Multnomah County Behavioral Health is serious about trauma-informed care. So when staff proposed a downtown low-barrier center for people experiencing houselessness and mental illness, the first thing they did was convene advocacy groups and people with lived experience to help shape the vision.
More than two years later that vision is clear, as the day center-shelter-housing project moves from design into construction.
“As we continue to reflect on the past year and half, in light of what we are seeing from the COVID-19 pandemic, in addition to ice and heat, clearly we can see the need for a project like this to better meet the needs of our community,” Health Department Director Ebony Clarke said Thursday during a Board briefing on the project. “With our priority to lead with race and doing our work through a racial equity lens we do believe this is going to be accessible, trauma informed and equitable.”
Division staff who have spearheaded the project described for commissioners the two key ways this project differs from so many programs designed to meet the needs of people with mental illness: it’s truly trauma-informed and peer-driven.
Beginning in February 2019, Behavioral Health held the first of 10 meetings with peer stakeholders. Those stakeholders have weighed in on building and facility design, staffing, staff training and services. The project team held subsequent meetings with neighborhood associations, area businesses, behavioral health providers, culturally specific service providers and first responders.
“Peer engagement is the piece that makes this project unique,” Lynn Smith-Stott, supervisor in the Office of Consumer Engagement, told the Board. “It was intentional to meet with peers before providers. “We wanted people with lived experience to guide the services we have on site at the center.”
The project team also toured regional centers similar to the one they hoped to build.
“We met amazing people who really helped us understand challenges, strengths and possibilities,” said Christa Jones, a senior manager in the Behavioral Health Division. They picked up design concepts that allow for easy flow through spaces, suggestions on clear and inclusive policies and procedures, and staffing patterns that are trauma-informed.
“We learned there can never be enough storage,” she said with a smile, “That green spaces are vital, and allowing pets reduces barriers to people who rely on them for support.”
They also learned that trauma-informed is so much more than design and staffing. It’s about the details: everything from building materials and paint colors, lighting temperature and brightness, to texture, signage, art, and incorporating natural light.
Deandre Kenyanjui, consumer engagement coordinator in the Division, has worked on the project since the beginning.
“It wasn’t but seven years ago I was navigating services, and there was nothing like what we’re trying to create,” he said. “We live up to being intentional about this work and for the first time I’m able to bring my whole self into a project. I just want to say thank you for that.”
Kenyanjui lamented that too often people with lived experience aren’t consulted when agencies design programs and projects intended to meet their needs. But in this project, peers have driven the process.
“Peers have guided us on hiring, safety, trauma informed design, leading with race,” he said. And unlike most programs that send clients to many different locations to receive many different services, “we bring services to people.”
Imagine, he said, you’re someone who has walked through many systems, being told there’s something wrong with you, being told, “This is what you need.” And finally you walk into a space of people who are just like you, not above you, but working for you.
The first floor day center is projected to open from 7 a.m. to 10 p.m., staffed by peer professionals, with referral services, behavioral health services and social series on site. For people who aren’t ready or interested in engaging in services, it will be a place to shower, get a meal, check email and charge a phone.
The second floor will provide 42-bed co-ed shelter beds, staffed by peer professionals and clinical providers. The shelter will offer temporary respite for up to 30 days for guests working with social service and behavioral health providers to establish ongoing support.
And on the third floor, Bridge Housing will provide 20 guests with up to 90 days of housing while clinic and peer professionals work together with guests on plans to transition into stable housing or a long-term treatment facility.
Guests will be referred to the shelter and housing programs through day center staff and by area programs.
Commissioner Susheela Jayapal said Kenyanjui’s words gave her confidence the project will be a success.
“Hearing how you experienced the process of creating this center tells us a lot about how it’s going to operate and work for the people we want to serve,” she said.
Commissioner Lori Stegmann applauded the role of peers in shaping the project. “To hear you talk about this being peer-led clinically-supported is really refreshing. Oftentimes, and rightly so, the government gets criticized for not doing their outreach. And you all have done a tremendous job making sure that was a priority.”
In May, the Board approved design and construction plans for the Center, authorizing the project to move forward. Behavioral Health plans to open the first-floor day center in 2022, followed by a 42-bed temporary shelter and then by a 20-bed “Bridge” housing floor.
The opening will be tiered, allowing staff and partners to accommodate guests and adjust to the new model. It will also allow the program to adhere to any public health guidance regarding COVID-19.
“I really appreciate that as you open, you’re thoughtful about how that’s done, opening the day center and then going from there,” said Commissioner Jessica Vega Pederson. “It’s really smart to make sure everything opens as successfully as possible.”
Commissioner Sharon Meieran said she’s long anticipated a project such as this opening in downtown Portland. “Chair Kafoury, I so appreciate your leadership for making this a reality and having the opportunity to be part of the process,” she said.
Chair Deborah Kafoury thanked the presenters.
“Every day brings us closer to the Center opening, which will soon offer so many people safety, healing, support, and a path forward,” she said. “Much of that optimism and hope comes from the intentional work that the Office of Community Engagement has done to make sure that the right stakeholders — and especially people in the peer community — are shaping what those services will look like.”