Mental Health and Addiction Services

Oregon ranks dead last when it comes to rates of mental illness compared to access to care. We rank second in the nation when it comes to rates of substance abuse, and last among states when it comes to access to care. Dead last. The consequence of untreated mental illness and substance abuse is too often chronic homelessness (where we rank fifth). In order to address homelessness, we will need to dramatically improve our mental health system and addiction treatment services, which will be a top priority for me as County chair. 

Here’s my plan.

First, we need to bolster the effectiveness of our crisis line, which serves as the primary point of entry when people are seeking help for themselves or for others. We must increase the resources and assistance available for those who contact the crisis line. The line must offer extensive help, including direct navigation and follow up to eliminate any chance of people falling through the cracks. 

Too often, people are shuffled from agency to agency and asked to navigate bureaucratic processes. But this is asking too much. Those calling are often struggling with stress, mental health issues, alcoholism, drug use and/or trauma. Not addressing their needs can lead to eviction and homelessness, worsening or triggering further severe trauma and often self medication.

To better meet the needs of our neighbors, we must increase staffing for the crisis line, provide the line with additional resources to help callers (particularly with access to housing or rental assistance), follow up with people to ensure that help and navigation has been successfully provided, ensure the line is consumer friendly, be able to serve people speaking all languages and of all ethnicities, and provide multiple pathways into the system (phone, email, and walk-in options). 

Other points of contact, such as 211, rental assistance, public safety officers, hospitals, Portland Street Response, homeless navigation teams, must be able to directly transfer people to our mental health crisis treatment services, ensuring that “there is no wrong door” when trying to access these services. 

Second, we must bolster our mental health care systems and meet the needs of the whole person, including physical and mental health, as well as substance use issues. People seeking help must be provided with robust, patient-centered care without wait times. That will require:

  • Reducing wait times for critical and life saving services. People in crisis cannot wait, and people currently have to wait up to six weeks for services, which is unacceptable. 
  • Providing mental health and/or addiction treatment services, both inpatient and outpatient services, that are effective, “people centered,” accessible, and culturally and linguistically specific. 
  • Expanding low barrier, community-based services, linguistically and culturally specific services, and peer support. 
  • Boosting pay for behavioral health care workers across the spectrum of services, including peer support specialists and certified recovery mentors, will improve recruitment and retention, and build a pipeline for the growing need for behavioral health care providers, especially culturally- and linguistically-specific providers; 
  • Expanding co-occurring mental health and addiction treatment for people who are chronically homeless. There is a shortage of services that treat co-occurring conditions, which is a particularly acute problem for those living on the streets. 
  • Reducing the backlog in the state’s mental hospital, which is overwhelmed and clogging up the mental health system. Reducing this backlog can be done by expanding our ability locally to treat the aid and assist population with outpatient treatment options.

But other improvements and investments are needed throughout the system. For example, we will use new sources of funding and revenue from the Support Housing Services measure that voters approved in May 2020 to tie together and expand our wrap-around services with the understanding that providing treatment, employment supports,  housing, healthcare services will help our homeless neighbors get back on their feet.  

We will also grow our long term transitional housing for people in early recovery from addiction, as well as those participating in services. We need to invest in a continuum of housing needs from providing a short term safe and stable place to go, to a permanent home. There are many effective models for transitional and supportive housing. We must invest and remove barriers to expand access to these services. Transitional and supportive housing enables someone to work towards a permanent home with wrap-around supports. We know what works - it’s time to invest. 

I will increase oversight of our systems and track race and ethnicity data to ensure that we fund effective programs for all of our communities, particularly our most vulnerable populations. 

I will expand alternative shelter, housing, and safe rest options to give those most reluctant to go to traditional shelters an opportunity to improve their living conditions. Providing behavioral health, addiction treatment, transportation assistance, case management and other critical services to address all of their needs will ensure that our neighbors can transition into stable housing. 

I will improve and expand our harm reduction efforts, which prevent the spread of diseases and - more importantly - save lives. 

I will continue to support expansion of our mobile crisis services, such as Portland Street Response, to reduce police contact with those suffering from mental health issues and reduce the inappropriate use of our emergency rooms. I will also reinvest in a sobering center that can accept those under the influence of methamphetamine, who require much different care than those under the influence of alcohol. These two investments - in mobile crisis services and a sobering center - will relieve pressure on our emergency rooms, give police an immediate place to take people, and free up public safety officers to do other work. 

I’ll ensure that our downtown Behavioral Health Resource Center opens on time, and that its services include waiting-list assistance for those unable to get immediate care. The Center will provide respite and treatment for people with mental illness and addiction issues, as well as laundry, showers, healthcare, referrals, peer-support services, emergency shelter, and transitional housing. I’ll expand similar services into east county. 

I will not be afraid to try new models, partner with innovative organizations and the private sector, advocate for assistance from our state and federal lawmakers, and utilize the compassion of our community to help our most vulnerable. 

Unfortunately, mental health issues are a growing problem throughout our society. Our youth are experiencing rising rates of anxiety, depression, and other mental health issues, and Oregon ranks 47th when it comes to the prevalence of mental illness and access to care. That’s why I will expand mental health services to our young people, both in the school setting and out, and provide them with the support they need to navigate individual and societal challenges.

I will also pilot an innovative program to build community engagement and relationships among those suffering from anxiety, depression, and social isolation. Using the idea of “social prescriptions,” health providers will be given the option of prescribing a range of non-clinical interventions to help patients with mental illness find relief, such as tending to a community garden, painting a community project, or working at a local event. These efforts can build confidence and connection, and reduce depression and anxiety. Participants will be compensated should they decide to participate. I believe this pilot can serve as a model for community engagement in an era of increased isolation and anxiety.