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Oregon mental health leader says state finally has money to boost treatment beds; Staffing them is another matter

The head of Oregon Health Authority’s behavioral health division says the state is making strides toward providing enough beds to house Oregonians with mental illness who can’t live on their own.

The biggest challenge, said division director Ebony Clarke, is finding employees who can care for them.

“What we’re finding is that we have the funding,” Clarke told The Oregonian/OregonLive, “but we don’t have the human capacity to staff new programming.”

As the state distributes more than $230 million earmarked in the last legislative session for behavioral health housing, it’s promising to add more than 1,100 much-needed units in licensed residential facilities across the state by June 2025.

But as The Oregonian/OregonLive reported last month, nearly a quarter of the jobs at Oregon’s mental health clinics are vacant, and six Oregon counties didn’t have a single psychologist last year. People of color, children and rural Oregonians are most affected by the lack of mental health workers.

Clarke, a licensed clinical social worker, took the reins of the Oregon’s behavioral health division eight months ago. Before that, she spent more than a decade at Multnomah County’s health department, including as its director.

The state agency, she said, is trying to find ways to attract health care workers to rural communities and to nudge more students toward careers in behavioral health.

She said the state raised reimbursement rates by 30% for rural and culturally specific behavioral health providers last year, a way to increase pay for those workers.

The agency has also said it will prioritize giving student loan repayment grants to rural providers and provide funding for clinical supervision, a costly training requirement for students. The state is also offering sign-on bonuses and grants to help house and retain rural providers.

“OHA will continue to advocate for funding for creative solutions to address workforce issues,” Clarke said in a follow-up email.

Clarke said the agency has also approved rate increases for coordinated care organizations, the health networks that administer care for people who are on Medicaid. The goal, she said, is to offer more behavioral health services and hire more providers. Medicaid covers low-income Oregonians and people with disabilities.

She said OHA is distributing $80 million to recruit and retain more behavioral health providers, with rural and historically underserved communities taking priority.

Clarke acknowledged that the state’s efforts face big stumbling blocks. Recruiting qualified mental health providers, particularly in rural areas, remains difficult. They have to travel long distances, and housing is often scarcer in remote communities.

But as the state wrestles with how to recruit and retain staff, it’s still trying to figure out a long-term plan to solve the behavioral health crisis.

Gov. Tina Kotek ordered an analysis of the state’s mental health housing capacity. By the end of the year, the state will have a full accounting of how many treatment beds it has, including secure residential treatment facilities and substance abuse housing.

That report will help drive a five-year plan, Clarke said, to help allocate funding and identify what the state needs to build.

Clarke said that as she works to help stabilize Oregon’s behavioral health system, she hopes to draw on the lived experiences of individuals and communities across the state.

She noted the staff of the health authority’s Office of Recovery and Resilience, created in 2021, includes nine people who have experienced behavioral health issues. Those staff members are tasked with going to local communities and drawing people with behavioral health challenges into discussions that inform state policy.

“I’m a believer that individuals and communities really do hold the answers,” Clarke said. “We have the ability to be courageous and say we’re not the experts in all things behavioral health. And if we do identify ourselves as experts, how are we willing to try something different to get a better outcome?”

Nicole Hayden contributed to this report.

—Jayati Ramakrishnan;

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