restraints,” the report states.
“The Unwanteds” report argues for the Portland Street Response as a better option than sending the police when the issue is trespass – people not wanting to leave the hospital.
Street Roots issued the Portland Street Response plan in the March 15 edition of the paper, calling for six vans, staffed by teams of medics and peer support specialist crisis workers, 24-hours a day. The 911-dispatch system would triage calls, such as these “unwanted person” reports at hospitals, to Portland Street Response.
In many cases, a Portland Response team would be a better alternative to police because they would be trained in behavioral health crises and de-escalation – and they would not arrest people.
What is clear, though, is that the Portland Street Response has to be a big enough effort to meet the need. An underfunded, under-capacitated program will create an unsatisfactory response. “The Unwanteds” report calls on “hospitals, insurance companies and coordinated care companies” to help fund a robust crisis team.
The city of Portland allotted $500,000 toward designing a pilot for the Portland Street Response in the 2019-2020 budget. Commissioner Jo Ann Hardesty's staff, in collaboration with Mayor Ted Wheeler's staff, is leading the design process over the next few months. Street Roots will report on opportunities for the community to provide design input.
Of course, the hospital staff and Portland Street Response will need alternatives to jail. The report also calls for more community-based behavioral healthcare, more recuperative care — places for people to heal when they are discharged, such as beds at Central City Concern – and more housing, particularly housing connected to behavioral health services.
Perhaps what is most heart-breaking is how many people are arrested when they don’t want to leave a hospital setting. They want help. Dan Currin, an emergency department crisis intervention specialist, described recently to Street Roots that the ER is something of “a haven to many.”
“There are many people who come in who don’t have resources,” he said. “I don’t know what it would look like without an ER,” he said.
The new report from Disability Rights Oregon reveals that too many times, there’s no place left for unhoused people but jail. This has to change.
Kaia Sand is the executive director of Street Roots. You can reach her at kaia@streetroots.org. Follow her on Twitter @mkaiasand.
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