Before the coronavirus shut down most of the city, Chris Drake had a pretty set routine. He had classes on Monday and Wednesday. Other days, he’d make the trip from his camp alongside a stretch of Interstate 5 in North Portland to downtown where he’d get coffee, use the bathroom and freshen up before heading to Starbucks to use the internet.

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In the afternoons he and his partner, Tina, and the people they camp with would head to one of the places in the city that serves meals or they’d go to their camp and cook there.

“It was just stable. Set. It didn’t change,” Drake said.

Chris Drake pokes his head out of his tent on a rainy day in North Portland. Drake was camping alongside I-5 before moving into the LGBTQ outdoor emergency shelter in Southeast Portland.

Chris Drake pokes his head out of his tent on a rainy day in North Portland. Drake was camping alongside I-5 before moving into the LGBTQ outdoor emergency shelter in Southeast Portland.

Jonathan Levinson / OPB

But that all unraveled as schools and businesses shut down and Oregonians started staying home to help stop the spread of the novel coronavirus. Drake, who is unhoused and autistic, said stable routines are important to his mental health and the past few weeks have been anything but stable.

“With every single day, a new routine, a new change, a new something going wrong,” Drake said. “My brain has just been breaking. My entire being has just been breaking.”

As the coronavirus ripples through the economy and health care system, it’s also exacerbating some mental health issues. Fears of getting sick, of losing a job, of being isolated at home are all factors that can increase anxiety or depression for the housed and unhoused alike.

Drake is transgender and grew up in a religious home where, he said, “a man is a man, a woman is a woman. There's nothing in between.” He was depressed and often suicidal growing up. It wasn’t until he met another trans person online, a Mormon with a similar family experience, that he started to realize it was alright to be himself.

Since coming out to his family about a year ago, he’s barely spoken to them. But Drake said he hasn’t felt depressed and suicidal since then.

Until now.

Since the shutdown, his mental health has declined. It caused a strain between him and his partner, and they recently broke up. Drake, who sometimes hears voices telling him cruel things and making him want to take his own life, said the breakup has been devastating.

“The demons started talking, started screaming at the top of their ability and just started tearing me down,” he said. “But it's just been hell.”

Chris Drake, center, checks into the LGBTQ outdoor emergency shelter on April 16, 2020, in Southeast Portland. Drake is autistic and says the coronavirus has disrupted his daily routines and worsened his mental health.

Chris Drake, center, checks into the LGBTQ outdoor emergency shelter on April 16, 2020, in Southeast Portland. Drake is autistic and says the coronavirus has disrupted his daily routines and worsened his mental health.

Jonathan Levinson / OPB

Drake was accepted into the LGBTQ outdoor emergency shelter being opened up in Portland. City health officials have set up these camps to help some of the most vulnerable people experiencing homelessness safely shelter in place. On a Thursday in mid-April, Drake and his dog, Rory, checked in with the volunteers running it. Drake hopes it might provide some stability.

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“At least here I know I'll have food, a place to lay down,” Drake said, smoking a cigarette outside the camp. “My things won't be stolen in five seconds. ODOT can't come just sweep me.”

Joan Laguzza, a mental health provider and volunteer with Portland People’s Outreach Project, a harm reduction and street outreach organization, said the pandemic has highlighted how tenuous a lot of people’s financial situations are.

“You see how easy your house of cards can go down now because this one thing happened,” Laguzza said. “And it could be something even less than a job loss.”

Tents line a street in front of boarded up shops on April 15, 2020, in downtown Portland. As businesses have closed and resources have moved online or over the phone, mental health treatment has also become more difficult to access for many in the unhoused community.

Tents line a street in front of boarded up shops on April 15, 2020, in downtown Portland. As businesses have closed and resources have moved online or over the phone, mental health treatment has also become more difficult to access for many in the unhoused community.

Jonathan Levinson / OPB

The past couple of months, people who live inside have had a small taste of the anxiety and stress induced by not knowing where your next paycheck will come from, or not being able to go to the store to get what you need.

“People who are living outside are having just as much mental health stress,” Laguzza said. “But they experience it differently because they are already living on the edge.”

As key resources like mental health care have moved to the phone or online, they’ve become more difficult to access.

“It can be difficult for people who are staying outside to access that service because they might not have a good phone plan with good data,” Laguzza said. “They might not even have a telephone and they might not have a private place where they could go and have an hourlong session with the clinician without worrying about being overheard.”

On a tree-lined street alongside Laurelhurst Park, Mercedes Moreno was waiting to go get lunch with the people she's been camping with. Moreno has a rare disease, called Cushing's disease, caused by an excess of cortisol. She moved to Portland from Montana five months ago to be close to Oregon Health & Science University and the critical health care she needs.

Mercedes Moreno has Cushing’s disease and moved from Montana to Portland five months ago in order to be closer to OHSU and the medical care she needs. When the coronavirus hit, she lost her job, her health insurance and her apartment. Now she lives outside.

Mercedes Moreno has Cushing’s disease and moved from Montana to Portland five months ago in order to be closer to OHSU and the medical care she needs. When the coronavirus hit, she lost her job, her health insurance and her apartment. Now she lives outside.

Jonathan Levinson / OPB

Within two weeks of arriving here she had a job at a dog groomer and a place to live. She was just starting to feel settled when the coronavirus hit and she lost her job. When she couldn’t pay rent, her roommate changed the locks and she had to move into her car.

“I feel like every time I get up, I get kicked back down,” Moreno said.

Moreno takes medication that can cause liver toxicity and she usually goes to the doctor once a week to get checked. But when she lost her job, she also lost her health insurance. She hasn’t been to the doctor since April 2.

Losing her job, her apartment and her health insurance have all been extraordinarily stressful, she said. Cushing’s disease can also cause anxiety and depression.

Mercedes Moreno, right, enjoys a free lunch that is distributed to people who need it in Southeast Portland's Sunnyside Park.

Mercedes Moreno, right, enjoys a free lunch that is distributed to people who need it in Southeast Portland's Sunnyside Park.

Jonathan Levinson / OPB

“It’s been rough,” she said, before going to Sunnyside Park where a group was giving out free lunch. “It’s a battle trying to sit there like, ‘This is going to get better.’”

And that is one of the hardest aspects of the stress caused by the pandemic, Moreno said. Whether you are living inside or outside, there’s no certainty on when the crisis will end.

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