Making Suicide Prevention a Routine Part of Care

Sep 11, 2017

national suicide prevention week ribbon and logoSuicide Prevention Week is Sept. 10-16, but preventing suicide is something Central City Concern (CCC) thinks about every day of the year. “Zero Suicide” is the national model of treatment that CCC’s Old Town Clinic (OTC) has adopted and integrated into all aspects of the primary care it provides to more than 5,000 individuals it serves annually. It’s a commitment to the idea that every suicide can be prevented with the right kind of care.

“No matter what your position, we’re all responsible for suicide prevention,” says Brian Barnes, Associate Director for Behavioral Health in Primary Care at OTC. Barnes explains that making suicide prevention a system-wide priority and a routine part of care is the key to ensuring that no one falls through the cracks. Having clear, established procedures is better for patients and better for staff because it normalizes prevention and helps everyone know how to get the right kind of help.

“Suicide prevention starts way back so that when we see a patient we are looking at the whole picture."

At Old Town Clinic, this has meant incorporating questions about suicide into regular patient visits, establishing new protocols to ensure that clinicians are aware of patients who have a plan to harm themselves and designating a suicide "clinician of the day" who can respond to help, usually within five minutes. An intervention by the clinician of the day can last several hours—enough time to really engage someone in a moment of crisis, gain new perspective on a situation that may seem hopeless and come up with a concrete safety plan for the day, which clinic staff follow up on. Implementing these changes entailed a team-effort at the clinic, with leadership for designing and operationalizing the new procedures from Susan Marie, Senior Medical Consultant for Behavioral Health in Primary Care, and Lydia Bartholow, Associate Medical Director for Outpatient Substance Abuse Disorder Services.

“This type of work is more typical in a specialty mental health setting,” says Barbara Martin, Senior Director of Primary Care at CCC. But in serving some of Portland’s most vulnerable residents, OTC aims for a comprehensive approach. Many of the clinic’s patients face struggles that make primary care especially challenging: finding housing, getting and keeping regular access to health care, or dealing with addiction and other severe mental illness. At the same time, health care providers can lean on CCC’s extended network of wraparound services in housing, addiction treatment, employment services and social support.

“Suicide prevention starts way back,” Barnes says, “so that when we see a patient we are looking at the whole picture.” It requires going beyond crisis-intervention and stabilization to address long-term needs that support overall health and well being. Recalling how the clinic staff helped one person who recently attempted suicide, Barnes notes: “We were able to get her treatment here, at Old Town Clinic, change some things with her mental health medications, and get her housed in CCC housing with programming specifically designed for people recovering from addiction. We consider all of that primary care, because it’s primary to the person, to their overall care.”

Having clear, established procedures is better for patients and better for staff because it normalizes prevention and helps everyone know how to get the right kind of help.

Barnes and Martin both emphasize that everyone can help make zero suicide a reality. Go with your gut, they say, and reach out to a hotline or many of the other resources available if it seems that someone is at risk of harming themselves. “The most important thing is to listen,” Martin says, “because the evidence shows that if someone is getting close to a point of despair, thinking about hurting themselves, they often talk to people.” And Barnes adds: “Every person’s behavior can be explained if you understand the context, but if you don’t have time to understand the context, then get someone who can.”

• • •

The Multnomah County Crisis Line is available 24/7: 503-988-4888. 
The National Suicide Prevention Lifeline is also available 24/7: 1-800-273-8255
The David Romprey Oregon Warmline offers confidential peer support from 9:00 a.m. to 11:00 p.m. every day: 1-800-698-2392



Monthly Volunteer Spotlight: August 2017 Edition

Aug 30, 2017

For this month's volunteer spotlight, we are turning to another volunteer who has multiple roles at Central City Concern. While Michael initially got started with Central City Concern as a volunteer at the Old Town Recovery Center Living Room program, much like last month’s spotlighted volunteer, his interest in the behind the scenes work for nonprofit organizations led to him expanding his role to include a variety of work in the Public Affairs department. Both roles are well-served by Michael’s ample ability to be an open ear to others. Hayden Buell, who supervises Michael at the Living Room, summed it up, saying, “Michael stands out as a volunteer in his ability to listen to our members and get to know them and their stories in a way that really honors their individuality. He’ll just sit down and give them space to share themselves.”

Michael was so generous in turn as to share himself with us for this month’s spotlight!

• • •

Peter: What is your name and volunteer position?

Michael: My name is Michael Thomas Taylor, and I volunteer with CCC in two places. I’ve been at the Old Town Recovery Center Living Room since February and I’ve been helping in the Public Affairs department as well. I actually came in to talk to Susan [CCC’s Marketing and Communications Director] just because I wanted to do an informational interview, as I’m interested in moving into nonprofit work. Then Matt [CCC’s Grants Manager] said, “Hey, if you’re looking for an opportunity to help out and get some experience, you can help me with grants.” I’ve written a lot of grants as a professor, so that seemed like something that made sense. Then Susan had some projects, doing interviews with CCC clients, and blog posts.

