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Decriminalizing Mental Illness 

Deschutes County is set to open a stabilization center this spring. With a 17-fold increase in mental health calls over the past decade, it's a welcome addition

Calls to the Bend Police Department involving people who were "allegedly mentally ill" increased by 172% from 2010 to 2017. People affected by mental illness end up in prisons and jail at a much higher rate than people without a diagnosis. In response to the increase in calls, Deschutes County has created a number of innovative programs—backed by federal grants—aimed at intervening early to connect people with the resources they need to stay out of jail and the emergency room.

The Deschutes County Stabilization Center will open in the spring of 2020 and will cost approximately 
$2.5 million per year to run 24 hours a day, seven days a week. - COURTESY DESCHUTES COUNTY
  • Courtesy Deschutes County
  • The Deschutes County Stabilization Center will open in the spring of 2020 and will cost approximately $2.5 million per year to run 24 hours a day, seven days a week.

For many people with schizophrenia, bipolar and psychosis, the first point of entry into mental health treatment is the criminal justice system, after they commit petty crimes like trespassing or disorderly conduct, explained Holly Harris, crisis program manager for Deschutes County Health Services. Forty-four percent of people in Deschutes County Adult Jail had a mental illness in 2016, according to a study by the County. Once they enter the system, it's hard for them to get out, as their symptoms make self-advocacy a challenge, Harris said.

On a national level, Oregon ranked dead last in a 2018 study by Mental Health America, comparing the state's high prevalence of mental illness with low rates of access to care. But Harris believes that locally, the community's progressive services for those with severe mental illness may serve as a model for the rest of Oregon, and even other counties across the U.S.

Co-Responder Program

On a typical day, Abby Levin rides alongside officers from Bend PD, helping them respond to calls that range from wellness checks for a person with suicidal ideation, to direct interventions with someone engaged in "criminal mischief."

"There has been a huge shift in law enforcement and their openness and willingness to collaborate with mental health," said Levin, who works as a professional counselor within the Community Response Team, the mental health unit Bend Police Chief Jim Porter added in 2015 to effectively respond to the increase in mental illness calls. "Everyone is having better outcomes. No one wants to use force when interacting with someone. We can de-escalate these situations much more effectively because the officers have more support."

Levin's position is funded through Deschutes County's Law Enforcement and Behavioral Health Partnerships for Early Diversion Grant—a federal Substance Abuse and Mental Health Services Administration grant that will also partially fund a new Stabilization Center, slated to open this spring.

Stabilization Center

Stabilization centers are popping up around the country as a way to divert those struggling with a mental health issue from landing in jail or the emergency room, according to Harris, who has toured 17 facilities since the project was initiated in September 2015. Some stabilization centers also provide a safe place to go for those coming off of drugs and alcohol, but the dangers of detoxification require more medical staff, so the Deschutes County Sobering Center will not be added to the project until 2021, when county commissioners will decide whether to add these additional expenses into the budget.

The center is slated to open this spring inside the former probation and parole building near the Bend Fire Department off Hwy. 20, which cost over $1.5 million to renovate. The improvements include five recliners with dividers for privacy, water features to create a peaceful environment, and an open office and conference room for mental health professionals, nurses, psychiatrists, peer support mentors and case managers.

Harris described an example candidate for stabilization named Bill: He's been diagnosed with schizophrenia; he refuses to take his medication because he does not think he's mentally ill, and he was recently evicted from his home, but had to be physically removed because he believed he owned the house. He doesn't fit the criteria to be forced into a psychiatric hospital, so now he's homeless. For Bill, loneliness and isolation trigger schizophrenic episodes.

Once the center opens its doors, if Bill ends up "breaking in" to his old house, instead of being arrested, he'll be taken to the center. There he can socialize with the staff and his peers, receive psychiatric treatment, have a warm meal and a place to sleep, and ideally re-engage long enough to develop a plan for a new place to live.

Forensic Diversion Program

Harris helped start Deschutes County's Forensic Diversion Program three years ago to help people with mental illness who end up in the Deschutes County jail.

The FDP team is made up of mental health professionals, peer supports and case managers who meet with people who are incarcerated to first establish rapport. When that person gets out of jail, the team works to immediately connect the person to mental health treatment and meet their basic needs for housing and safety.

"Some of the people we've worked with have had a ton of charges; they are well known in the criminal justice system," Harris said. "But we've worked with 80 individuals since we began and we have seen a 58% reduction in the rate of recidivism."

"I feel like we are doing some incredibly innovative and progressive things in Deschutes County, so the national statistics about Oregon... they just don't resonate with me locally," Harris said. "We've had a mobile [mental health crisis response] team for over 14 years; most communities do not. We have a police department with a mental health unit; most communities do not. We are getting a stabilization center; most communities don't have one. We've been a model for the state in many ways."

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