Unity Center closes to new EMS patients due to safety concerns

Portland's emergency room for the mentally distressed closes to new entries to deal with state investigation.

Legacy Health has temporarily closed to new emergency patients a special facility that was set up to be the region's emergency room for the distressed and mentally ill, due to a state investigation launched after an employee complaint that the center is an unsafe "hell hole."

It's unclear why the Unity Center for Behavioral Health needs to close its doors to EMS transports to deal with the investigation, but one local mental health advocate says the center should be doing a better job of letting the public know.

"They're leaving us in the lurch. That's irresponsible to not tell people what the alternative is," said Jason Renaud of the Mental Health Association of Portland.

Kristin Whitney, the Unity spokeswoman for Legacy, said Monday afternoon that "Unity Center is not accepting EMS from the field. Unity Center decided to temporarily suspend all new patient transfers to allow time for staff to implement new practices. Unity Center is currently not accepting patients being transported by EMS from the field, transfers from other hospitals, or direct admissions. The hospital is still accepting walk-in patients and is, of course, still caring for the patients currently in the facility per our normal operations."

Unity Center was created in early 2017 by local hospitals and health systems after local doctors and advocates for the mentally ill pushed Portland to emulate a specialized emergency ward in Alameda County, California, for people in need of psychiatric care — including those who are homeless. Many psychiatric beds at hospitals in the region were shut down as a result of Unity's creation.

Since February 2018, the state has been investigating complaints from employees that patients have been assaulting other patients due to poor safety practices and understaffing at Unity, according to documents first obtained and reported on by the Portland Tribune.

The Oregon Health Authority, which licenses health care facilities, had been considered close to wrapping up its investigation, having issued a notice of findings to Legacy to allow the facility to submit what's known as a plan of correction. The state has thus declined to release documents providing more detail on the investigation.

But now Unity has closed its doors to new patients, citing the OHA probe.

"Throughout the course of this week, Unity Center has been fully cooperating with the Oregon Health Authority who have been on site investigating specific concerns related to patient safety, " wrote center Vice President Chris Farentinos, according to an email leaked to mental health advocates and shared on Monday. The language of the email suggests it was sent out late last week or over the weekend.

"The safety of our patients is paramount to our mission at Unity Center. We have work to do to ensure the highest safety standards for all our patients at Unity Center," Farentinos wrote.

"In order to implement these important improvements, we will temporarily close to admissions and remain on divert status to fully dedicate staff to these critical tasks and administer further risk mitigation protocols.

"We ask for your patience as we work quickly to meet or exceed expectations. We do not yet have a firm timeline of when we will be able to reopen to admissions but will communicate updates to you in a timely manner."

In March, a report by the state Occupational Safety and Health division of the Department of Consumer and Business Services documented safety problems at Unity and what appeared to be a concern widespread among some employees that the model is not working.

The state investigation found about 300 assaults and at least 23 injuries to employees in the first seven months of the center's operation. Investigators reported on a culture in which management didn't seem to know how often employees were being assaulted, and some staffers were afraid to say anything about the assaults — fearing it would hurt their careers.

Legacy at the time refused to comment, citing a lawsuit filed by its employees that faulted it for similar concerns.

It has since issued a statement saying that while mistakes were made during the center's first year, officials are committed to fixing things and being fully transparent, citing safety concerns highlighted by OHA.