Homeless Portlanders Report Challenges Accessing Healthcare

(This story was first published in The Lund Report, which calls itself “Oregon’s most vital source of health news.” A link to the complete story is at the bottom of the post.)
In interviews with The Lund Report, homeless people said they were poorly treated by local healthcare providers, although several said they had positive experiences, and accessing care is a low priority until health concerns reach emergency status.
Charles Blackmon, 56, in Old Town Chinatown on Easter 2017. Photo by Thacher Schmid.

Homelessness both causes and results from serious health issues, according to the National Alliance to End Homelessness. But homeless people on the streets of Portland say the treatment they’ve received from local healthcare providers has not just helped their health problems—it’s contributed to them.

Emma Christensen, 27, walking with her pit bull, Prince, near the east end of the Steel Bridge, where she’s lived the last three years, said she had a miscarriage four months ago. Yet she said she spent less than eight hours at a local emergency room before leaving because staff were disrespectful towards her.

Christensen said she has “anxiety, PTSD and bipolar manic depression” and a history of drug use. She said she stopped using, though, when she found out she was pregnant.

“I did know I was pregnant and I ceased my drug use,” she said. One day, she said, she experienced vaginal bleeding that was “very painful and emotionally disorienting.”

“I willingly went to Legacy Emmanuel because I was in so much pain,” she said. But “because of the way that the staff were, I didn’t stay.”

The way staff were? Christensen said they were “short,” “judgmental” and showed a “lack of recognition for [my] being a human species.”

Now, Christensen said, if she had another health concern, she’d probably ignore it.

“I probably just wouldn’t go, because the way that they treat the homeless is just not okay,” she said.

A Legacy Health official declined comment.

Coverage of Portland’s unsheltered homeless population often focuses on housing, reflecting the city’s housing/homeless “state of emergency,” renewed last October. Rarely if ever do local media report on the health needs and experiences of local homeless, even though study after study has shown homeless people use a disproportionate amount of public health dollars.

Oregon has 13,238 homeless, according to HUD’s Annual Homeless Assessment Report to Congress, released last November. The state’s 61% rate of unsheltered homeless is third-highest in the nation. (Results of a new Point-in-Time homeless count in Portland performed in January—likely to be higher than the last—are due in May.)

Interviews with six homeless individuals on the streets of Portland revealed three patterns:

  • Healthcare is not top priority for many living on the streets; it often takes a back seat to other basic concerns like food, shelter or work.
  • Houseless people often have a lack of trust in the healthcare system, or say they’ve been treated poorly by emergency room and hospital staff.
  • Unsheltered homeless have immediate, ongoing healthcare needs and describe frequent, recent interactions with emergency rooms and local clinics that serve the homeless.

Not all homeless have had bad experiences with local healthcare.

Raul Martinez, 48, said he was referred by Transition Projects to a Multnomah County clinic for help with an infected molar, and felt good about how he was treated.

“They checked blood pressure, everything.”

Some have even received alternative natural medicine, for free.

Linda Russell, 57, lives at Bud Clark Commons, a Home Forward building that provides housing and services for chronically homeless. She said she received acupuncture treatment courtesy of JOIN, a local nonprofit.

Russell, who was carrying an Easter meal courtesy of Union Gospel Mission, said she has severe depression and Affordable Care Act coverage, but prefers natural medicine.

“I don’t worry about all that [healthcare],” she said. “If it’s my time to keel over, it’s my time.”

Russell has three teeth left, and used to have dentures when she was in Vancouver, Washington. “I want to [get new dentures], but I don’t know what kind of insurance you need. You’re only allowed one every few years.”

One Side of the Coin

There are two sides to every coin, but HIPAA rules make it illegal for healthcare or social services agencies to discuss allegations like those made by Christensen without signed releases. What’s more, media have traditionally tended to treat homeless people as unreliable—it can be hard to believe someone who is using drugs or experiencing mental illness.

Yet we ignore the experiences of the “human species” living on our streets at our peril. And many unsheltered people are not only lucid, but highly intelligent.

Sean B, 41, is a certified pressman and college graduate who used to print the Boston Herald, he said. For the last year and a half he’s been on the street, most recently under Interstate 5 in a tent next to a posted “Illegal Campsite” notice. He said he has a Bipolar 1 diagnosis and regularly self-medicates, drinking “four liters” of wine a day. He has gone to Hooper Detoxification Stabilization Center—a Central City Concern facility located a couple blocks up the street from Sean’s NE Lloyd Blvd. tent site—three times in the last year and a half when he started getting the shakes.

Does Sean feel the system that helps him sober up takes good care of him?

“Not so much,” he said. “I was kept in a lit hallway for six days” on a gurney at Oregon Health Science University, he said. “They tried to get me into Unity [Center for Behavioral Health], but I guess I wasn’t f**ked up enough mentally, which is crazy after two life-support incidents.”

Read the rest of the story at TheLundReport.org.