"LAST TIME Cascadia's predecessor pulled something like this, I knew two people who committed suicide," said mental health advocate Marian Drake, addressing Multnomah County Chair Ted Wheeler last Wednesday afternoon, May 21, during an emotional two-hour meeting concerning the financial collapse of the county's giant mental health-care provider, Cascadia.

There's a public meeting to discuss Cascadia's future on Thursday, May 29—at 6 pm, in the cafeteria at Benson High School—but the provider has yet to announce details of a plan to ensure continued care for its 6,500 clients across Oregon.

Earlier this month, it emerged that Cascadia had taken a $2 million line of credit from its bank without telling anyone outside the agency. CEO Leslie Ford resigned and was replaced by Derald Walker, and as a temporary solution, the state and county bailed Cascadia out by accelerating $1.5 million in payments due to the group for work already performed.

Since the financial problems hit, many of Cascadia's clients have been worried about the future of their housing and psychiatric services. Director of County Human Services Joanne Fuller says it's likely Cascadia will be "a much smaller organization" once the county's plan is put into effect—it's likely, too, that Cascadia's services will be farmed out to other providers across the county. However, "the clients are our top priority," she says. "We don't want to destabilize things by moving quickly to make changes that then have negative impacts and hurt consumers."

Beckie Child of the Mental Health Association of Oregon says there's "angst" around potential instability. "My concern is that people will go into crisis because of all this angst. It's very difficult for Cascadia to build trust with a client if they see a doctor and don't know if they're going to see them again," Child says.

"I'm less concerned about myself, but more for the less-capable clients," says Ryan Hamit, also a Cascadia client and client council president of the Garlington Center, one of Cascadia's centers.

"One person was yelling about things, another person was yelling and screaming, and shouting, 'my house, my house, my house,'" Hamit said at the May 21 meeting, bursting into tears. "They don't want to transition out of where they are now. It's been quite shocking."

Wheeler, who was conciliatory at the meeting, thanked people for their frankness. He said, "This is no longer a dollar and cents issue, it's a moral imperative" to come up with a solution to Cascadia's problems. Until a solution is offered, however, this situation puts a great deal of pressure on Wheeler to prove his mettle as county chair in a crisis.

"We need to make sure we're not just setting the system up for failure again," said John Holmes, director of the Portland chapter of the National Alliance on Mental Illness.