About a dozen years ago, Wasco County Sheriff Lane Magill became aware of a growing need for treatment services for residents experiencing mental health crises in his county. Faced with a lack of residential care services in the region, he struggled to find help for people experiencing homelessness or veterans who suffered from PTSD. The surge of fentanyl-related overdoses in the county since 2021 also highlighted the link between behavioral health and substance use disorders and the lack of local treatment options.
But that may now soon change. As first reported in the Columbia Gorge News, Magill expects to break ground this year on a new residential treatment facility in The Dalles. It would offer 16 beds to treat residents in Hood River, Wasco and Sherman Counties for substance use disorders, along with a walk-in center for people in mental health crisis. Sheriff Magill joins us to talk about the status of the $50 million project, and the regulatory roadblocks it faces.
Note: The following transcript was transcribed digitally and validated for accuracy, readability and formatting by an OPB volunteer.
Dave Miller: This is Think Out Loud on OPB. I’m Dave Miller. Lane Magill has been the Wasco County Sheriff for the last eight-and-a-half years. As he’s put it, mental illness is not a law enforcement issue, it’s a healthcare issue. But very often it falls to his deputies to respond to people in various kinds of crisis, and very often there are no treatment options for them.
That could change soon. As first reported in the Columbia Gorge News, Magill hopes to break ground this year on a new residential treatment facility in The Dalles. It would have 16 beds to treat residents in Hood River, Wasco and Sherman Counties for substance use disorders, along with a walk-in center for people in mental health crisis. Sheriff Magill joins me now. It’s great to have you here.
Lane Magill: Yeah, thanks for having me.
Miller: So, as I noted, you’ve been the sheriff for eight-and-a-half years. You’ve been in the office for more than, I think, 23 years now.
Magill: Yeah, midnight on December 31 was the 23 year mark. I started January 1, 2002, at 6 o’clock at night
Miller: So it flips over in the new year. How have you seen mental health or behavioral health crises in the county change over those two-plus decades?
Magill: Yeah, significantly. Like I was telling your producer Allison earlier – in my initial interview – almost 15 years, or maybe even further, when Oregon started divesting itself of its mental health system … I remember to this day when they closed the Eastern Oregon Psychiatric Center down in Pendleton. And then right after that, I think, or maybe just before that, they shut the Dammasch system down here in Portland – and rightfully so. Remember the “One Flew Over the Cuckoo’s Nest?” Those facilities were antiquated. They weren’t places where people should be. They were more like jails or prisons
Miller: And warehouses.
Magill: Well, not necessarily warehouses per se. But it wasn’t like where they could get adequate treatment as far as just being in that home environment or residential environment, because that creates a really positive environment for healing individuals with drug and alcohol addiction or mental health addiction. And I knew right then that if Oregon didn’t get back on the stick and start reinvesting money in mental health services, we were going to potentially be in a pretty tough shape. It didn’t take very long – about one-and-a-half or two years – and unfortunately, especially in Oregon and across the nation, our jails have become the default mental health institution for low level crimes and different things like that.
So yeah, I’ve seen it deteriorate to the point where we are now today. I mean, we’re ranked last in the nation for mental health treatment. We’re ranked, I think it’s 48th or 49th for drug and alcohol treatment in the nation. So yeah, I’ve seen it impact not only my community directly but the state of Oregon, as well as our nation.
Miller: Do any particular stories come to mind when you think about this?
Magill: Oh yeah. I could probably give you hundreds of stories of individuals that unfortunately we’ve lost in our community. And I have two of them that I can think about sometimes on a daily basis, as far as that they didn’t receive the mental health or behavioral services that they really so desperately needed. Unfortunately, those two individuals took their lives. One of them was one of our military veterans, which makes it even more tragic in my mind.
So yeah, I’ve had plenty of impacts with a lot of different people that I’ve seen people lose their lives and stuff. As well as other individuals that are still alive, but they still are impacted by lack of services for getting mental health, behavioral health, and drug and alcohol services, for sure.
Miller: What has this meant, the overall situation you’re talking about, for the four-county lockup NORCOR [Northern Oregon Regional Corrections] in The Dalles that serves not just Wasco County but three other neighboring counties?
