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With a sewing machine and creativity, state hospital seamster helps patients on journey

A seamster at the Salem psychiatric facility gives patients a little more control over something that’s easy to take for granted: how they dress
Elizabeth Flick, a seamster, inside the clothes store at Oregon State Hospital in Salem, Oregon on Nov. 21, 2023. | JAKE THOMAS/THE LUND REPORT
December 14, 2023

On a typical day four new patients enter the Oregon State Hospital, the state’s largest psychiatric facility, in Salem. For the most part, they come from jail or the streets with mental illness so severe a judge has ordered them there. Dislocated, often agitated, they find themselves swallowed into the hospital’s massive, red-brick complex that spans 850,000-square feet — just slightly bigger than the Moda Center in Portland. 

But when they’re ready, they’re likely to encounter a more welcoming presence: Elizabeth Flick, who hands them a big bag of clothes. 

“On the surface, we give them clothes,” Flick told The Lund Report. “But the reality is that we give them a little bit of a sense of control.”

Flick assists patients with what she described as an overlooked influence on their mental health: their clothes. She is one of three in-house seamsters at the hospital who alter and sew garments. 

On average, Flick works with five to six patients each day. Some patients coming from jail or the streets are admitted with only the clothes on their backs. 

After meeting them, she mends well-worn jackets or other treasured “comfort items” for patients, and also makes alterations to help their clothes fit better. 

Flick also helps patients pick out pants, dresses, shirts, jackets and other items in the hospital clothes store. 

“I’m grateful for people like Elizabeth because I went for over 20 years homeless on the streets,” Jaspar, a state hospital patient who only gave his first name, told The Lund Report. He said Flick helps people like him “reach the stars.” 

Jaspar said Flick sewed an elastic band in his baseball cap after it broke, made him a puffy pirate shirt, and is keeping her eye out for a pin-striped vest. 

On the day of The Lund Report’s recent visit to the hospital, Jaspar wore a pair of Dickies and a T-shirt. The shirt had an image Jaspar drew of a bearded man with striking green eyes wearing a pin reading, “Love is love.”    

A shop like many shops

The clothes shop where Flick works is located past a tree-spotted courtyard where bundled-up patients could see their breath while taking chilly November morning strolls. Near the hospital convenience store and coffee shop are a pair of dressed mannequins set up next to a glass door. Above the door is a sign with the word “clothing.”

Seamster Elizabeth Flick looks through racks of clothes inside the store at Oregon State Hospital in Salem, Oregon, on Nov. 21, 2023.

Inside the shop, Flick or another seamster stand behind the counter, ready to help patients. Flick, 34, recently wore plastic-rim glasses, a baggy sweater and her red hair in braids. Nearby sat her pink water bottle with a sticker reading, “Read Books. Be Kind. Stay Weird.”

Roughly the size of a neighborhood coffee shop, the store wouldn’t feel out of place in a Portland shopping mall. There are racks of jeans, plaid button-down shirts, stacks of T-shirts, coats and bins of undergarments. It has that recognizable sterile clothes store smell.

Behind the shop counter hangs a vintage JC Penney ad for back-to-school clothes that Flick found in a drawer. Next to it is one of five sewing machines. Those include specialized machines: a Serger, used for cutting fabric and edge binding, as well as a Juki, for heavy-duty fabrics. 

Coming to Flick’s domain can be overwhelming for new patients, who are unused to having so many options, she told The Lund Report. Patients who were homeless before coming to the state hospital are more likely to try and grab as many clothes as they can because they’re used to their possessions being stolen or lost. 

Every patient gets a personalized shopping experience, with a seamster on hand to help them find items and make alterations for a more exacting fit. Clothes are free, and if a patient asks about payment, Flick jokingly replies with gusto, “We’ll put it on your credit!”

A visit to the clothes shop can mean a “night and day” change in the disposition of a patient chafing under their highly regimented life at the state hospital, said Flick.

“They go from grumpy and argumentative to really happy, really chatty,” said Flick. “Their body posture is a lot more open — that’s a whole mood turnaround.”

