Opinion: Exodus of mental health workers requires state response

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Julie Dodge

Dodge is the Acting Director of the Multnomah County Behavioral Health Division.

A man shouts in a downtown street. Across town, a teenager can’t get out of bed. Across Oregon, COVID-19 has adversely affected our individual and community behavioral health. Eighteen months of stress, isolation and disruption led to an increase in depression, substance abuse and violence throughout the community.

Now, the behavioral health workforce we asked to respond to is faltering under this historic demand. There are not enough substance abuse counselors, crisis workers, mental health counselors, peer support specialists or mental health providers to provide services. which results in waiting lists and fewer opportunities for people to get the help they need.

A survey conducted in August by the Mental Health and Addictions Certification Board of Oregon found that one in five certified behavioral health workers statewide was either not working or working less due to poor pay, lack of support, and burnout. Behavioral health workers have seen more people with higher levels of need, who are, in some cases, aggressive and violent.

The mass exodus of workers cripples care for Oregonians – from children to the elderly, in residential and outpatient settings, for mental health and addiction disorders. In September, the number of beds available in residential mental health services had declined by 25% in Multnomah County due to staff departures and COVID-19 quarantines. Outpatient behavioral health services fare much worse: with vacancies and fewer appointments, access dropped by 40% statewide, according to the Oregon Council on Behavioral Health. Fewer than 30 residential drug addiction beds are available for youth statewide, a 70% drop from the previous year.

It is unbearable.

In the last legislative session, Oregon made historic investments in behavioral health, including funding both staffing and capacity of behavioral health housing and housing services. But these phenomenal opportunities cannot be realized without a workforce.

Stress has long been shown to increase substance use, anxiety, depression, interpersonal violence and community violence. The COVID-19 pandemic has brought 18 months of sustained stress, made worse by wildfires and smoke, winter storms and extreme heat. Oregon has seen a 40% increase in drugs overdose deaths in 2020. Adolescent emergency room visits for behavioral health crises increased by 30% nationally. First responders and care navigators are trying to connect people with mental health services, but waiting lists are already three to four months long.

Throughout, frontline behavioral health workers have responded despite less social, professional and emotional support due to COVID-19 restrictions. They are exhausted.

A broad coalition including the Association of Oregon Community Mental Health Programs, the Oregon Council on Behavioral Health and the Oregon Alliance, call on the Oregon Health Authority to:

  • Provide immediate cash supports to organizations struggling with the financial impacts of rising costs and insufficient revenue;
  • Deploy the National Guard to fill vacancies in residential programs;
  • Increase funding to recruit and retain staff;
  • Reduce administrative burden by suspending non-essential reporting and rules that slow down hiring and service delivery;
  • Publicly recognize and appreciate the workforce.

We also need the public’s help. Urge the governor and lawmakers to increase the rate of pay for this work. If you know a counselor, social worker, crisis worker, peer support specialist, or other behavioral health worker, thank them. Buy them a cup of coffee. Bring them a meal. Send them a note of encouragement.

To our friends and colleagues working in the midst of this crisis: We see you. We can feel you. We are very grateful to you. We need you.

Heather Jefferis, executive director of the Oregon Council on Behavioral Health, Cherryl Ramirez, executive director of the Association of Oregon Mental Health Programs and Royce Bowlin, executive director of the Oregon Alliance co-authored this editorial.

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