Mental Health Meltdown

Willamette Week – May 23, 2001

The gunshots that killed Mexican nursery worker Jose Mejia in the hallway of a local psychiatric hospital last month are still reverberating.

Even as the furor over the police shooting begins to ebb, Portland’s mental-health system is melting down under the strain of the closure of Pacific Gateway Hospital, which has removed 66 psychiatric beds (out of a total of roughly 250) from a system that was already operating well beyond capacity.

“I believe we are ‘an accident waiting to happen,'” wrote county mental health worker Shawin Khan in a May 17 email to her supervisor, Bill Toomey.

Like the mythical butterfly of chaos theory whose tiny atmospheric perturbations trigger hurricanes on the other side of the globe, the Mejia tragedy–which began with a dispute over bus fare–is sending shockwaves through the medical system. On April 20, three weeks after the shooting, state authorities closed Pacific Gateway. Now the eight-bed Crisis Triage Center, designed to be the system’s “front door,” is backing up because it has nowhere to send patients in need of care.

The CTC was “on divert”–i.e., full–for 286 hours, or 40 percent of the time, in April, compared to an average of 110 hours, or 15 percent of the time, in previous months.

With the CTC bursting to capacity–patients have been sleeping on mattresses on the floor–psychiatric patients are instead diverted to hospital ERs, chaotic and confusing places where they receive minimal treatment and suffer long delays.

Others have been sent to facilities as far away as Medford or Pendleton at a cost of $1,800, which is charged to the patient.
“It’s very troubling,” says Laura Pierce, an ER manager for the Providence Health System.

Meanwhile, as local ERs fill with psychiatric patients, they can no longer accept medical emergencies–broken arms, appendicitis, or other trauma–further straining an existing shortage of ER space and widening the spiral of confusion.
–Chris Lydgate