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Walden seeks input on mental health issues

Mental health care workers, law enforcement representatives and parents told a congressman Tuesday that mentally ill people face many challenges, including a lack of adequate care and housing.

Those were among the major concerns community members voiced during a round table discussion with Rep. Greg Walden, R-Ore.

Walden asked for input as he works to fine tune and promote the passage of the Helping Families in Mental Health Crisis Act, which is pending in Congress.

"It's so valuable to get this input because you all are on the front line," he told a roomful of people filling his Southern Oregon District Office in downtown Medford.

The nation lacks enough mental health workers and needs to find ways to convince people to become psychiatrists and work in settings that include jails and rural areas, said Stacy Brubaker, division manager for Jackson County Mental Health Services.

The proposed bill could lead to a national strategy for boosting the number of mental health professionals. It includes steps toward that goal, such as the establishment of a minority fellowship program, according to Walden's office.

Dr. Jamie Grebosky lauded the bill for its provisions to increase tele-psychiatry, in which patients meet with providers remotely. Tele-psychiatry could help people, especially in rural areas, get the mental health care they need, he said.

Grebosky said too often patients receive treatment in the most expensive settings — hospital emergency rooms and through the criminal justice system.

"We reach patients in crisis," he said.

Walden said jails and prisons hold too many mentally ill people — who should receive treatment to improve their chances of staying out of the criminal justice system.

The bill encourages states to create more community-based mental health treatment options, including assisted outpatient treatment. It would also create more inpatient psychiatric beds in hospitals.

Representatives from hospitals and Compass House, a daytime club for people with mental illness in downtown Medford, said patients don't have enough places to go after they leave hospital emergency rooms or the psychiatric unit at Asante Regional Medical Center.

Joanna Tew, an employment coordinator at Compass House, said about 10 regulars at the club have to be sent out on the streets when the doors close at the end of the day.

Tew said one young woman is following her treatment plan and taking her medication, but faces an uphill battle because of homelessness.

"At five o'clock, I'm putting a 20-year-old girl on the street," she said, noting a man who visits Compass House walks the streets all night because he is afraid of being victimized if he falls asleep.

Mentally ill people face many housing hurdles, including lack of money, a criminal record for some and a severe shortage of rental units in the area that is affecting all people, whether or not they are mentally ill, community members said.

Jackson County has created a mental health treatment court as part of an effort to get defendants care and keep more out of jail and prison, but many lack stable housing, Brubaker said.

Some mentally ill people are faking or causing injuries and illnesses so they can hang out at night in hospital emergency rooms, or they shoplift so they can go to jail, Tew said.

Addiction treatment expert Rita Sullivan said the stigma associated with addiction needs to be reduced so it is treated like other health problems. She noted mentally ill people often have substance abuse issues.

The proposed bill would create an assistant secretary for mental health and substance abuse disorders.

Blair Johnson, who has a relative who struggled with mental health issues, said, in some ways, patients have too many rights. Many mentally ill people can't be forced to receive treatment unless they represent an immediate danger to themselves or others.

"How can we get people in and treated when they don't realize they are ill?" she asked.

Johnson praised local law enforcement agencies for their efforts to train officers and deputies to respond to people with mental illness. An Ashland resident, she said the Ashland Police Department responded to help more than a dozen times before her relative was stabilized.

"The Ashland Police Department was my incredible ally," she said, adding, "They were able to de-escalate the situation."

Jackson County Sheriff Corey Falls said law enforcement needs more tools to help mentally ill people. He said there is also a lack of facilities to house, treat and help people.

"Jail becomes a default for someone with mental health issues," he said. "That's a problem."

The bill takes a step toward empowering parents and caregivers by breaking down some of the privacy rule barriers that stop them from receiving information about their loved one's mental health condition and treatment.

Additionally, the bill expands coverage of mental health services, boosts early intervention for youths and young adults, increases access to medication and requires hospitals to create discharge plans to help patients receive care.

Walden said the bill represents meaningful reform that could ultimately bring down spending by reducing homelessness, imprisonment and emergency room visits.

Staff reporter Vickie Aldous can be reached at 541-776-4486 or valdous@mailtribune.com. Follow her at www.twitter.com/VickieAldous.

Greg Walden