Magill: Correct, yes.
Miller: If you look at the population there, for example, how many of them have serious diagnosed mental health issues or substance use disorder?
Magill: Interestingly enough, we worked with the CUNY Institute and did a two-year study on individuals that were at NORCOR, that had been lodged there three or more times, or four or more times. I didn’t bring this exact stats with me, but individuals that have been there for three or more times have been diagnosed with a drug flag, they call it, or a marker – I think that’s the technical term for it – about 57% of the time. And if you go to the individual that’s been there four or more times, it jumps to 62%. But the interesting part about that is if you go back to the mental health side of it and you look at the three or more times users, that jumps to … 47% of those individuals are diagnosed with a serious persistent mental illness of some sort.
As it affects us in the jail itself, just the facility itself, it’s forced us to actually open an entire mental health wing. We can keep between nine and 11 individuals in that wing. Generally, they’re male because most of the population in our facility is male. However, we do have avenues for females and stuff like that to receive mental health services. We actually have a mental health clinician that’s on staff full-time at NORCOR right now for the four counties. So, yeah, it significantly impacts us, not only from a standpoint of just the numbers but services as well, because they’re very, very limited.
Miller: What are the existing treatment options right now for these two separate, sometimes coexisting issues of substance use disorder or serious mental health issues?
Magill: Oregon breaks it up into, I think there’s six what they call ATABs [Area Trauma Advisory Board] – don’t quote me on what ATAB means. I have too many acronyms in my mind because I’m a police officer. [Laughter] So I could probably talk in acronyms if you really wanted to.
Miller: No. Let’s stick with words.
Magill: It’s a good idea. But ATAB, I can’t remember what it is, but ATAB 6 is where we are in the North Oregon Gorge area. So that’s Hood River, Wasco, Sherman Counties. We have zero services. We don’t have treatment beds for drug and alcohol addiction. We don’t have beds for mental health crisis individuals, sub-acute or acute, of course – there’s not very many acute beds except here on the west side. Matter of fact, there are no acute beds on the eastern side of Oregon. So, yeah, it’s a huge impact test because we have absolutely zero services there.
Now, with that being said, we have our local community mental health provider, our CMHP [Community Mental Health Program]. I’m sure a lot of people out there that are listening have heard that term. So we have Mid-Columbia Center for Living, and they provide mental health services to Hood River, Wasco Sherman and Hood River Counties. They have access to beds, but we don’t have any beds locally that we can provide those services to. So we don’t have drug and alcohol beds for substance use disorder. We don’t have beds for residential treatment facilities or secure residential treatment facilities.
Miller: What does that mean for your deputies or, say, police officers in some of these cities, who encounter somebody whose main issue they’re dealing with is a mental health crisis, not a low level crime?And I guess it’s up to your deputies or officers to determine that. But, let’s say that that’s the situation. The real problem here, the obvious underlying problem is a mental health problem. What options do you have?
Magill: Not a lot. So when you break it down into individuals that are in mental health crisis, you look at it from two perspectives or two viewpoints, however you want to call it. You have individuals that are in crisis where they’re in acute mental health crisis, so they’re a danger to self or others. And under Oregon statute, law enforcement has the ability to take that person into protective custody on what we call a police officer hold. The mental health authority or CMHP, like I talked about, has the ability to put a director’s hold on that individual. If there are individuals that are of acute nature, we automatically transport those individuals from our county, which is in The Dalles – generally that’s where it’s at – all the way to Unity here in Portland down by the MODA Center. That’s for acute individuals.
Here’s the catch. It’s an actual hospital, a physical hospital, a psychiatric hospital. It’s an actual hospital when you look at the bricks and mortar side of it and the services that are provided there. Here’s the catch on this whole thing. Secure residential treatment facilities can deal with subacute individuals. So a lot of the individuals that we would like to get into RTF, or an SRTF as we call that, or even just a walk-in crisis center where they could reach the services right then and there, and be cared for by professionals, we don’t have any of that. So it’s really, really frustrating for law enforcement. And particularly, not only in our area but statewide and nationwide, what do we do?
