The Oregonian/OregonLive recently launched a reporting project on Oregon’s mental health struggles, drawing on the strengths of four reporters and three editors to dive deep into essential facts and stories.
Coming off the pandemic, we’ve all heard about the difficulty students are having after months of isolation. And the sight of people in crisis living in public spaces has prompted tremendous reader interest in what we can do to get them help.
Our team reported a staggering statistic: Oregon leads the nation in childhood mental health conditions, with one-fifth of young people ages 12 to 17 reporting having a mental illness.
And, according to new survey data, Portland ranks No. 1 among 30 large U.S. metro areas for young adults using medication for depression or anxiety: 25% of ages 18-34.
Also noteworthy: Nearly one-third of adult Oregonians report they have a mental health condition. This is according to a 2020 federal mental health survey, the most recent available.
You notice I didn’t say 27% of adults in Oregon “suffered” from mental illness. Many people manage their mental health just fine with diet, exercise, therapy, medications or a combination. And not all mental illnesses interfere with daily life.
“Some are mild and only interfere in limited ways with daily life, such as some phobias (abnormal fears),” the American Psychiatric Association says. “Other mental health conditions are so severe that a person may need care in a hospital.”
However, as our reporting has shown, the barriers to accessing any level of mental health care are high.
This project was born from a newsroom brainstorming session earlier this year, in which mental illness emerged as an undercurrent across many beats. A lack of access to care was exacerbating many of the state’s most pressing problems: homelessness, drug addiction, the overtaxed criminal justice system and the underachieving education system. It seemed too large an issue for any one reporter to take on, yet too important to tackle piecemeal.
That’s why we launched four reporters and three editors to focus on where we stand nationwide in our care of people with mental illness and whether there are other places that do a better job.
Reporter Jayati Ramakrishnan has chronicled the challenges at the Oregon State Hospital, the state’s largest psychiatric institution, as it failed to keep up with the number of patients sent there by the courts. A federal judge stepped in and imposed limits, but the sheriffs running Oregon jails also argued they were not prepared for an influx of people back into their custody.
In the first installment of our 2023 project, Ramakrishnan traced decades of failed policy that brought us to the present day. Like many states, Oregon was successful at moving mentally ill people out of often dehumanizing institutions. But the state never fully realized the promise of community care.
Now, Ramakrishnan wrote, “Oregon’s community clinics and clinicians are overwhelmed with patients seeking mental health treatment, housing and addiction services. Rampant fentanyl addiction and pandemic-related hospital and court disruptions have further stressed the system. With no openings for new patients, each part gets further backed up.”
The most reliable – yet less than ideal – place people receive treatment is through the criminal justice system.
Reporter Nicole Hayden covers the homelessness crisis and its strong intersection with untreated mental illness and addiction. She crunched the numbers and found Oregon needs more mental health services than the average state. So while our spending is comparable, we have higher demand, and we rank near the bottom of all states in helping people with mental illnesses.
Hayden didn’t just point out the problem. She identified places Oregon could do better.
“Receiving mental health care when symptoms first begin can reduce the rates of severe depression, psychosis, addiction and suicidal thoughts,” she wrote. “But Oregon makes getting early care difficult by letting insurance providers off the hook and not requiring counties to provide adequate mental health services to meet residents’ needs.”
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The state required insurers to provide access to mental health treatment to the same extent as physical health care, but leaders didn’t follow through to ensure private insurers – or the state-run Oregon Health Plan – actually do, she found.
And in a state with 800,000 children, she reported, only 35 beds are available in residential mental health treatment facilities for kids.
Sami Edge, a reporter on our politics and education team, tackled the lack of providers in the third installment of the project. She reported that six Oregon counties didn’t have a single psychologist last year.
Some mental health agencies have a 25% vacancy rate for staff positions. Burnout and low wages are common, and in rural areas the unavailability of affordable housing exacerbates the issue.
She also identified gaps in providers, such as therapists, especially in rural areas.
Momentum has shifted recently to address the crisis, Edge found. Several universities are now training Oregon’s next generation of workers, aimed at making gains in the treatment of children and racially diverse populations that are underserved now.
A fourth installment, also by Hayden, will publish soon. Hayden reports on the difficulties a woman with schizophrenia has faced in getting residential treatment, even with advocates working on her behalf. Reporter Ted Sickinger has another installment in the works on the shortage of residential beds.
“We created this temporary, focused team to dive into a crisis unfolding daily before our eyes,” said Laura Gunderson, director for public interest and accountability. “But also, when these reporters return to their regular beats, we know they’ll use this knowledge to better inform their reporting and deepen the level of their stories going forward.”
You can find the entire project, as well as related stories, at oregonlive.com/mentalhealth.
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