When it comes to police conduct in this city, there is always a bounty of finger pointing to go around.
The Department of Justice’s report on its investigation of the Portland Police Bureau points its own fingers, too. It is critical of the police bureau’s “unconstitutional” overuse of force, including the repeated application of Tasers, on people experiencing or perceived to be experiencing mental illness. It points to the bureau’s administration and deficiencies in policy, training and supervision. We agree, and support the creation of an independent body for police oversight.
The DOJ also cites a lack of capacity in social services to handle mental health crisis situations, including the absence of a crisis triage center. Entire chains of communication had gaping holes between the street and accessing acute care.
Indeed, the report packs its criticism with caveats around limited resources and an inordinate expectation that police officers take care of mental health crises, at least as they appear on the streets, among those facing perhaps the worst moments of their lives.
One finger is missing, however. The one that should be pointing back at Washington D.C. and the health care industrial complex. This is a health care issue, after all, and for all the potential the DOJ report can offer us in terms of reform and improvements, it is a view through the lens of the criminal justice system.
The potentially devastating interaction between police and people in the throes of mental crisis has to be a health care priority. We can appeal to local and state services to refine programs and dedicate more funding to the cause, but until we have meaningful health care reform at the federal level we cannot create the systemic change needed to prevent the tragedies occurring on our streets.
The Affordable Care Act significantly improved options for people with mental health issues, but it does not ensure a federal commitment to funding mental health care. For children and low-income individuals and families, mental health care relies on federal and state programs such as Medicaid and the State Children’s Health Insurance Program. Yet these programs are routinely cut. Medicaid reimbursements are far below the cost of treatment, and states are forced to shift or reduce funding to services for the poor.
According to the National Alliance on Mental Illness, states have cut more than $1.6 billion from their mental health services over the past three years. Oregon has bucked this trend, slightly increasing its funding for mental health services. But this crisis doesn’t have boundaries, and clearly the commitment falls short of the need we see daily in our city.
If the federal government wants to look at the problem of people in mental crisis on our streets, it has to point the first finger at its own policies toward health care, body and mind.