January 31, 2021
In a year of a global pandemic, mass protests, and forest fires that gripped and affected the entire state, the staff at Unity Center for Behavioral Health somehow kept true to a fundamental promise: Keep providing in-person psychiatric care to everyone in need of emergency mental health services and keep its doors open 24 hours a day, seven days a week.
In any other year, these victories would be challenging enough. But on this, Unity’s four-year anniversary—celebrated appropriately during a time of social distancing—the staff’s quiet heroism and the organization’s steadfast dedication to its mission shine through ever more brightly. And one truth has never been more evident: Unity Center fills a huge void in the local network of mental health services.
“This past year has been a novel environment to say the least,” says Anne Gross, M.D., Unity Center’s medical director for psychiatric emergency services. “The pandemic. Social and physical distancing. Everything’s been unanticipated—for everyone, everywhere. But I can’t say enough about our staff at Unity. Their focus was to maintain physical, in-person access to psychiatric care for those who needed it. To do that safely during a pandemic took creativity, invention, teamwork, and most of all, sheer commitment to our patients’ care.”
Of course, while the past year has highlighted Unity’s significant role in providing emergency mental health care, no matter the circumstances, its ability to adapt and thrive during a pandemic is just one chapter in a larger story. The approximately 10,000 visits a year Unity Center receives from patients in need of mental health care is the fuller picture. Unity Center has been a transformative presence whose role is still evolving.
The idea for Unity Center was conceived seven years ago. Legacy Health had been exploring the idea of providing care for mental and behavioral health emergencies based on the notion that people in a behavioral health crisis could be better cared for in an environment designed specifically for their needs with a focus on getting them access to behavioral health specialty care quickly.
True to its name, Unity Center has been a collaborative effort from the start: Leaders from Adventist Health, Kaiser Permanente, Oregon Health & Science University and Legacy Health gathered staff, ideas and resources and participated in planning. The four partners are still involved today, continuing to fund Unity Center and participating on its board of managers. A $20 million gift from the Robert D. and Marcia H. Randall Charitable Trust inspired other local philanthropists to help with the remaining $20 million in capital costs to launch Unity Center.
Since opening four years ago, a staff of about 530 psychiatric providers, nurses, social workers, administrators and more, work to provide emergency care for adult patients and inpatient care for adult and adolescent patients. The adult and adolescent units are separate, each with their own staff and treatment approaches. But the spirit of hope, hospitality, compassion and recovery guides the entire organization, along with a commitment to treat not merely in-themoment emergencies but to create an ongoing treatment plan after discharge.
In treating adults, Unity focuses on a trauma informed approach. In simplest terms, that means every patient has an experience with trauma and treatment should be sensitive to that trauma, so it doesn’t cause even more harm.
“Health care can be traumatizing,” says Nate Boyett, a clinical interventions specialist who has worked at Unity since inception. “But we try to minimize the trauma at every stage. We aim to never forget the history of a person and deliver care that’s as safe and compassionate as
possible.”
For the adolescent unit, which helps children ages 9 to 17, treatment is driven by a collaborative problem-solving model that empowers patients through understanding, empathy, and sharing perspectives.
“One critical thing we advocate for is to have the kids’ point of view out there, too,” says Randy Riedel, a clinical therapy specialist in Unity’s teen unit. “The parents put their points of view out there. So, we get both points of view. How do we get them together? How do you speak to kids—to people—differently? One way is to put all the perspectives on the table.”
Riedel notes that patients come from every social and economic background in the Portland area and for just as many reasons.
“Kids come here for all kinds of problems. Feeling pressure, experiencing trauma. Maybe from families that are struggling. Kids fall through the cracks. It’s a wide swathe of kids here, from low income to well-to-do families. Depression and crisis know no boundaries.”
That broad swathe is what unifies both units with their different approaches and populations. In both, a basic principle moves the staff, says Alison Daniels, an adult inpatient social worker.
“We treat everyone with dignity and respect,” she says. “And unless someone is better served at a hospital because they need strict medical attention, we never turn people away. They’re welcome here. That’s in keeping with our idea of de-stigmatizing mental illness. It doesn’t
matter how someone got here—whether they’ve come here on their own or whether the police brought them here. When we meet a patient, we meet them where they are at.”
Like the patients they serve, Unity’s staff come from diverse social backgrounds, ages, and work and training experiences. Their work is often chaotic, fast-paced, stressful. Tense encounters with patients can happen. But the staff is driven by the mission to care deeply about those in need of mental health care, and to encounter difficult and often horrible situations with kindness.
“Unity is one of those places at the forefront of how the DEI (diversity, equity, and inclusion) movement impacts patient population,” says Daniels. “Our staff has strong feelings about that. We are doing our best, one person at a time, to make that part of the world better. Personally, I use kindness: We encounter people who don’t have kindness in their lives. And often, that kindness is the best intervention. Being of service is so important in this world for me and my co-workers.”
Dr. Gross, Unity’s PES medical director, says that is the reason why Unity’s staff is special. They are driven by the work itself, not by external outcomes, headlines, or press highlights.
“That’s the unifying piece,” Dr. Gross says. “Our staff is about absolute commitment to patient care—a commitment to this mission.” It’s one reason why, at a time when telepsychiatry had become the norm, Unity never stopped in-person care to patients who could not connect to a clinician or provider in any other way.
For everyone at Unity, the work is just beginning at this four-year mark. As with any work environment, there have been highs and lows over four years. There’s still much to explore, much to expand upon.
“Where do we go from here?” Dr. Gross says. “One thing that comes to mind is our ongoing partnerships with the continuum of care—unit to unit, peer to peer. But also our partnerships with the community. We will continue to grow them. Yes, Unity is unique and important. But ultimately, we’re just part of this larger continuum.”