Sentenced to the Sidewalk: 4 takeaways from our series
Last week, Salem Reporter documented the life of Melinda Lou Kayser, an unsheltered woman who died of hypothermia on a sidewalk last November.
The news organization’s investigation found that her death came just 11 weeks after Marion County investigators determined she could take care of herself. But for months Kayser’s disabilities and mental health issues left her struggling to feed herself, care for her injuries and attend to hygiene.
The circumstances contributed to her death, the investigation found.
Here are key findings from the investigation.
THE SERIES:
Part 1: Melinda Lou Kayser died on a cold Salem sidewalk months after county investigators determined she could care for herself. Her life included years of turmoil as her mental illness worsened.
Part 2: In an effort to protect civil rights, Oregon has created a mental health system that generally requires someone to commit a crime to get help. That leaves Salem Hospital’s psychiatric ward a revolving door that stitches people up or stabilizes them without much hope of long-term fixes.
Part 3: After years of inaction, lawmakers are taking up reforms to make it easier to civilly commit people for treatment. But space needed for such care lags behind what’s needed.
Finding 1: Inaction by officials leaves a flawed system in place.
Decades of inaction and missteps by politicians and the Oregon Health Authority leave few options outside of the criminal justice system for people who desperately need help.
Kayser’s daughter, Jessica Finnegan, exhausted every option available before finally seeking to have a judge order her mother into treatment.
All her life, Kayser faced schizophrenia, depression and substance use. Relatives said her first psychotic episode came in her 20s, the day she found her beloved father dead. After that, she endured a series of physically abusive relationships.
Kayser’s drug use and outbursts made housing her a challenge for her family. An apartment soon became a place where her mental health worsened with a lack of supervision, leading to an eviction.
As she was left to the streets, county investigators concluded she still was able to care for herself sufficiently to ward off state intervention.
That was the last of many times that Oregon’s mental health system shirked responsibility for one of its most vulnerable residents
Finding 2: High legal barriers make it nearly impossible to commit unsheltered people who can’t care for themselves.
Homeless service providers in Salem said that they have never known an unsheltered person in Salem to be forced into treatment for being unable to care for themselves. Rigid standards require that investigators conclude that someone who can’t feed themselves or seek shelter will die within weeks.
Over decades, unclear definitions of what Oregon courts can consider for commitment have become stricter, and the system has shifted to focus toward homicidal and suicidal behavior rather than self-neglect.
Until they reach the brink of death — slipping into unconsciousness, overdosing or bleeding profusely — social service workers either hand them a business card they aren’t able to respond to, or a meal to get them to the next day.
Nine out of 10 cases for civil commitments in Salem are rejected by county investigators before reaching a judge.
Investigators are given no more than three days for interviews and observations. They aren’t trained medical professionals.
Finding 3: Salem Hospital is virtually the only local source for emergency psychiatric care
Doctors at Salem Hospital are stitching up the same unhoused people and stabilizing their psychotic episodes over and over again, knowing the care will do little to improve life once they leave the hospital.
Salem Hospital’s emergency room is one of few gateways to mental health care for unsheltered people who cannot care for themselves.
After a short stabilizing stay, unhoused people usually are discharged back onto the sidewalk. Oregon officials for years have neglected to add capacity for long-term mental health treatment. What room is available increasingly is devoted to people accused of a crime.
Treatment professionals say Oregon has to do better for its most vulnerable citizens.
Finding 4: Advocates hope legislators will act on civil commitment reforms this year
“I just cannot believe that they witnessed someone urinating on themselves, talking to themselves, but because they could answer questions, they wouldn’t get her into the hospital. So I would change that. Do whatever I could to change it. So it didn’t have to happen to other people.” – Melinda Lou Kayser’s daughter, Jessica Finnegan
While solutions to fix Oregon’s civil commitment standards are hotly debated, there’s a clear consensus that Oregon needs to improve care for people with severe mental illnesses, and needs more capacity to take care of them.
Legislators are considering lowering the bar for civil commitment, including an advancing bill that would allow someone to be forced into long-term treatment based on their recent pattern of behavior. Now, investigators can only consider the conduct in a moment in time, limiting their ability to make the case for commitment.
The reform legislation also would expand what can be considered dangerous conduct warranting commitment.
Other bills would add capacity to care for hundreds more mental health patients across the state. And dozens of such spaces are being built now in Salem. It’s a start, but well below what the state says is needed.
Now what?
After publishing the series, Salem Reporter received emails and calls from concerned readers asking what they can do to help people in Kayser’s situation.
Salem has numerous volunteer and donation opportunities to support unsheltered people. Here’s a list of places to start.
Local legislators consider public opinion when voting. Use this online tool to find your state senator and representative and weigh in.
One pending legislative reform is now in the Joint Committee on Ways and Means, which is considering the cost of any change. The co-chairs are Sen. Kate Lieber, and Rep. Tawna Sanchez, Portland Democrats.
Rep. Paul Evans, whose district includes portions of South and West Salem, is a member of that committee. He can be reached at Rep.PaulE[email protected] or at 503-986-1420.
Rep. Tom Andersen, a Democrat who serves central and southeast Salem, has been involved in legislation on civil commitment. He can be reached at [email protected] or 503-986-1419.
Rep. Kevin Mannix, a Republican who represents north Salem, supports the bill. He can be reached at [email protected] or 503-986-1421.
Read about how we reported the series here.
Contact reporter Abbey McDonald: [email protected] or 503-575-1251.
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Abbey McDonald joined the Salem Reporter in 2022. She previously worked as the business reporter at The Astorian, where she covered labor issues, health care and social services. A University of Oregon grad, she has also reported for the Malheur Enterprise, The News-Review and Willamette Week.