Well, a lot of times we don’t do anything because we can’t get them the services that they so desperately need and [they] are actually, in some cases, just literally crying out that they want those services. So, super, super frustrating because, like, what do we do? It’s like, nothing. You walk away a lot of times. You try to get mobile crisis involved, or maybe another clinician, or a family member, or something like that, but “it’s a dead end” is really what it comes down to.
Miller: What do you hear from your voters, your constituents, your residents about what they want you to do in those situations? I guess what I’m really wondering is, if you hear from a significant percentage of your county residents that they want them to lock these people up, if that’s what you hear, what do you say?
Magill: I hear it all the time. I hear that about half the time and I hear “don’t lock ‘em up” half the time. There’s this dynamic, that I have a lot of people that … I grew up in Wasco County. I mean, I’ve lived there 54 of my 58 years. So I understand the mindset of individuals and stuff like that, saying, “you know what, just put them in jail, throw the key away.” And I’ll be very, very honest. Twenty years ago when I got into this business, if somebody had a mental health crisis and they had committed a small crime, a petty crime, a misdemeanor or something like that, just put them in jail and that’s the end of it. And then, as I’ve matured in my career and experienced a lot of the stuff and the impacts that it has on our communities, it’s like, no, this is the wrong way of thinking about it.
Miller: I don’t feel like I totally understand your conversion. What is it that made you change your mind? If before, that would have been your approach, and now it’s 100% different, how did you change?
Magill: Well, interestingly enough … and it’s probably a longer story than what we have for today.
Miller: Give us a try.
Magill: Yeah, for me, I began to realize really quickly in my career, within that first … well, I’ve been at this for 23 years, so after about year five and this constant transporting people to Pendleton – because that’s where we would go to – and then bringing them back to the courts and stuff like that. It’s like, yeah, they’re the professionals, let them deal with it. This isn’t something that we should have to deal with.
Miller: Meaning, mental health professionals are the professionals here?
Magill: Yeah, mental health professionals, drug and alcohol professionals, those individuals to help these people. I was like, no, that’s their responsibility, that’s not ours.
Then I began to realize over time, when I really started looking at the nuts and bolts of how it impacts us, it’s like, wait, one, it’s not my philosophy because, like I said, I came out of the private sector. I’m a very solution-oriented person. And I had to kind of do a reset in my brain. It’s like, no, this is not working. We can’t continue down this path of where we’re at. Of course, then there was this domino effect of facilities being closed and stuff like that. It was really at that point in time in my career [when] I was like, we have got to go back, get to the root of this problem, and start thinking about it and how are we going to serve these individuals, not through the criminal justice system.
Now, don’t get me wrong – and I say this a lot – there are individuals who have mental health issues. There are individuals who have drug and alcohol issues, all the things that we’re talking about. And unfortunately, some of those individuals do commit crimes where they have to be lodged, arrested and put in jail. We all have to understand that and I’m not dismissing the fact that anybody who has a mental health issue should not be arrested or should not be held accountable for those crimes that they may have committed. What I’m saying is that, at that point in time in my life, there’s a lot of this stuff that is happening that we need to get to the root of the problem and how to solve that. And a lot of that is everything from treatment services to those types of things.
Miller: Can you describe the Gorge Resolution Center, your vision for it in The Dalles?
Magill: Yeah, this has been about a five-year project, almost six years now. My ultimate dream has always been to have a campus, a mental health campus where we could bring individuals that are in crisis. I mean, I’d love to have a class one facility like Unity in the Gorge. I think it’d be an amazing resource. We all understand that’s probably – and I did at an early part of this conversation – a huge lift from a financial standpoint of staffing and all that because it’s an actual hospital.
I’ve always felt that if you could have a place, a campus, where individuals could come and we could bring individuals from law enforcement, or people could just walk in and receive services all in one spot … So let’s say they come in, and they have a drug and alcohol addiction, and they’re in crisis, we get them stabilized through crisis, and then we can get them into drug and alcohol treatment. Let me be really clear, a lot of this stuff is dual diagnosis. You said it yourself. We have these individuals that have a drug and alcohol addiction problem that cause mental health issues, or they have mental health/behavioral health issues and they “self-medicate.” That’s the slang term for their addiction. So being able to take them from one spot to the next to create that continuum of care is extremely important.