P: So, you got most of your grant writing experience from your time as a professor?

M: Yeah, that’s one of the things you do as a professor – research, and if you want to do research you have to pay for it, and if you want to pay for it you have to write grants.

P: How did you get in to that line of work?

M: Short answer? I ran away to Europe. I grew up in the States, but I wanted to see more of the world pretty quickly. I spent a year abroad in Hungary as a foreign exchange student in high school. I wanted to stay connected with that, so in college, I started out as a music major and ended up as a German major, which worked because it got me back to Europe. I spent a year in Austria and a year and a half Germany, and then one thing led to another and I ended up doing a PhD in German. [A PhD in German] is an in-depth study of language and literature, but for me it also became a study of cultural history. A lot of my published research is in queer history or the history of sexuality, with a focus on Germany, and I branched out to do some work in curating exhibitions and communicating queer history to the public. That gave me some pretty awesome experiences and a fairly international background. I had some post-docs in Germany, and I was in France for a summer. Then my first job was in Canada, so I’ve kind of lived in lots of different places.

“Recovery can’t happen if you’re alone, that’s the first step is getting help. That’s why the connection is so crucial.”

P: What was that job in Canada?

M: I was an assistant professor of German. I was there for five years before I came to Reed College. We loved Canada – and even took Canadian citizenship! – but frankly it was too cold. I kind of thought [Reed] would be the next step in my career, but things have turned out differently and I’ve decided to make a career change.

P: And I guess part of that change and interest in nonprofit work is your time here! What initially drew you to CCC?

M: Being in recovery myself, but I also knew lots of people who’d been helped through CCC programs. I feel really strongly about the mission, and I have friends who work at CCC. [One of those friends and I] were actually snowshoeing on Mt. Hood, and we were just talking about this career change and what goals do I have. I mentioned I was interested in learning more about social service work. He was just like, “If you want to get a sense of what that might look like, you could come volunteer in the Living Room!” We had talked about what that space looks like and the community model they have there. What I love about the Living Room is that it’s not necessarily about clinical services. It’s really about a safe space, it’s about a community in which everybody is a member and everybody participates.

P: So there’s no barriers in between people there.

M: Yeah, the hierarchy is flattened out and everyone participates equally. A lot of the spiritual tools I’ve learned from being a Radical Faerie, about holding space and community, are happening at the Living Room and I just thought that was something I would love to be a part of.

P: Any experiences that have stuck out?

M: Well, getting to know some of the people. Everybody has their own story, and some people are more open about that or not. You need to build trust and sometimes you just need to be there and be present for people, so they see that you’re there, and you’re safe, and you’re interested in them and their success.

Sometimes we color, we just sit down and color and you just kind of talk with people and see what’s going on in their lives. There’s mental illness in my family and I don’t think my family had the tools that it needed to deal with that. You know, pills were often the solution, and that doesn’t always work without some sort of community support and skills model.

It was super powerful for me to come in to a room and see people, some of whom have very severe mental illness, just have a place to be to be understood, to be accepted, to be safe, to fit in, to connect in their own particular way. That has been really powerful and meaningful. It just puts a human face to people that we all live with. We all live in the same space together. That’s important, just to recognize that.

Every morning we sit down for an hour and do a group. There’s an icebreaking question like, “What would you do if you had a million dollars?” Or sometimes something more intense, like, “What does recovery mean for you?” Everyone gets to speak, we have a stuffed bunny we pass around to indicate it’s your turn to speak. It’s often a lot of practice in holding community norms and values, letting other people speak, not interrupting, balancing “I have a lot to say” against “everybody needs to speak.” So slowing things down, and just learning how, practicing, being a community together.

“I guess it’s a recovery cliché, but the stories are so different, and they are all the same. To really recognize that sameness as a source of strength and community, I think is really powerful.”

P: With the client stories that you have been writing, have there been any stand out moments from the interviews?

M: You know, I am just consistently amazed at the resilience of people. That’s really powerful. I guess it’s a recovery cliché, but the stories are so different, and they are all the same. To really recognize that sameness as a source of strength and community, I think, is really powerful.

P: Being able to identify with others or see models for success?

M: And normalizing the struggles that people have gone though. So much about mental illness and addiction is about isolation, and I think breaking that sense of isolation is crucial to recovery.

P: Big or small, I think we’ve all felt that sense of relief when someone says, “No, I feel the same way, I’ve been through the same thing.”

M: I think recovery needs that. Recovery can’t happen if you’re alone; that’s why the first step is getting help. That’s why the connection is so crucial.

P: So, what keeps you volunteering at CCC?

