Today, Mayor Ted Wheeler released an on the record video statement to discuss Portland’s homeless crisis as it intersects with substance use and behavioral health issues. This ‘problem statement’ video comes off the heels of extensive research, outreach and numerous discussions with Mayors from across the United States—Republican and Democrat, small towns and big cities, rural and urban communities—who all agree homelessness, mental health, and substance use is a nationwide crisis impacting American cities. Mayor Wheeler has brought this discussion to leadership from across the State of Oregon, including elected officials at the City, County, Metro, and State level.
Unique to Mayor Wheeler’s plan is the development of Temporary Alternative Shelter Sites to work in-tandem with existing homelessness shelter services to get homeless Portlanders off the streets and better connected to services. This conversation sets the stage for the bold initiatives lead by Mayor Wheeler to ultimately eliminate unsanctioned, unsheltered camping in Portland through the development of affordable housing and Temporary Alternative Shelter Sites.
Mayor Wheeler's full statement:
One of the most challenging issues facing Portland today is our homeless crisis. Homelessness is a complex issue with many causes, requiring multiple solutions. I want to talk to you about the intersection between homelessness, behavioral health, and substance use disorder.
First, some context. How big is the problem?
According to the 2022 official point in time count, thousands of people are living unsheltered on our streets, and unsheltered homelessness in Portland increased by 50% from 2019 to 2022. Far too many in our city are living in dangerous and squalid conditions. This is nothing short of a humanitarian catastrophe for our unsheltered neighbors, and it also creates public health, safety and livability concerns for the entire community.
Let me be clear, there is nothing humane about the situation on Portland’s streets. And that’s why 94% of Portlanders identify homelessness as their top issue. Our collective goal should be to eliminate unsanctioned, unsheltered camping in Portland. To do that, we need a workable, and compassionate, means to connect people to whatever services they need to get off and stay off the streets. This could be shelter, housing, treatment, workforce training and other services.
Currently there are hundreds of unsanctioned camps spread out across virtually every neighborhood of our city, over a massive 146 square mile area. This makes it impossible to hire enough outreach workers to meaningfully connect people to services, including shelter. And due to the current dispersed nature of the homeless population, there’s no way to provide the kind of consistent case management or follow-up required to successfully connect people to the services they need. According to the Oregonian, 95% of the people experiencing homeless they surveyed indicated that they had never been approached by an outreach worker or offered any services.
The status quo is not a compassionate response. Leaving vulnerable Portlanders to live outside in the elements in dangerous conditions poses issues to both the individual experiencing homelessness and the community. There is overwhelming evidence that the homeless face incredible danger on the streets. A report recently found that 20% of all homicide victims in 2021 were homeless. The Multnomah County Health Department found that at least 193 homeless individuals died in 2021, a 53% increase over the prior year. Furthermore, they found the average age of death among homeless men to be 48, and among women 46. That is more than three decades younger than the average life expectancy in the United States. Between 2019 and 2021, Portland Fire & Rescue responded to over 2,500 fires in homeless encampments. Sadly, 31% of Portland’s fire deaths in 2021 were those in the unhoused population.
The safety of both people living on the streets and our broader community is at risk.
What’s driving the homeless issue in Portland and how do we address it? People are homeless for many different reasons. Research suggests that the lack of affordable housing is the key driver, and the provision of that housing cannot be overlooked as a strategy to preventing and ending homelessness. But the intersections between homelessness, substance use, and behavioral health issues complicates the situation for many.
<Substance Use Disorder>
Many assume that people become homeless because they use drugs or have untreated behavioral health issues. The truth is much more complex than that. It is bi-directional. While some people undoubtedly become homeless because of drug use or mental health issues, the vast majority are homeless first, and then begin using drugs or developing behavioral health issues late
Let’s talk about drugs in Portland. In 2020, Oregon voters passed Measure 110 to become the first state in the nation to decriminalize personal possession of drugs. Measure 110 was also intended to provide significant new resources for desperately needed drug treatment programs. While I support the intent of Measure 110, the funding has been extremely slow to be deployed and the state’s drug treatment infrastructure continues to fail despite efforts of many people in the treatment community.
Making matters worse, two relatively new, cheap, and widely available synthetic drugs are wreaking havoc in Portland and across the country.
The first is P2P Meth, sometimes called the “new meth.” This is insidious stuff. It can cause severe psychosis, brain damage, and anti-social behaviors including violent outbursts, destructive behavior, and extreme paranoia. Oregon has the highest meth use rates in the United States. In 2021, Meth contributed to nearly half of all homeless deaths in Multnomah County.
The second synthetic drug, Fentanyl, may be even worse, and our community is awash in it. It is cheaper and more potent than heroin. According to the Multnomah County Medical Examiner, fentanyl overdoses in Portland increased 588% over a recent two-year period. Across all age groups, Oregon’s fentanyl death rate grew by almost 500% from 2019-2021. Oregon leads the nation in the growth of youth fentanyl deaths rate, with deaths for kids ages 15-19 increasing over 900% between 2019 and 2021. Yet Oregon only has four youth treatment programs, all with months-long waiting lists.
