Pamplin Media Group – Crisis Mode: Lack of Mental Health Resources in Oregon Remains a Big Concern

In Lake Oswego and across Oregon, experts say access to care is lagging far behind.

Editor’s Note: This is the first in a series of articles on the crisis in youth mental health.

The howl of an ambulance siren echoes through the neighborhood. Perhaps a person has been injured in an accident or is suffering from cardiac arrest.

While these are plausible assumptions, the reality is that the ambulance could also transport a child victim of a mental health incident.

With the country’s current mental health crisis, emergency room visits for these issues are not uncommon. While there are mental health resources available to young people in Oregon, they are scarce — especially at a time when the state has experienced heightened social justice unrest and the impacts of the ongoing pandemic.

“People are concerned about the well-being of children and families and their mental health needs during the pandemic,” said Chelsea Holcomb, director of child and family behavioral health for the Oregon Health Authority. “We have all been affected as a community, and young people have different resilience skills depending on their developmental age and the conditions and concerns they already faced before the pandemic.”

In December 2021, United States Surgeon General Vivek Murthy issued an advisory noting that the youth mental health crisis was “exacerbated” by the pandemic.

“We know that mental health is shaped by many factors, from our genes and brain chemistry to our relationships with family and friends, neighborhood conditions, and broader social forces and policies. We also know that , too often, young people are bombarded with messages through the media and popular culture that erode their self-esteem – telling them that they are not beautiful enough, popular enough, smart enough or wealthy enough,” reads- on in the introduction to the report. “It comes as progress on legitimate and painful issues like climate change, income inequality, racial injustice, the opioid epidemic and gun violence seems too slow. And while tech platforms have improved our lives in important ways, increasing our ability to build new communities, provide resources and access information, we know that for many people they can also have harmful effects. responsibly and safely, these tools can pit us against each other, reinforce negative behaviors such as bullying and exclusion, and undermine the safe and supportive environments young people need and deserve.”

The pandemic has only amplified these factors, while creating additional experiences that have significantly affected the lives of young people at home and at school.

According to the National Alliance on Mental Illness, 20% of young people between the ages of 13 and 18 live with a mental health problem. And national research has shown that symptoms of depression and anxiety are said to have doubled during the pandemic.

Of the 80,000 young people observed during this research, a quarter presented depressive symptoms while 20% presented anxiety symptoms.

“Early clinical data is also concerning: in early 2021, emergency room visits in the United States for suspected suicide attempts were 51% higher for adolescent girls and 4% higher for adolescent boys compared to the same period. in early 2019,” reads the Surgeon General’s report.

What’s going on in Oregon?

In 2020, Oregon ranked 47th in the nation for mental health based on a system that encompasses both the prevalence of mental illness and the availability of care. In 2021, Oregon was propelled to 41st in the nation.

Michele Veenker, executive director of the Clackamas County National Alliance on Mental Illness, said research has shown the main cause of stress and anxiety is access – or lack thereof – to mental health care. .

“What really opened my eyes, that our young people identified this as a huge gap in our system,” Veenker said.

But there are two big problems Veenker has seen in the behavioral health industry that have slowly come to light over the years.

While a decline in the number of providers has been seen across sectors, Veenker said it’s been particularly prevalent in the mental health field with clinicians, peer support specialists and other similar positions. .

Veenker said many factors account for the decline in provider numbers, including fewer people going into the mental health field, traditionally lower wages compared to other forms of health care, and burnout rates. increased professionalism during the pandemic.

“For something we already knew was a crisis, it made it worse,” Veenker said.

This decline in staffing – along with a decrease in capacity – has also been seen in secure facilities that house people with more serious mental health conditions.

Lack of availability

Holcomb said there are community mental health care services that allow people to better live their lives in the community, and residential services that provide different levels of care for young people.

With federal standards for psychiatric residential treatment facilities in Oregon, there are three levels of care – the most comprehensive of those being secure inpatient programs that provide the highest level of security, staffing, therapy and access to psychiatric care. The second level is subacute care, which provides more of a stabilization assessment where young people will spend two to six weeks in care. The third and most common level is the psychiatric residential treatment service, which Holcomb describes as a less safe form of hospital care.

Although the state does not currently have a central access system to measure how long children typically stay in each level of care, Aria Seligmann, strategic communications manager for Behavioral Health Services at Oregon Health Authority, said the state plans to launch a pilot program. for a tool like this in 2022.

The Oregon Health Authority said the length of stay is determined by the child’s needs, whether it’s days or months.

Veenker said secure facilities are difficult to access.

“To enter a hospital-type facility, a person must present imminent danger to themselves or others,” Veenker said.

Holcomb noted that there is also an acute hospital level of care that provides beds for children struggling with mental health issues.

Overall, there has been a decline in youth bed capacity in Oregon in residential facilities.

For residential psychiatric treatment services and subacute care, there were a total of 144 beds available in 2019, 164 beds in 2020 and 147 in 2021. As of December 1, 2021, there were only 83 beds available in the Oregon.

For secure inpatient programs, there were only 42 beds available in 2018 and 2019, and 45 in 2020 and 2021. As of December 1, 2021, there were only 31 beds available in Oregon.

“We had capacity needs and concerns that were already identified before the pandemic,” Holcomb said, adding that other impacts related to the drop in bed capacity included staff and children contracting COVID-19, exposure risks and declining workforce. “It’s all sectors at all levels, but I think health care as a whole has seen a dramatic decrease in these professions.

“We’re kind of both in crisis response mode…while thinking, ‘Can we still look to build while we try to stabilize and sustain our current supplier network?'”

Although some facilities have added beds over the years, space has also been eliminated at various facilities due to the current labor shortage.

Stay tuned for part two of this series, which will focus on the police response to mental health issues, the role of the Oregon Youth Authority, how insurance hinders access to care and more. .

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