M: I feel deeply committed to the work CCC is doing, and I’m getting some great experience. And I love the people. It’s just fun to be here and I’m genuinely excited about the work I am doing.

P: What would you say to someone who is on the fence about volunteering?

M: Try it out! What do you have to lose?

• • •

If you are interested in learning more about volunteer positions in at Central City Concern’s health and recovery, housing, or employment programs, contact Peter Russell, CCC’s Volunteer Manager, at peter.russell@ccconcern.org or visit our volunteer webpage.



NHCW 2017: Serving a population where they live

Aug 18, 2017

On September 23, 2016, leaders from six Portland health organization gathered at Central City Concern’s Old Town Recovery Center to announce an unprecedented $21.5 million dollar investment in the Housing is Health initiative that will fund three new CCC buildings in Portland. The crown jewel of this shining trio is the Eastside Campus, which will serve medically fragile people and people recovering from substance use disorders and mental illness with a health care clinic and 172 housing units.

“This significant contribution is an excellent example of health organizations coming together for the common good of our community,” said Ed Blackburn, CCC president and CEO. “It also represents a transformational recognition that housing for lower income working people, including those who have experienced homelessness, is critical to the improvement of health outcomes."

Each floor is designed to foster healthy peer relationships, with vibrant common spaces where residents, supported by CCC staff, can build community.

CCC will break ground on the Eastside Campus in late October 2017. The center will build on CCC’s existing Eastside Concern program, and will offer integrated housing and clinical services, including substance use disorder treatment, primary care and urgent care. More than 3,000 CCC patients each year will access care in a unique and welcoming health home environment.

The housing portion of the Eastside Campus will have about 172 units of housing, including short-term medical stabilization and palliative beds as well as transitional housing for people in recovery from behavioral health disorders. Each floor is designed to foster healthy peer relationships, with vibrant common spaces where residents, supported by CCC staff, can build community.

“It’s important to serve people where they live."

“It’s important to serve people where they live,” said Blackburn. “This project will replicate the integrated care we give at our Old Town campus to help people get back on their feet and achieve health and self-sufficiency.”

The Housing is Health initiative is supported by Adventist Heath Portland, CareOregon, Kaiser Permanente Northwest, Legacy Health, OHSU and Providence Health & Services. The new construction includes the Eastside Campus, Stark Street Apartments and Charlotte B. Rutherford Place apartments on N Interstate.

The CCC Eastside Campus is scheduled to open in Winter 2019.



NHCW 2017: Adapting the system to work for our most complex patients

Aug 17, 2017

Central City Concern's Summit team takes care of our Old Town Clinic's most complex and medically fragile patients. Instead of expecting patients to fit into a health care system, the Summit team adapts the system to work for them by offering flexible scheduling, around-the-clock availability, and even home visits. Like many of the programs we've featured during National Health Center Week so far, the Summit team goes above and beyond to break barriers and narrow the gaps that keep vulnerable individuals from becoming as well and healthy as they can be.

We're so excited to share this video about Summit with you, which features Summit team staff and several Summit patients talking about what sets this program apart and how it impacts the lives of those it serves. A version of this video was originally shown at the National Health Care for the Homeless Conference in June.




NHCW 2017: Breaking down the walls between housing & health

Aug 15, 2017

While he waited for his name to rise to the top of the Central City Concern housing wait list, Glenn O. lived out of his van in northwest Portland. As he walked back to where he had last parked, he found his van stolen. Gone. And with it, all his possessions, including his dentures.

Not long after, he moved into CCC housing. But even with a roof over his head, his troubles weren’t over. The doctor he had begun seeing wanted him to eat healthier, but without dentures, the list of foods he could eat was short. What he could eat, and how he ate them, led to intestinal problems and months of feeling sick and uncomfortable.

He called his insurance to see if they would cover new dentures. After all, they were stolen, not carelessly lost. They said that they could only cover new dentures once every 10 years. He’d only had his dentures for three.

Glenn went back to gumming his food, feeling unhealthy, and going against his doctor’s orders.

• • •

Moving into Central City Concern permanent housing is often reason enough for our new residents to feel good about their trajectory. The assurance of having a roof over one’s head feels like a giant step forward toward something better. Indeed, we know that having housing is one of the most significant determinants of health, so becoming a resident of CCC housing is definitely an occasion to cheer.

However, being housed isn’t a guarantee that better health is on the horizon. Even for residents of CCC housing, especially those with more complex health care needs, successfully engaging with CCC’s health care services—or any health care services, for that matter—can feel like a world away. The connection between housing and health care is crucial: how well a resident's health needs are met is tied closely to a resident’s likelihood of successfully staying in housing, says Dana Schultz, Central City Concern’s Permanent Supportive Housing Manager.

Though CCC provides both housing and health care, the nature of the programs, as well as privacy considerations, have traditionally made it difficult to share information between the two areas of service. But where Dana saw walls, she also saw an opportunity. The situation called for a way to put teeth behind a core belief that housing is health. That way? A program called Housed and Healthy (H+H).

