Study outlines high cost of meeting Oregon’s substance abuse and mental health treatment needs

By Courtney Sherwood (OPB)
Feb. 1, 2024 4:42 p.m.

Oregon Health Authority staff say a look at behavioral health treatment across the state will help it map out solutions.

Oregon is years away from having enough beds to treat everyone in the state who needs in-patient substance use and mental health support, according to a study out Thursday from the Oregon Health Authority.

The agency says it would take at least $500 million over five years to build the clinics and other facilities the state needs and set up beds for treatment. And that doesn’t include the cost of operating new programs.

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The report will come as little surprise to those who have followed Oregon’s first few years under Measure 110, which decriminalized possession of small amounts of drugs. The state’s addiction crisis has deepened since 2020, when voters approved the new law.

Related: Kotek signals she would sign bill recriminalizing drugs in Oregon

But quantifying the scale of need will help guide the state’s response, said Ebony Clarke, Oregon Health Authority’s behavioral health director.

“It’s grounding expectations in reality,” Clarke said.

Oregon has about 4,800 residential beds available to treat people with behavioral health disorders, but needs to add another 3,000 beds to meet what’s needed in the next few years. There’s a need for a wide range of additional treatment options, including support for psychiatric hospital care and adult foster homes.

A file photo of the Unity Center for Behavioral Health in Portland, which provides psychiatric treatment in the city. A report issued Thursday by the Oregon Health Authority says the state needs to invest heavily in behavioral health beds to meet demand.

A file photo of the Unity Center for Behavioral Health in Portland, which provides psychiatric treatment in the city. A report issued Thursday by the Oregon Health Authority says the state needs to invest heavily in behavioral health beds to meet demand.

April Ehrlich / OPB

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The report looked at disparities across the state, as well. It found that some rural areas of the state have no residential treatment options for substance use disorder or for supporting people experiencing withdrawal — and there are gaps in available beds in those categories even in more urban areas.

Where treatment facilities do exist, people seeking care sometimes face long waits, in part because of staffing challenges. And some people seeking treatment, including those with criminal records and people of color, face even higher barriers.

The analysis was commissioned by Gov. Tina Kotek last year.

“We need more resources, to be sure, but we also need better data so we can better serve Oregonians,” the governor said in a statement. “This preliminary assessment tells us more about the gaps we need to fill to ensure Oregonians in every corner of the state can access the care they need, when they need it.”

Oregon has spent more than $1.5 billion on behavioral health care over the past four years. But it will take multiple two-year legislative periods to fund and address the state’s residential behavioral health shortfalls, Clarke said.

“Oregon’s current shortfall in capacity would be even greater again without the prior investments that the Legislature has made over the past four years,” she said. “We understand that we have to act now.”

Related: Overdoses have become a daily reality on the streets of Portland

The Oregon Health Authority has identified some “shovel ready” opportunities to bring more behavioral health beds into service within the next two years, Clarke said.

The agency also plans to update and expand upon its report by June, and aims to incorporate a broader funding strategy into that revision, she said.

The Oregon Health Authority’s research has focused on support for adults. It will take more research to outline what it will take to meet the needs of children and older people, and to analyze the workforce needs it will take to provide inpatient behavioral health care.

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