Told of Flick’s work, Jason Renaud of the Mental Health Alliance of Portland is impressed. Patients are typically nervous coming into the state hospital, and while the services she provides may not qualify as treatment, he thinks it definitely contributes to healing and recovery.

People experiencing mental illness “are concerned about our dignity and how others see us, and also how to express ourselves — often that’s done through our clothing,” he said. “For someone to do something so sweet as to repair a piece of old clothing to help someone feel at home and welcome and that this is a place of healing and not of incarceration, that’s a really wonderful gesture.”

In a place like the state hospital, “You’re trying to help a person find what it feels to be normal, and to receive help and to learn to give help,” he added. “We’re trying to help them to be more human.”

“Who would think to do this?” he said. “But someone did, and it’s quite charming.”

Clothes vary by season; dresses needed

Flick walked past a tidy rack of brightly colored women’s blouses and sweaters with jeans on the other side. The store’s clothing inventory, she said, is a mix of community donations and state-provided items, like pants and shoes.

The clothes vary by the season. A patient recently snagged a Halloween-themed T-shirt with the words, “Every day is a treat at Grandma’s” from one of the mannequins, said Flick. 

The clothing store tries to accommodate all patients’ styles and Flick said she asks staff and volunteer services for donations of stylish street clothes. But she said accommodating everyone can be challenging.  

“We don’t get dresses very often,” she said. “And women love dresses.”

Dresses have to have a high enough neck and straps, and when nicer ones come in, they “go like hotcakes,” she said. Brand-name clothes are also popular. Muumuus or “lounger” dresses are the default option for patients who refuse to wear pants, she said.

Another popular item is hooded sweatshirts, which Flick described as “gold” because they help patients dampen noise and avoid overstimulation while giving them a place to recoil when they feel uncomfortable.

“Wearable safe spaces are a thing,” she said.

Inside the state hospital it can be hard to tell the difference between staff and patients because both wear flannel shirts, sweaters and other street clothes. One of the telltale signs of who is a patient are their shoes, which are state-provided and have orange soles and are velcro (laces are considered a safety hazard).

Flick stepped into an office next to the shop and emerged with a stack of colorful cards and letters from patients thanking the seamsters. One card from a patient happy with a tank top reads, “To the clothing store girls! Thank you sooo much!”

Elizabeth Flick holds up a shirt inside the clothes store at Oregon State Hospital where she works as a seamster on Nov. 21, 2023.

After bridal shops, jumped at hospital job

Flick learned to sew from her mother when she was 7 in order to make accessories for her Barbies, and she remained interested in clothing and design while growing up.

“Bodies are weird, and they’re weird-shaped and I don’t have an off-the-rack-body shape,” she said. “So I realized I really needed to get into the sewing skill to be able to change clothes to fit me better.”

After high school, she earned an associate’s degree in custom dressmaking and took jobs doing alterations for bridal shops and other retailers. When a job for a state hospital seamster came open, Flick applied within five hours for the position. She said she was eager for the opportunity because she wanted more regular working hours than retail jobs and was drawn to the benefits package of a state job.

Flick said working at the hospital clothes store isn’t that different from her previous jobs. The work also comes with interesting tasks that require creativity, she said. She recently sewed together a stuffed monkey with a 10-pound bag of rice inside it that a patient will hold to balance out other stimulation.  

“We see that patients tend to have one thing they will wear until they physically can’t wear it anymore because it’s their comfort item,” said Flick. “It’s something that gives them that little bit of security. “As much as possible, our job is to really repair it to like a reasonable level so that they can extend the life of it to feel that just that little bit more secure for longer.”

Flick brought out a well-worn red plaid jacket she splayed on the counter. She was asked to remake its threadbare cuff and reinforce its lining to make it last longer.

“In a very real sense, I am helping people on their mental health journey by being here and doing the work that I do,” she said. “And that’s extremely valuable to me.”

Anyone wanting to donate clothes can reach out to state hospital Volunteer Services at [email protected]

You can reach Jake Thomas at [email protected] or via X @jakethomas2009.