"Our supportive housing program realized that we can’t distance ourselves from our residents’ health—it’s everything to them and it’s everything to us."

“We started Housed and Healthy as an initiative to better support our residents’ health by engaging with them where they are: in our housing,” Dana says. “Our supportive housing program realized that we can’t distance ourselves from our residents’ health—it’s everything to them and it’s everything to us.”

The Housed and Healthy program serves to improve the connection between health clinics—be it CCC’s own Old Town Clinic and Old Town Recovery Center or other community providers—and CCC’s supportive housing program, and vice versa. Since H+H started, all new residents of CCC’s permanent housing are given a health assessment so that staff can gain a fuller picture of the new tenant. They are asked about their health insurance status, any chronic health conditions they may be dealing with, and who, if anyone, their primary care provider is.

Perhaps most importantly, new residents are asked to sign a release of information, which unlocks the line of communication between CCC’s housing and health service programs.

“Once the two program areas can start talking, we can immediately map out a web of support,” says Dana. “Our clinic can flag the resident’s electronic health record to show that they live in our housing and note who their resident service coordinator is in case they need their help reaching out to a patient. In turn, our resident service coordinators can know which providers and clinics their tenants are connected to in case health issues arise.”

Housed and Healthy represents a big shift in the way supportive housing sees its role in the well-being of its residents. Housing staff are integral to extending health care out from the clinic setting into where their patients live.

The health assessment can also help H+H coordinators identify potential issues—related to their physical or mental health, or to substance use disorder—that, if unaddressed, could result in a resident losing their housing because of violations that put the safety and peace of the rest of the housing community at risk.

“In the past, we’ve seen people not succeed in our housing for reasons that, in retrospect, were preventable,” she says. “If we know what to look out for and the team of support people we can coordinate with, we can put out fires before they really burn down a person’s entire life.”

Housed and Healthy represents a big shift in the way supportive housing sees its role in the well-being of its residents. Housing staff are integral to extending health care out from the clinic setting into where their patients live. H+H even brings opportunities for health education, such as chronic pain workshops and classes like Cooking Matters, straight to residents. In doing so, the chances that patients continue to have a place to live increase.

Glenn, who had seen Dana in his building frequently as part of her work as the H+H Coordinator, approached her about his denture problem. His issues didn’t put him at high risk of losing his housing yet, but he wanted to follow his doctor’s eating advice. He was, after all, nearly three years sober, and he wanted to continue feeling healthier.

She promised him that she’d look into it. She consulted with Glenn’s Old Town Clinic care team. She researched resources and made countless phone calls. Several weeks later, she gave Glenn the best news he’d received since learning that he had his own CCC apartment: she found a city program that would cover nearly the entire cost of new dentures.

“Dana did all the work I didn’t know how to do. The questions she asked me sounded like she knew a lot about what I needed,” Glenn says. “Now that I have dentures again, oh yeah, I feel healthier now. I’m so grateful to her.”

While Housed and Healthy is ostensibly a housing program, it functions as a way to not only expose residents to the many ways to better health, but as a de facto arm of health services that can reach into where their patients live. Gaps in care get caught and filled; residents are supported in better utilizing health care services; and people like Glenn find trustworthy faces to bring health-related concerns.

“Our housing staff want to see our residents healthier; health care providers want to see their patients housed,” Dana says. “It just makes sense.”



CCC Celebrates National Health Center Week 2017!

Aug 14, 2017

Happy National Health Center Week from Central City Concern!

The health center movement was born during a time of extraordinary challenge, opportunity, and innovation in the United States. Today, as we face threats to the Affordable Care Act, a HUD budget proposal that would reduce housing subsidies by more than $900 million nationwide, and crises like the opioid epidemic and Portland’s housing affordability crisis, I find myself reflecting on our predecessors in the good fight for health care, housing, and equal opportunity and against poverty, homelessness, and oppression. We have a long way to go, but I take heart in recognizing how far we’ve come in the past fifty years.

Today, one in fifteen members of our community receive their care at a federally qualified health center. Here in Oregon, almost all of our FQHCs are designated by the state health authority as patient-centered primary care homes, meaning that they meet six core performance standards (access to care, accountability, comprehensiveness, continuity, coordination and integration, and patient and family-centered) that support positive patient outcomes, good experience of and access to care, and cost control and sustainability. Just a few weeks ago, we at CCC were thrilled to have our Old Town Clinic recognized as a Tier 5 patient-centered primary care home, achieving the highest level of recognition possible in the state. Being homeless or low-income in Portland doesn’t mean receiving substandard care: we should feel deep pride as a community that our most vulnerable friends and neighbors have access to excellent care through our health centers.

