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From The Desk Of Marion County Commissioner Colm Willis

Written by Colm Willis on Feb. 8th, 2024
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The other day, I saw a headline in the Willamette Week titled, “The State’s Leading Psychiatrist Says Oregon’s Approach to Mental Health is Wrong.” In the article, the newspaper interviewed the Chair of the Department of Psychiatry at Oregon Health and Sciences University. Intrigued, I continued reading and discovered that this academic’s big idea is that Oregon spends too much money on poor results when it comes to behavioral health because it partners with counties. If the state would just take over behavioral health and provide all of the services itself, it would fix the problem. This just goes to show that some kinds of stupidity apparently require a Ph.D. 

What this academic in his ivory tower doesn’t seem to understand is that the problem with the mental health system in Oregon is not that the state lacks control over the system, it is that the state has too much control! In Marion County, the state gives us money to provide specific services to specific individuals, it does not simply give us resources and then encourage us to go do good things.  The Oregon Health Authority (OHA) tells us exactly what to do with the behavioral health dollars it provides to us. If the state does not fund the right solutions for folks facing a behavioral health crisis, the crisis doesn’t improve, and there is little we can do about it.  

Last year with state funding, Marion County spent over twenty-one million dollars providing outpatient therapy, crisis services, and addiction treatment to over 1,500  individuals who were either homeless or were at risk of becoming homeless in Marion County. And many of these services are important. Without our work, we would see even more individuals suffering from unaddressed addiction and mental illnesses on our streets. But Marion County cannot make up for OHA’s failure to provide hospital-level services for the sickest people in our community.  

The Oregon Health Authority is the only entity that controls the hospital level of care for individuals with mental and behavioral health conditions in the state of Oregon, and OHA has not significantly expanded its capacity in this area despite the desperate need. Instead, after spending $400 million to renovate the State Hospital in the last decade, the number of inpatient beds at the State Hospital actually shrank by 5%.

What is worse, last year the Oregon Health Authority started to release individuals, who had been credibly accused of committing crimes, from the State Hospital into our community before they were stable or able to stand trial. This has only exacerbated the crisis on our streets. 

Oregon is now dead last in inpatient mental health capacity in the United States. Instead of expanding capacity at the State Hospital, OHA is releasing unstabilized mentally ill individuals into our community who have been accused of crimes. And, now we have so-called experts calling for the folks at the Oregon Health Authority, the same people who created this problem, to take over the entire system. This would be like hiring an arsonist to put out your house fire!

All of us here in Marion County pay income taxes to the state, expecting that this money will be used to appropriately address the behavioral health crisis we see on our streets. When the Oregon Health Authority misallocates these resources, everyone loses. Oregon’s approach to mental health has been wrong, but the solution is for the state to have less control over the system, not more.

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