From World Radio, this is Double Take. I'm Les Silers.

Several miles from Portland's old town, three Union Gospel mission workers stand handing out sack lunches and pass to dinners.

A handful of people shuffle through the food line with their hoods up and their heads down.

This is a sanctioned homeless camp, one of several in the city designed to get people off

downtown streets.

But it's stark sleeping pods, concrete floors, and chain-link fences make it look more like

a dystopian village.

Here in Portland, a city practically synonymous with rampant homelessness, thousands of people are living on the streets in emergency shelters or transitional housing.

As of 2022, one analysis ranked the area sixth among the nation's major cities for its ratio of homeless residents. A tangled web of underlying factors play a role.

But, in some of the most difficult cases, one stubborn issue keeps surfacing.

Untreated mental illness.

Adam Moore is Union Gospel Mission's Director of Homeless Services.

Last year, he saw about 600 shelter visitors.

Of the 600 people, there's probably 100 or 200 that have ongoing pretty severe mental health

issues. One woman, his team met, refused repeated offers of help. She couldn't get around

on her own anymore, so she just lay in a filthy mattress. Because she couldn't take care of herself. She couldn't get around on her own anymore, so she just lay in a filthy

mattress. Because she couldn't take care of herself. She was at risk of being abused or raped

by people on the streets. A heat wave rolled in, and temperatures climbed over 100 degrees.

One of the missions outreach workers had been keeping tabs on the situation.

Now, she made a last-ditch effort to save the woman's life.

She took her notes and went before a judge.

She basically made the argument that, look, she has refused food and water from me,

...