We’ve seen the damage that fentanyl can cause. Just a few weeks ago a man intoxicated by some combination of alcohol, cannabis and fentanyl attacked a 78-year-old man and caused extensive harm as he was experiencing a mental health crisis reaction to the substances. Recently, the Portland Police and the DEA made an arrest where they confiscated 2 kilos and 30,000 fentanyl pills. According to experts, this is enough fentanyl to kill 1 million people. And it's not even the largest amount confiscated. Eugene police recently recovered 8 kilos in a drug operation.
My own personal view is that when outside players transport substances through our communities with the intent to harm or kill millions of Americans there is a name for this. Weapon of mass destruction. I appreciate that many in our federal government are starting to see it as such. Another side effect of these increasingly prevalent drugs worth noting is an unwillingness to be in enclosed spaces. Enclosed spaced like congregate shelters, motel rooms, or housing of any kind. The bottom line is that synthetic drugs are complicating the solutions required to successfully address homelessness.
When it comes to behavioral health issues, the story isn’t much better. Oregon is routinely listed among the top states in terms of mental health treatment needs, but consistently ranks near, or at, the bottom of states when it comes to delivering needed services. The last list I saw put us at 49th out of 50 states. Our behavioral health systems are failing us all, but they hit the homeless population especially hard. 40% of homeless individuals tell us that they have either a significant drug use disorder or an untreated and disabling behavioral health issue. 20% tell us they have both. Oregon has an unfortunate history of under-investing in affordable housing, behavioral health and substance use treatment. And now we are seeing the results. The lack of critical services at the state, county and local level is why we have struggled to help people get off the streets.
Now it's up to us to act to turn things around, and that’s what I am doing in my capacity as mayor. Continued innovation is the ONLY way we will make progress on the intersection between homelessness, substance use, and behavioral health issues.
Here is part of what we are doing. You have likely heard about the five resolutions recently brought to, and approved by, the city council. I want to explain to you the goals of these resolutions. They serve as a roadmap for the revitalization of Portland.
To put it simply, our homelessness plan consists of three building blocks.
The three building blocks are:
- First, a significant investment in affordable housing,
- Second, moving the unsheltered homeless closer to safety and services,
- And third, the creation of a criminal justice referral system that incentivizes those with a criminal history to seek housing, services, and/or treatment.
Regarding affordable housing, we are working with our state partners to increase tax abatements and deferrals to make more affordable housing projects pencil out. We are asking the state legislature to allow us to use urban renewal areas to create more affordable housing. And locally, we are identifying up to 400 shovel ready sites owned by the city of Portland that could be used for affordable housing.
We need over 20,000 units of housing just in the Portland area to close the affordability gap. It took years to grow this gap, and we must act now to reverse it. Regarding bringing services closer to people who need them, rather than trying to deploy services to hundreds of unsanctioned encampments, we are creating a limited number of larger Temporary Alternative Shelter Sites across the city that could provide navigation to drug treatment, healthcare, mental health services, job training and other services. This is an idea that was created with direct input from people with lived experience.
The city council has already committed $27 million to our alternative shelter site concept, and we hope that the state and Multnomah County will work with us to deliver these critical services. And while we are seeking to reduce and ultimately eliminate problematic unsanctioned campsites across the city, we are NOT seeking to criminalize homelessness. Rather, we are working with the DA and others to create a referral program into services that could allow people to expunge older warrants.
Some have criticized this approach. They argue that funds should only go toward the so-called housing first model and prioritize housing, not the alternative shelter approach. I want to be clear, I support building affordable housing. And in no way will I ever endorse a policy that criminalizes poverty. I believe in acting to immediately help those left to linger on our streets. When I say this, I mean today, NOW. Not next year or five years from now.
Every day that people live unsheltered on the streets they are exposed to drugs, potential behavioral health issues, and dangerous criminal elements. Some would have us leave our fellow Portlanders on the streets. I cannot, in good conscious, ignore people to suffer on the streets.
According to a study conducted by Home Forward, we know that people living unsheltered on our streets are waiting years, sometimes more than five, for affordable housing. We need to act now to save lives and reduce harm. We can both create more affordable housing options AND provide immediate services to those who are struggling to survive on the streets.
Finally, I must make it clear that cities across America are struggling with these same issues. Portland is by no means alone. This means we need the federal, state and county governments to work with us to address the complexities of homelessness. In short, I believe we will offer a bold new direction to Portland. This is what Portlanders want. And no city, certainly not Portland, can wait any longer.
download (portland.gov) (Fire data)
Oregon Overdose Landscape - Presentation from Jan 2023 on Fentanyl Deaths/Including Youth
Ranking the States 2022 | Mental Health America (mhanational.org) Mental Health Rankings
2021.Oregon.NSDUH.Highlights.Final.pdf - Google Drive Meth Rate / Mental Health Rankings
588% Fentanyl Overdose Number is from Multnomah County Medical Examiner