Along with providing high-quality, sustainable, accessible care, health centers like Central City Concern also partner closely with other social services providers and health care organizations. At CCC, we bring together health, housing, and jobs under one organizational roof, and we also rely on and treasure our relationships with community partners, who enable us to reach far more people than we would on our own. At the Bud Clark Commons, we partner with Home Forward, Transition Projects, Inc., and others to provide urgent care, mental health, and case management services to homeless and formerly homeless Portlanders. At our Puentes program, which provides culturally and linguistically specific behavioral health care to Portland’s Latino community, our close partnership with El Programa Hispano Católico enables us to bring care into places where the community already gathers. And across our continuum of substance use disorder services, we’re partnering closely with our friends at CODA, Inc., and Health Share of Oregon to develop and implement Wheelhouse, a hub-and-spoke model of care that will enhance access to medication-assisted treatment for people with opioid use disorders. When homeless and low-income Portlanders access services through Central City Concern, they’re tapping into a much larger network of support both within CCC and with our partners.

This year, in keeping with National Health Center Week 2017’s theme of Celebrating America’s Health Centers: The Key to Healthier Communities, we wanted to share some of the ways in which CCC, together with many partners, works to bring high-quality care into our surrounding community by extending our work past clinic walls and directly to where people are. You’ll learn about how our programs work to improve access, outcomes, and sustainability to support the people we serve and our larger community. We may still have a way to go, but we’re going together.

Leslie Tallyn
Chief Clinical Operations Officer



Monthly Volunteer Spotlight: July 2017 Edition

Jul 28, 2017

For our latest monthly volunteer spotlight, we’re delighted to feature Jack Ramsey, who volunteers in not just one, but two, roles with Central City Concern! Read our Volunteer Manager’s interview with Jack to find out how his past professional career informs one of his volunteer roles, as well as how his second role has shaped and enriched his life today.

• • •

Peter: What is your name and volunteer position?

Jack: Jack Ramsey and I have two roles. I volunteer over at the Old Town Recovery Center Living Room and my job there is to just kind of generally help out, to chat with clients, and become part of that operation. That includes anything from washing dishes to making sandwiches. Mostly what I do is talk with folks and I’ve been doing it about nine months now I think. I feel like I’ve made friends there. If there’s a week that I can’t be there because I’m out of town, I miss them. I’ve really learned a lot from those guys. About myself, about the kinds of people that you see on the streets. People that are homeless and suffering from mental illness, addiction, they’re kind of superheroes to me, because they’re able to deal with those issues and really improve their lives.

The other is that I’m a member of the Marketing Advisory Council and what I bring to the party there is 40 years of work doing advertising and marketing.

P: I wonder if you could talk about that a little bit.

J: Well, I got in to marketing because I could write. I worked for a couple of computer companies down in California, ended being an ad manager for one of them, and then I was recruited in 1976 by a small advertising agency in Silicon Valley that just happened to have as its main client a young company by the name of Intel. That was sort of my big break. During that time, a guy named Steve Jobs walked in. He had liked the Intel work we were doing and talked my boss in to helping him. About six month later we had developed all that original Apple brand and I had written the first ad for Apple.

P: What was that first ad, do you remember?

J: I just remember that it wasn’t very good. We didn’t know what a home computer was! I asked my boss, “What are they doing?” He said, “Well, it’s a home computer.” So I said, “What’s that?” and he said, “That’s what we have to figure out!”

Steve brought in a bunch of things, like a naked circuit board and a TV monitor, and he said he was going to change the world, and we were going to help him. We had to figure out what Apple would look like and what the voice should be.

When Intel moved a big part of its operations to Oregon in 1978, I moved here to open an office for my agency. My plan was to come up for a year or two and have an adventure and here I am almost 40 years later.

I almost completely retired about 3 years ago and my wife and I bought an RV and hit the road for a year. I learned for the first time in my life to live day to day and take what comes. I actually did do a couple branding projects from the road, but it was fun. I love being in the game. If I crave anything in my life, it’s solving problems.

P: Do you find that some of the skills you built in your career come in to your work at the Living Room?

J: In a lot of ways, it’s sort of the [photo] negative image of my career. I’m not selling anything, there’s no agenda with it, and I get to purely engage on a human level, with all these amazing people that are fighting the worst things you can imagine. I just get to go hang out with amazing people.

The way I ended up at the Living Room was, as I was retiring and I actually had more time to do what I wanted instead of what other people wanted me to do, I kind of wrestled with it for a while. Should I go back to school or volunteer? I couldn’t find volunteer opportunities that were meaningful to me. I met a guy one day and he says, you should get in touch with CCC. I applied on the website and I wrote a note that said that I’m happy to do anything.

I remember 30 years ago driving down Everett street and there was a guy staggering across the road and I said to my friend, “Do you ever just feel guilty, that there but for the grace of God go I?” So the opportunity to work in the living room with all these folks really appealed to me. It’s been an amazing experience and continues to be. And I’m not giving it up.

