Guest opinion by Jack Hart, published in The Oregonian, April 4, 2010
The day before a Portland police officer killed Jack Collins, I stepped onto my deck to enjoy the sunshine. Incoherent shouts and mournful howls floated out of Washington Park, the ranting of some tortured soul perched on the John Reed Memorial Bench. Who knows? Maybe the babbling drunk was Collins himself. It’s a relatively short walk from my back fence to the Hoyt Arboretum headquarters where the transient died March 22.
On the other hand, there’s no shortage of candidates for deranged or inappropriate behavior in Portland public spaces. A day or two after Collins died, I saw two women taking a break near the Lewis and Clark column quickly retreat when a transient wandered out of the shrubbery, threw a well-used sheet of cardboard on the ground and dropped onto it for a snooze. The day after that I watched a young father take his two toddlers by the hand and hold them close as a burly man descended the hill next to the Goose Hollow MAX stop, ranting incoherently. I’ve seen ragged men defecating in the shrubs in front of the Portland Art Museum and in plain view along West Burnside.
Jason Walters, the officer who shot Jack Collins , isn’t responsible for dumping the untreated mentally ill into our streets. We are. And we –not the police –are responsible for the consequences.
Over the decades, we’ve been wildly inconsistent about the homeless mentally ill. During the early years of the republic, we simply jailed them. A wave of reform in the mid-19th century called for more humane solutions, and the day’s liberals promoted the asylum as the preferred alternative. The Oregon Hospital for the Insane, one of the first medical facilities for treating the mentally ill, dates to 1864. But by the mid-20th century public opinion had shifted again. The 1947 novel “The Snake Pit” demonized the mental hospital, and in 1962 Ken Kesey’s “One Flew Over the Cuckoo’s Nest” continued the theme in an Oregon setting. By that time much of progressive America had written off the mental hospital as an outdated barbarity.
In the late 1950s well-meaning reformers launched a movement to deinstitutionalize the mentally ill. They recited a new mantra of “community-based care,” with the ultimate goal, according to Jimmy Carter’s Commission on Mental Health, of “maintaining the greatest degree of freedom, self-determination, autonomy, dignity, and integrity of body, mind, and spirit for the individual.”
Deinstitutionalization was wildly successful, and Oregon’s experience echoed the national one. Adjusted for population, our state’s 1958 public mental-hospital population of 5,000 has fallen by more than 90 percent. Most of patients released were seriously ill. Nationally, more than half of the patients consigned to the streets had schizophrenia and most of the rest suffered from bipolar disease, extreme depression or organic brain disease.
The problem, of course, was that we never provided nearly enough effective community-based care to take up the slack. At the same time, we undermined legal means for making sure seriously ill people who couldn’t function as outpatients took medication and received decent food and shelter.
When Oregon became a state, any justice of the peace could declare someone a lunatic and commit him, a situation that invited abuses. Society reacted by making involuntary commitment tougher and tougher until, in 1975, the U.S. Supreme Court outlawed it for anyone minimally capable of surviving on his own and deemed not an imminent danger to himself or others. Today, odds are nobody could force the poor soul who was howling on the park bench behind my house into any kind of treatment.
The result, according to Dr. E. Fuller Torrey, one of the leading critics of our system, was a “psychiatric Titanic” that sank every goal set by Jimmy Carter’s mental-health commission. Torrey says the folks we deinstitutionalized often live “virtually devoid of ‘dignity’ or ‘integrity of body, mind, and spirit.’ ‘Self-determination’ often means merely that the person has a choice of soup kitchens. The ‘least restrictive setting’ frequently turns out to be a cardboard box, a jail cell or a terror-filled existence plagued by both real and imaginary enemies.”
We’ve come full circle –back to the time when we left mental illness to the police and jailers.
The U.S. Department of Justice reports that 16 percent of the jail and prison population is mentally ill, and other estimates are far, far higher. A Human Rights Watch report concludes that on any given day 70,000 U.S. inmates are psychotic and that up to 300,000 suffer from mental disorders. Our prison system, according to the report, is “serving as a warehouse for the mentally ill.” And, compared to other prisoners, mentally ill inmates are twice as likely to be living on the streets before their arrest and more likely to have committed violent crimes.
Police and corrections officers didn’t ask to deal with this situation, they don’t have the resources to deal with it, and by and large they’re minimally trained to handle it. Usually, they cope the best they can, often with patience and compassion. Lacking alternatives, jail is often the only option. “Frontline” quoted a Los Angeles police officer who described frequent arrests of the homeless mentally ill “suffering from malnutrition, with dirt-encrusted skin and hair or bleeding from open wounds. . . . It’s really, really pitiful. . . . You get people who are hallucinating, who haven’t eaten for days.” Jailing them means “they get shelter, food, you get them back on their medications. . . . It’s crisis intervention.”
When Jack Collins came out of that Hoyt Arboretum bathroom, Officer Jason Walters stood there alone on the front line of the mental-health crisis. And now protesters are in the streets, condemning him for taking action when we ourselves have failed to do the same.
Yes, Portland police can probably review their rules of engagement and probably can improve the way they investigate police shootings and communicate their findings. Yes, some police react to the mentally ill with excessive force. But we’re fixated on issues that won’t solve the problem because, ultimately, they’re not the cause of the problem.
If we want to stop this insanity –and I’m talking about our policy, not the victims of it –we need to address its roots. There’s nothing kind or compassionate about a system that guarantees deranged people civil rights at the expense of their rights to food, shelter and medical care. Let’s quit pretending that alcoholics, addicts and the mentally ill relieve themselves in the streets because they lack public toilets and are homeless because they lack housing. Let’s demand leadership that uses plain language, avoids meaningless platitudes and proposes practical solutions that we’re willing to pay for, including modern, humane alternatives for the asylums we closed decades ago.
And, yes, I know that Portland has dedicated people working on the problem, that we’re getting a new medical clinic to serve the homeless, and that we have a county crisis line and mobile mental-health response teams. Outpatient services no doubt keep many of the mentally ill on their medication and off the streets. But we clearly have a long way to go before we fully deal with the homeless mentally ill. In the meantime, let’s stop blaming the police for problems we created. If we, as a society, had dealt with the mental-health crisis, chances are Jack Collins never would have been in that Hoyt Arboretum bathroom, his face, neck and hands covered with blood.
The final report on the incident isn’t in, but assume, for a moment, that we have the basic facts right. If I was armed with a pistol and was standing, alone, with my back to the wall and an apparently deranged man advancing on me with a razor-sharp blade, I know what I’d do.
How about you?
Jack Hart is a former managing editor at The Oregonian who now works as an author, teacher and writing coach.