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Many of Portland’s least fortunate live in tents pitched on sidewalks or in aging campers parked in small convoys behind grocery stores.
High housing costs and financial adversity are the primary root causes behind the burgeoning population on the streets; only about one in three people who are homeless in Portland report having a mental illness or a substance use disorder, or both.
But the combination of homelessness with substance use or untreated mental illnesses has led to a lot of very public tragedies.
People with schizophrenia, for example, have died of hypothermia on the city’s streets. Residents have given birth out in the open, to premature infants who did not survive. Methamphetamine, cheaper and more harmful than it used to be, is creating a heightened risk of overdose and psychosis.
Mental illness can be part of the story of how a person ends up homeless — or part of the price of survival on the streets, where sleep and safety are scarce. Unsheltered residents in Portland die thirty years earlier than the average American, according to county data.
These grim realities have ratched up the pressure on politicians to do something.
In Oregon, some politicians, including Portland mayor Ted Wheeler, have proposed changing civil commitment law, so doctors have more leeway in compelling treatment for patients who are too sick to know they need care.
Without such changes, they argue, people with untreated addictions or mental illnesses are stuck cycling between the streets, county jails, and state psychiatric hospitals.
“I think we can do better by people than allowing them to flounder,” says Janelle Bynum, a state legislator who represents suburbs east of Portland.
Bynum was the sole Democrat to sign on to a pair of bills, introduced by Republicans earlier this year, that would expand the criteria for involuntary commitment in Oregon. “My intention was to signal how cruel I think our current system is,” she says.
As multiple crises spill into streets, calls for change
Half of the country’s unsheltered people live in California, and though only about a quarter or third of them are estimated to have a serious mental illness, they are the ones residents are most likely to encounter in California’s cities. Mayors from San Francisco, San Jose, and San Diego have all expressed frustration that the threshold for psychiatric intervention is too high.
“When I’m often asked, ‘Mayor, why aren’t you doing something about this