P: Any stand out experiences during your time here?

J: Yeah, there was one guy at the living room, and we would get in to these heavy philosophical conversations about human nature and science and philosophy. This is a guy who lived for ten years on a front porch. He is really a brilliant man.

P: That’s not something that we all get to do, is see the depth of people who are experiencing homelessness.

J: And what quality people they are and thoughtful and intelligent and self-aware. Even if they are in recovery from addiction or dealing with a mental illness, they’re learning how to be productive, functional people. It’s heartwarming for me to see someone’s eyes light up when they see me, because they know that I’m happy to see them too. Or when someone comes over and asks me to come talk to them. I actually feel like I’m making a difference in these people’s lives.

I’ve lead an exciting life and I’ve gotten to experience all kinds of successes and failures, but in a lot of ways, this is the most rewarding thing I’ve done. This has gone from “Oh gee, what am I going to do in my spare time?” to really one of the most rewarding things I’ve ever done.

P: Not everyone is able to make that kind of transition.

J: I know, I feel honored that I am allowed to do this.

P: Helps keeps the skills sharp too! We haven’t talked about the Marketing Advisory Council too much, but you had said that you crave problem solving, do you get your fill of that with the MAC?

J: Well, I just came from a MAC meeting! The best thing about it is that I don’t have to do the work, but the worst thing about it is that I don’t get to do the work

At the last MAC meeting we discussed these new ads for CCC, and that we need to makes sure these ads engage people on an emotional level. This isn’t just about telling people what CCC does, it’s about making people care.

P: If you could sum it up, what keeps you coming back to volunteer?

J: The people. They’re just wonderful. The clients are wonderful people that impress me, that touch my heart, that amaze me. The people that work here and the other volunteers are here for all the right reasons. We’re here to help people. It’s a much more rewarding mission than trying to make money or make somebody a star. It’s honest.

P: What would want someone to know who is on the fence about volunteering at CCC?

J: Take the plunge! The water is great. You’ll never know yourself as well as you will when you’re doing this, when you’re working completely selflessly.

• • •

If you are interested in learning more about volunteer positions in at Central City Concern’s health and recovery, housing, or employment programs, contact Peter Russell, CCC’s Volunteer Manager, at peter.russell@ccconcern.org or visit our volunteer webpage.



"My battle with addiction and ADHD"

Jul 25, 2017

Babs, a patient of Central City Concern's Old Town Recovery Center (OTRC), approached us earlier this year with a story to tell. Her story to tell.  And with the help of Dr. Brent Beenders, a former OHSU psychiatry resident at OTRC, she wrote it out. We're grateful that Babs is a part of our CCC community and honored that she asked us to help share her journey.

• • •

My name is Babs. This is my story about battling addiction.

I've been an addict of methamphetamines and heroin for many years. I’ve experienced numerous periods of sobriety and relapse. NA meetings, SMART Recovery meetings, and various types of therapy provided me some, but not sustained, relief.

To fully appreciate my story we need to begin with my birth. I was born in 1960. I had various injuries during my birth. The umbilical cord was wrapped around my neck and my hand was pressed into my skull causing a compressed skull fracture. I am convinced that I was trying to get the cord from around my neck, thus causing my brain injury.

Not that this was enough, but my mother was addicted to alcohol, heroin, and barbiturates before and during her pregnancy with me. My mother’s attempted suicide while I was in the womb also may have been significant in my early development. I had seizures starting from birth. This combination of traumatic brain injury, seizures, and being born addicted to heroin and barbiturates set me up for a lifetime of frustration, fits of anger, anxiety, depression, cognitive difficulties, and severe attention deficit and hyperactivity disorder. Eventually I developed addictions to substances.

I had severe ADHD from a very young age which caused me difficulty in school; I was unable to sit still and could not concentrate on my work or comprehend what was taught. My symptoms were severe enough that I had to repeat the second grade; this was disruptive in that I lost my first group of friends. Finally, I was treated for my ADHD. This improved my hyperactivity, attention, and ability to focus. Despite learning disabilities, finally I was able to progress through several grades. Unfortunately, my doctors at the time thought that ADHD would resolve with puberty, so my medication was discontinued at age 12. I was able to struggle only through the first half of my sophomore year of high school after which I dropped out.

Three months after discontinuing my ADHD medicine was my first experience with street drugs. With the exception of a few brief periods of sobriety, I used illegal drugs daily for many years. I primarily used methamphetamine, but I also used heroin. My brain and body did not seem to know the difference between these different drugs. Without my ADHD medications, I found it near-impossible to use basic survival or coping tools. What the drugs did for me was provide brief relief from the chaos I was experiencing inside.

