Outside In Clinic celebrates 20 years of health, social services

From The Oregonian, September 9, 1988

If rolling with the punches is what it takes to survive, Outside In has been tumbling now — and landing on its feet — for 20 years.

To commemorate its anniversary, the social service agency will sponsor a street dance Friday in front of its office at 1236 S.W. Salmon St. Representatives from the Los Angeles Free Clinic and San Francisco’s Haight-Ashbury Clinic, the two other oldest free clinics on the West Coast, will be on hand to offer congratulations from their cities. Music will be provided by Napoleon’s Mistress, The Boys Next Door and Zoomorphics.

When Outside In opened its doors as one of the nation’s first free community health clinics in 1968, it generally was thought to be a temporary, five-year solution to the hippie-generation’s drug problem, said Kathy Oliver, Outside In’s executive director.

“Outside In is clearly not afraid to do innovative programs,” Oliver said.

These programs have generated criticism, often making it a challenge for the agency to get funding, Oliver said.

In March 1969, the Multnomah County Board of Commissioners voted unanimously to give the Outside In county mental health money if the clinic could come up with its own matching funds. But the Portland City Council denied it a solicitation permit. The following year, the city granted the permit and said it considered Outside In Portland’s leading organization in helping drug addicts.

Dr. Charles Spray, who founded the clinic along with Arnold Goldberg and Mary Lu Zurcher, said the council gave in only because it wanted to foist Portland’s drug problem onto someone else.

“It is always one of the problems that when you recognize a problem before everyone else and try to do something about it that when it is recognized you are perceived as part of the problem,” Spray said.

Spray said the agency recognized the growing numbers of alienated youth entering subculture lifestyles in the 1960s and concentrated on pulling them from the outside back into the mainstream.

Hence the name “Outside In.”

Despite frequent community opposition to its programs, Outside In has continued to change with the times to stay in operation.

“Outside In is constantly being altered and revising its program to meet the changing needs of its clients,” Oliver said.

In the late ’60s and early ’70s, Outside In administered first aid at rock concerts to fans who overdosed on drugs or were having a “bad trip.” At the same time it did free drug analyses to protect those who had overdosed from added poisons and fraud. Later, it operated a 24-hour hotline mobile unit called the Outside In Crash Crew, which handled crises like threatened suicides, overdoses or depression. It eventually spun off to help form the Metro Crisis Intervention Service that exists today.

Today, the agency’s full-time and volunteer staff operates a three-room medical facility, a pre-natal clinic, special clinics and programs for low-income or street youths, geriatric out-patient care and low-income adult counseling programs. Recently, Outside In began providing emergency and transitional services for street kids.

In June, the agency received a one-year, $67,000 grant from the American Foundation for AIDS research for an innovative program designed to help slow the spread of AIDS by giving drug addicts clean hypodermic needles in exchange for dirty ones. The needle exchange has been delayed until Outside In finds insurance coverage for the program.

Located in two buildings donated by the Unitarian Church, Outside In began 20 years ago with a $6,000 grant from the federal Public Health Service.

Its current $500,000 operating budget comes from the United Way of the Columbia-Willamette, Multnomah County, the city of Portland, Community Action Agency of Portland, the Portland Private Industry Council and private donations.

“Twelve thousand dollars comes from former Outside In clients,” Oliver said. “People are really grateful. I am always surprised considering who the clients are.”

Even so, Oliver said, funding shortages prompted by local and federal budget cuts will mean an end to Outside In’s successful transitional youth program by April 1989. Its continuing mental health counseling program also is threatened, she said.

About 300 street youths used the clinic’s services in 1983, and the number grew to more than 700 non-repeats from July 1987 to July 1988, Oliver said.

Most of those under the age of 20 have been physically or sexually abused at home and almost all are using drugs and alcohol, Oliver said. Most don’t have high school diplomas or job skills, either, she said.

Outside In has several programs to help displaced youths find jobs and put together resumes. The agency also provides case-management services to the youths in conjunction with the Burnside Projects Youth Shelter, which houses 24 youths referred by Outside In.

Through the transitional housing program, youths are provided a free apartment for 90 days while they participate in Outside In programs. Oliver said 71 percent of the 60 youths in the transitional program last year didn’t return to the streets.

“They’re survivors and very resourceful. If they can survive on the streets it shows they can survive in another setting,” she said.

Oliver said Outside In would continue its current services, and would add more AIDS prevention programs — as other social service agencies should — in the coming years.

“I think if the people who are against the distribution of needles could see the kids and see that so-and-so has tested positive their attitudes would be different,” Oliver said. “In a world without AIDS, we wouldn’t do this (needle exchange). We definitely don’t want kids doing drugs. AIDS has changed everything.”