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Emergency Departments Step Up After Portland's Psychiatric ER Turns Patients Away

The Unity Center for Behavioral Health started turning most patients away on Saturday.
Unity Center for Behavioral Health in Portland. | LEGACY HEALTH
August 1, 2018

Portland hospitals have stepped up to treat patients experiencing mental health crises amid the decision by the area's only psychiatric emergency hospital to turn most patients away.

The Unity Center for Behavioral Healthcare stopped accepting patients arriving by ambulance on Saturday during an investigation by the Oregon Health Authority.

The center, located in Northeast Portland, issued a statement Wednesday evening saying it was ramping up toward normal operations. The closure has affected patients arriving by ambulance. All emergency vehicles were being diverted to other hospitals, said Brian Terrett, spokesman for Legacy Health, a major employer at the center.

In the meantime, the center has been taking walk-ins. It admitted 12 patients who showed up in the last 24 hours, Terrett said.

During the closure, staff have been trained on new patient care procedures in response to an Oregon Health Authority investigation into workplace safety, assaults and staff injuries.

Providence Health and Services has seen a “slight uptick” in mental health admissions since the closure, Providence spokesman Gary Walker told The Lund Report in an email Wednesday.

“We are working closely with Unity and other behavioral health providers to make sure people are being treated in appropriate care settings,” Walker said.

He noted that this increase came during a decrease in demand for inpatient psychiatric treatment, which is typical for the summer.

Oregon Health & Science University said it has not seen an increase in mental health patients in its emergency room.

Cedar Hills Hospital is another facility that takes in mental health patients, said Neal Rotman, senior manager of the Multnomah County Health Department’s mental health program. Cedar Hills Hospital officials did not immediately respond to a request for comment.

Multnomah County’s crisis center, however, has not had an increase in calls.

Terrett said patients who are diverted are going to hospitals where they were treated before Unity opened in January 2017. “The hospitals have not lost their ability to care for someone having a psychiatric emergency,” Terrett said.

Hospital emergency departments “go on divert every single day,” Terrett said. He said Legacy Emanuel Hospital went on divert status last night because they didn’t have any anesthesiologists working.

A statewide system allows emergency personnel to look up the status of every hospital, he said.

The Unity’s ability to treat and board patients experiencing a mental health crisis could also affect law enforcement, said Jason Renaud, a board member of the Mental Health Association of Portland, an advocacy group for mental health patients.

Before Unity, law officers would either put patients experiencing a mental health crisis in jail or take them to an emergency room. If they went to the emergency room, officers would have to wait with the patient until they were admitted to a hospital, he said. Patients would get left in the emergency room for many hours or days before getting admitted to a hospital, he said. If they didn’t have supervision, they would sometimes leave.

The Portland Police Bureau’s Behavioral Health Unit notified the rest of the bureau of Unity’s diversion Tuesday afternoon, according to an email obtained by The Lund Report. It advised that Portland Police officers could still refer people seeking voluntary mental health treatment to Unity.

Portland Police spokesman Christopher Burley said the bureau did not have enough data at this time to determine whether Unity’s diversion is impacting behavioral health practices. In most behavioral health cases, he said ambulances are called to take patients to nearby hospitals or behavioral healthcare facilities. Police, he said, only transport patients in “extraordinary circumstances.”

In those unlikely circumstances, police officers would have to spend more time in emergency departments, but “that might be a moot point,” Burley said.

Multnomah County Sheriff’s Office spokesman Brandon White said Unity’s diversion has not affected how the sheriff’s office handles patients in a mental health crisis because the dealing with a mental health crisis is “not a new event for us.”

Multnomah County’s justice center has more than 100 beds for patients experiencing different levels of mental illness and mental health crisis, White said. “Impact to the sheriff’s office would be small.” The center had 15 beds available in its mental health unit as of 3 p.m. Wednesday.

The Unity Center is still caring for patients housed at the facility.

Terrett said it is “impossible” to say when the center will end its divert status.

“It will go off divert status when there is full staffing and we have the ability to care for any patient who safely walks in the door,” he said.