Uncertainty at David’s Harp

From the Oregonian, June 23, 2008

County changes raise the anxiety level at a Northeast Portland clubhouse for people with mental illness

Connie Carter was about 19 when she started hearing voices. She remembers her fear when she was checked into Dammasch State Hospital, the Wilsonville mental institution that closed in 1995.

“I thought they would give me shock treatments,” she says. “But they pushed me in the shower and put shampoo on my head.”

Carter’s experience 30 years ago was jarring, but at David’s Harp, it is not extraordinary. That’s why she comes to this outer Northeast Portland clubhouse for people with mental illnesses — to be with people who understand her.

David’s Harp, founded in 1978, is among Oregon’s oldest examples of the community safety net hastily sewn when people were discharged en masse from mental hospitals with little provision for their care. Now the clubhouse is also an example of the people and programs caught in the turmoil as Multnomah County restructures its mental health system in the wake of financial problems at Cascadia Behavioral Healthcare. Cascadia staffs David’s Harp, which is an independent nonprofit.

The county announced last week that several major clinics would shift from Cascadia’s management to other providers, setting off a domino effect of uncertainty for staff and clients at smaller programs such as David’s Harp.

Cascadia currently provides about 80 percent of the county’s adult mental health services, including housing, treatment and crisis services for mental illness and for drug and alcohol addiction.

A new plan sets a goal of having no more than 40 percent of county-funded mental health services provided by any single agency.

As late as Thursday, confusion remained over who would staff David’s Harp. But Karl Brimner, the county’s director of mental health and addiction services, said it now appears the Harp will stay with Cascadia.

Officials are still working out whether clients can keep going to the Harp and get their health care and case management at a clinic that Cascadia no longer manages. Most of the 110 people who go to the Harp see doctors and case managers at a Gresham clinic that will be managed by a new provider. Brimner said he favors letting clients use more than one provider if necessary.

“I see it as: How do we make this system work for the people getting services from it,” he said.

Client angst began in mid-April when Cascadia’s financial troubles surfaced.

“It’s been such a long time period where people have had to sit with so much unrest,” said Mary Kautzer, Cascadia’s program manager for David’s Harp. Clients — many whose peace of mind depends on familiarity and routine — have reported mounting anxiety and difficulty sleeping and eating, she said.

“I’d get mighty depressed if I didn’t have this place to come to,” said Don Rossetto, a Harp regular for 28 years.

Parkrose United Methodist Church launched the Harp 30 years ago with dozens of volunteers — some who still volunteer today — to give people a haven to make friends and enjoy activities. The Harp took over the church’s annex and became a nonprofit. Kautzer signed on as program manager right out of graduate school in 1982 and never left, staying on even as Mount Hood Mental Health and then Cascadia took control of county services. Cascadia works with the Harp’s board to run the program.

“We’ve been pretty much operating with a handshake for years,” said Thomas Price, an attorney and the Harp’s board chairman. “It’s a relationship of trust.”

An annual budget of $130,000 pays Kautzer for one day a week, a part-time supervisor and three full-time staff members. The six-day-a-week program provides a meal, outings, group discussions and second-hand clothing. Staff people say they find hope in helping people live independently.

“I just have such a personal investment in the lives of these people,” Kautzer said. “You just want to take care of them.”

The feeling is mutual. Recently, Rossetto and Connie Carter shared a table for bingo. Next to Carter was Michael Bohan, who eyed bottled water that he hoped to win.

Staffer Celeste Connell tracked bingo cards for a client who is deaf and for Rossetto and another client who are blind.

Juanita Elliott signed up on the chore board as bingo caller. So she spun what the clients call the “mixer-upper,” extracted the first bingo ball and called out the number.

“I got bingo!” Carter announced later when she won, one of several players to win that night.

She hopped up in her scarf-bedecked, wide-brimmed straw hat and chose shampoo as her prize.

Soon, Rossetto won. Connell described the prize options to him. He chose a Tom Petty tape — he’s into vintage rock ‘n’ roll.

The bingo game ended, but Bohan didn’t win his bottled water. So Carter handed him her shampoo.

“You didn’t win, so you can have it,” she told him.

“Thank you,” he said, and slipped the bottle into his backpack.

But Rossetto was troubled. He asked Connell whether he could share something with her. She sat close. He explained that a woman at the clubhouse the other day insulted him and made him cry. Connell reassured him.

“I feel better, Celeste,” Rossetto said. “You know, this keeps me out of the hospital and I like coming here. I like everyone here. You’re like my fourth family.”