It looks like any quiet home nestled in Northwest Portland. The turn-of-the century dwelling once served as a boarding home. And though that’s changed, it continues to serve people today, offering space for stabilization, treatment and preparation for life’s next steps.
“We worked to preserve and retain its apothecary feel,” said Mike Nomina, director of residential services for Cascadia Behavioral Healthcare, who provided a tour of the home for Multnomah County Chair Deborah Kafoury and others.
“This is a trauma-informed environment.”
Cascadia Behavioral Healthcare’s Glisan Street STP home — or Stabilization, Treatment and Preparation home — is just that. It’s a transitional housing program that provides psychiatric stabilization services, legal skills training and a range of additional supports to help homeless people, who are also involved in the justice system, prepare to rejoin the community.
Modeled after Central City Concern’s STP program, Glisan Street STP was designed to fill a need for transitional and supportive housing services for homeless defendants who struggle with behavioral health challenges. It launched in the spring of 2019. But unlike Central City Concern’s program, participants in the Glisan Street STP participants, struggle with more acute mental health challenges. Most are unable to assist in their own defense of pending criminal charges.
“They may be facing misdemeanor charges or possible low-level felonies,” said Bill Osborne, manager for Multnomah County Mental Health and Addictions Services, which oversees the program.
“The staff at Glisan Street STP work to have those clients understand their charges and work toward stability.”
Participants are referred to the program by Multnomah County’s Mental Health and Addictions Service Forensic Diversion Program, and the County’s Mental Health Court.
Without the Glisan Street STP program, “many of those defendants might cycle or languish in jail or a state hospital bed until they are able to assist in their own defense,” Osborne said.
It can cost as much as $1300 a day for a stay at the state hospital. But the Glisan Street STP offers a less expensive community-based alternative at roughly $235 a day. And it’s already making a difference according to program managers.
Last April, one resident, Michael, was facing misdemeanor theft charges. He also had lost the ability to see his family because of actions that led to restraining orders, said Chris Clark, Glisan Street STP program manager.
But a daily routine coupled with case managers, therapists, clinicians and skills trainers, who help build proficiency around life skills like grocery shopping, cooking, taking medication and making outpatient appointments, has led to stability.
“And he’s maintained stability,” Clark said.
Currently, Michael is engaged with Cascadia Behavioral Healthcare’s Forensic Assertive Community Treatment, a comprehensive team that not only saturates participants with services but also works with the courts, parole and probation and other partners to help break the cycles of jail and hospital stays.
Recently, his charges were formally dropped after he was able to fully participate in legal proceedings and he has reconnected with family.
Staff have continued to work with Michael as he prepares to eventually leave the program.
The last leg of this process is finding a safe place to live, Clark said. “But he’s stable and resolved everything and is connected to established services.”
“Homelessness should never be a reason to compromise fair access to the legal system," said Chair Kafoury. "The promise of Glisan Street STP is not only to help balance the scales a little more, but to do it with compassion and with dignity — that there’s a path out of the justice system and into a place of stability.”
The morning routine doesn’t begin promptly at 8 a.m. Glisan Street participants have the opportunity to sleep in for health-related needs.
“We wake people up to welcome them, every morning,” Clark said. “They do stretches and other body performance exercises, often paired with cognitive or mindfulness based exercises. Then we check in to see how people are doing and what goals they have for the week.”
The first floor of the 6,000-square-foot home serves as a common area with a kitchen, dining room, living room and bathroom that’s accessible for people with disabilities. The second and third floors hold bedrooms and a gaming room. Each person has their own bedroom.
Medications are placed in secured drawers for clients to access themselves, with reminders from staff if they haven’t taken them.
As the day progresses, participants may also be reminded of other important appointments, such as parole and probation or court check-ins, or appointments to set up health benefits and counseling meetings.
Meals on Wheels delivers lunch and dinner. Between meals, participants might be encouraged to cook their own food, do laundry or work on other daily life skills.
There are also planned outings like trips to the Oregon Zoo, local community centers or nearby food cart pods. At first, staff accompany clients who leave the facility. Once clients become more established, they can go on outings alone, but with curfews.
The home is not like a secured state hospital facility. Rather, it’s a support center for self-sufficiency. Staff are on-site around the clock to assist in emergencies provide crisis deescalation and maintain a safe and supportive environment.
In the evenings, guests participate in group sessions.
“We have an evening group that can range from activity therapy to coping skills training,” said Clark. “It’s meant to wrap up the day and check on people to see how they’re doing.”
The key philosophies at Glisan Street STP are to provide non-judgmental, compassionate and accepting interactions, explains Clark.
“People in this population rarely receive this from society or the system, including community, mental health and legal systems,” he said. “We’re trying to re-humanize and bolster them up to reengage with society, outside of institutions.”
The home may not be a good fit for some.
Technically, a participant can choose to leave at any point — but the hope is they stay, with the encouragement of the group environment.
“We do notify forensic diversion or mental health court if a participant walks away,” Nomina said shared with the tour group.
Participants also must sign a rules agreement and abstain from drug and alcohol use. If they relapse, depending on the circumstances, they can often continue on their path to recovery with support from program staff.
Sometimes staff have to look at other options, from residential treatment or an outpatient program, Nomina said, and will work to discharge someone to a more supportive program or emergency housing.
But so far, program managers are encouraged.
“We know those who engage in a program like this are more likely to engage in treatment and move on to the next level of care,” Osborne said.
“If clients are able to engage in this program, people tend to get stable and move through their charges and hopefully stay connected to mental health care. This happens at a fraction of the cost of a stay at the state hospital and keeps people with mental illness from languishing in jail.”
Ten people can live at Glisan Street STP at a time, but the home averages seven people per day.
Since March, 30 people have been referred to the program. They stay, on average, for about a month and a half. Those who successfully leave the program to their own home or residential treatment often stay for an average of 23 days.
Some participants have been booked into jail, while others have walked away. But many more have found stability.
Glisan Street STP is funded through the Oregon Health Authority Aid and Assist Emergency Board.
Like all programs, it will be subject to evaluation, including impacts and costs to the system as a whole.
“We’re encouraged by the outcomes of other comparable programs and look forward to more healthy outcomes for Glisan Street STP, as well as how this program will fit in with the continuum of services to help an often overlooked population,” said Osborne.