From the beginning of these years of drug use, I experienced numerous, deep physical and emotional traumas. The resulting PTSD further deepened my addictions and resulted in further personal turmoil. While there were many reasons for my turn to drugs, one important reason that I’ve come to realize is my untreated ADHD. With untreated ADHD, impulsivity ran rampant. ADHD, coupled with a naïve young adolescent brain, contributed to my drug use and other choices that resulted in years of intense victimization and abuse.

The key to breaking free from this cycle of drug abuse and trauma was getting adequate treatment for my ADHD. Given years of amphetamine abuse and sporadic use, finding a provider that would treat this disorder adequately was difficult—almost impossible—despite such an extensive record of my historical diagnosis and past treatment. I tried various treatment strategies recommended by various doctors over the years to address mood and anxiety, which were decidedly dysregulated. These included various antidepressants and antipsychotic medications; this treatment left me with even more severe depression and prone to fits of anger.

Though I had been a patient of Central City Concern’s Old Town Recovery Center years ago, I was getting increasingly desperate for help with my ADHD and how chaotic it made my life, so I decided to reestablish myself as a patient. Working with a psychiatric doctor, we found a medication that could be of immense help and would balance the chemicals in my brain, helping me focus, stay calm, regulate my emotions, and regain control of my life. But there was a big catch: I needed to show that I could be alcohol and drug free in order be given a prescription.

The doctor at Old Town Recovery Center—who, thankfully, understood how brain injuries, trauma, and addiction all affect each other—told me that if I could get alcohol and drug free, we could get started on medication. Ironically, without the right medication, sobriety sounded impossible. And given my current condition and my history of substance use, I was terrified that this was just turning out to be another dead end.

But something special happened: my doctor told me that she believed in me and my ability to get and stay in recovery. She saw that I needed it and that I wanted to regain control of my life. She not only saw the strength inside me, but the supports I could get outside myself.

During the time that I had to show I could get into and stay in recovery, I leaned heavily on the Old Town Recovery Center Living Room program, where a group of peers—each managing their own addiction and mental illness each day—helped me stay on the path of recovery. I learned how to sit in my discomfort and doubts, to embrace them.

Finally, in June 2015, we started the medication. It immediately calmed my thoughts and motor behavior. This allowed me to relearn how to focus on tasks, it provided me with motivation to accomplish tasks, and it allowed for me to sleep more regularly and soundly.

Most importantly it has allowed for me to remain in recovery. For so many years I was utilizing amphetamines and other drugs to try to help regulate my emotions, soothe my anxiety, and even allow me to sleep. With adequate treatment and continued recovery, I feel like I have now been able to finally “grow up.”

Even my interests have shifted. I’ve been on the board of a community health center and was able to help initiate a needle depository program for the City of Portland; among the many benefits of this, important to me is maintaining a clean public environment. I was also able to get some health issues addressed. I needed surgery on my neck and no surgeon was willing to operate on me because of my addictions. After my surgery, the sensations, strength, and dexterity in my hands all improved. I have been able to complete classes to become a certified peer support specialist. Now I can help others who are struggling with similar issues.

Recovery is a unique process for each individual, and I could not hope to elaborate on every step along the way. Here, I hope to have provided a sufficient overview to understand my recovery and the importance of treatment for ADHD.

Acknowledgments: In order to accomplish writing this article I utilized the help of Brent Beenders, MD, a psychiatry resident to help focus my thoughts and polish my prose. I would like to thank everyone who has helped me in my recovery.

I dedicate this to all the addicts out there who are still struggling.



Monthly Volunteer Spotlight: June 2017 Edition

Jun 30, 2017

For June’s monthly volunteer spotlight, we sat down to talk with Malinda Moore, whose energy and zeal for service have already made her a big part of the team at the Old Town Clinic. Read on to hear about how she got involved with CCC and what keeps her coming back as a volunteer.

• • •

Peter: What is your name and volunteer position?

Malinda: Concierge at Old Town Clinic, or as some of the clients say, you must not have made it in to the greeters at Walmart or the Home Depot!

P: Oh no!

M: No! They say it affectionately, especially the clients that recognize that you’re there more often. They remember people.

P: You’ve been there for how long now?

M: Since around Christmas of last year.

P: I’m sure you’ve become a familiar face for folks at the clinic.

M: You hope so. Every day is different. Some days there may be someone who needs a little extra arm around the shoulder and help to stay calm. Other days there are people who just need someone to say hi, or just do something that they don’t expect, like open the door before they get a chance to push the button. I can get out there and get that door open before the patient can. It’s just fun to see the look on people’s faces when someone is nice to them because they’re next to them.

P: That’s probably not something some of our clients see too often, is someone going the extra mile for them.

M: Exactly, and they deserve it as much as anyone does. That’s one of the most fun parts about it.

P: Is there anything that is challenging about it?