Think about it this way, the ultimate goal in my mind is to create a hub of stabilization. And think about it from a wheel standpoint, that hub stabilizes that individual. Then once that individual stabilizes, think of the spokes that come off of a wheel. Right now, I’ve got probably 20 spokes in my brain where people could go. One of those spokes may be through the court system. Maybe it’s not, maybe we’ve captured those individuals or they’ve come in on their own that are just struggling. And another part of it is continued health services that would help with not only their addiction problems, but maybe it might be something as simple as a job resume or something as complex as housing, whatever it is. So think about those spokes that you can get those people tied into, and you never break that chain. You always have that continuum of care. Then just think of the wheel itself, the wheels held up by the spokes – and that’s our communities.
So if you really want to think about it from that, that wheel is really what we call community restoration and getting those individuals back into our community. So my goal has always been to have that campus model where we can just everybody in one spot, because you lose people when you’re transporting them all around the state and things like that. However, we’ve run into major issues with that because of the IMD [Institutions for Mental Disease] rule …
Miller: Well, OK, you toss that off and we can’t dig deeply into this federal rule that goes back a number of decades, the point of which, if I understand correctly, is to not go back to the bad old days of having jail-like massive mental hospitals.
Magill: Yes.
Miller: The federal government set up these systems to say, no, we’re not going to give you money, states, if you’re going to do that. And it’s my understanding now, correct me if I’m wrong, is that one of the state’s readings of that law – whether or not it’s in federal rule, I’m not sure – is that you can’t have places that are both primarily about drug treatment and primarily about mental health treatment in the same place. That’s not a way to get around the 16-bed requirement ...
Magill: Yeah, so 1,200 feet or more has to be the separation. That’s what Oregon law says.
Miller: So that’s one potential impediment now, and my understanding is you’re awaiting guidance from the state to get more clarity there. And maybe there’s an exemption, maybe you can get around that. What else is standing in your way?
Magill: Well, that’s really the big thing right now, this whole IMD rule and how it affects our state. Matter of fact, I have a meeting here in a couple of days, next week actually, with the Oregon Health Authority to try to figure out alternatives to this, whether there’s waivers, different things like that. But that is really one of the biggest hangups. The reality of it is, there’s plenty of funding out there for these types of projects. I’ve received, right now, $12.5 million already for funding to build the substance use disorder facility. We’re still waiting on this – a $50.3 million dollar project for the Gorge. By the way, just so everybody knows this, this will serve Hood River, Wasco and Sherman Counties as the primary three counties. Then if we have extra room, so to speak, people will be able to bring them from all over the state if we need that.
But there’s plenty of money out there to do that. Like I said, we received $12.5 million. The governor actually has money allocated in her budget for these types of services and things like that. So it’s not really a money issue in my mind, it’s really more of a regulatory issue. And let me be very clear: I completely understand the IMD rule and its intent. It was in the 1960s. I mean, you and I could walk across the street and find family members, like, “you’re crazy.” That was the word they used back then, which is quite bad now in my mind. And we could take them and put them in protective custody, and take them to an asylum or an institution, and they’d be there the rest of their lives. That’s the wrong way, one, to treat a human being. And number two, they don’t, they don’t get the services that they might need if they were really having a problem.
So I totally understand the IMD concept then. I get it, because it was happening, people were being housed, quite frankly, like animals. It was pathetic and you start reading some of the historic history behind all that. It’s just offensive. Now, I think the 16-bed thing is OK. I don’t see a problem with that because we don’t want to institute, we know it doesn’t work. Why would we do it? For crying out loud, it doesn’t work in our jails when we just start packing them in there. Well, “they’re crazy and they committed a crime, just put them in jail.” Well, we know that doesn’t work. So let’s figure out things that do work. Let’s work with the IMD rule. Let’s make some adjustments to that, maintain it, but give us some flexibility to actually meet the needs of our communities, or our regions, or however that might look.
Miller: Lane Magill, thanks very much.
Magill: You’re welcome. Thanks for having me. I appreciate it.
Miller: Lane Magill is the sheriff of Wasco County.
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