M: I don’t have many challenges there. When you’re there observing, the front line people treat every one of those clients like it’s the governor or the mayor. And they remember their names! I can’t believe how many people come in every day and before they step in the door it’s like, “Hi, such and such, how are you doing?” The staff treat them and they treat each other with that same respect. And the clients treat each other with respect. They’ll take time to listen to each other and help each other out. They’re very compassionate with each other. It’s very uplifting to see these people be so compassionate and be working so hard to be doing what they need to do get better.

P: Have you had a particular moment stick out in the time that you’ve been volunteering?

M: There was one woman who came who was having a mental health crisis, and she wasn’t a client, but staff was working really hard to find how best to help her. When staff would leave, I would just sit with her and she had her head in her hands, but once I started talked to her she would put her head up and we would look at pictures of her dog, her boyfriend, and we had great conversations. It was nice to see that I didn’t have to be doing anything medical for her, just sitting there having a friend was good enough to make her feel better. Then you get to meet people that have such varied backgrounds and skills and they’re just such interesting people! There’s nothing big, but every day I come back and say to my husband, “Guess what? I had the best time talking to this person!”

P: Is that what keeps you coming back to volunteer?

M: Yes! I may go two days a week! I really look forward to it. I used to really look forward to going to work every day, so this is this same feeling, like, I get to go to work! And be with people I like to be with.

P: That’s a great feeling.

M: I’m very lucky.

P: And what is your background?

M: I was a medical speech pathologist, so I worked in inpatient, outpatient, home health, hospice, ICU. I got to do all of those. It was that kind of hospital where everybody talked to everybody. You could meet the doctor in the hallway and he’d want t know what you thought about his patient. There wasn’t this hierarchy. It was a great place to work. I get some of that same feeling from the Old Town Clinic. You just watch all these people at OTC and there’s just so much collaboration, it could be a role model for any clinic in the state. It’s not just a job there. The minute someone walks in the door someone want to help them.

P: What got you involved with CCC?

M: Oh, this is a great story! My husband, who is a retired attorney, pours wine in a winery in Albany and he got to talking to a woman at the winery, who happened to be a CCC employee and he came home that day and said, “We’re going to start donating to Central City Concern!” It was just like that. He was so impressed with what she told him. And then when we moved to Portland, I decided this is where I’d like to spend some time. So that’s where it started, the winery!

P: What do you think someone who is on the fence might want to know?

M: I think, no matter what they did, if it was something they thought they might like, they’re going to be treated really well. People are going to go out of their way to help them feel comfortable and they’re going to be appreciated. If I show up on a day I don’t normally volunteer, they’ll be like, ‘Aren’t you usually here on Wednesday?’

• • •

If you are interested in learning more about volunteer positions in at Central City Concern’s health and recovery, housing, or employment programs, contact Peter Russell, CCC’s Volunteer Manager, at peter.russell@ccconcern.org or visit our volunteer webpage.



"A poem for Khabral Muhammad, Aaron Sadiq and many other Black men I love."

Jun 23, 2017

By all accounts, the Imani Center mahafali graduation was a celebratory, joyous affair, but there were pockets of immense beauty and reflection to be found, as well. One of the day's more poignant moments came when Malcolm, an Imani Center graduate, shared a poem he had originally written for his cousin and his son that he felt was appropriate for the day. Everyone in attendance was deeply moved by the poem, which served to remind his fellow graduates of their worth, their path, and their promise,  We're grateful to Malcolm that he gave us permission to share his poem here.

• • •

A poem for Khabral Muhammad, Aaron Sadiq and many other Black men I love.

You my brother,

 are strong beyond your own knowing.

Even when you lay here,

heaving,

broken,

hurting.

You are strong.

Listen to me.

Your strength lies not in your right

or left hand.

Not in your thighs or back

or feet.

But in a place beyond you,

not to be touched,

or doubted,

only held here

when you need.

You will be unbreakable stone.

You will be the heat that burns the dross and waste.

You will be the solid earth on which they stand.

You will be the vine that pulls down the walls.

But for now, be like water. Be easy, flow over and around these obstacles. Seek your own level.

You, my brother cannot be conquered or defeated.

You will push on and over and past, like water.

You will overcome.

The truth is, you are a King among men.

But you have hidden yourself in the mundane, in the badlands.

You walk the badlands among shadows and bad men.

You do not belong chasing these shadows but you love it here.

And here you gleam.

The shadows are attracted to your shine.

You, are no mundane.

The water in you calls for release

It rushes back and forth in your veins.

The clash of tides is in you.

In your ears and toes and fingers it surges and thunders.

This dance you do-this up and down

This back and forth.

Aren’t you tired?

Isn’t this burden heavy?

Don’t you want to rise?

And join your people?

Don’t you want to rise?

It is all there for you. Yours to claim.

All of it.

You only have to release this weight.

Let go,

Let it go.

Let it go, ascend.

Malcolm Shabazz Hoover
Portland, 2017