Opinion: Emigration of psychiatric workers requires state response

Julie Dodge

Dodge is interim director of Multnomah County’s Behavioral Health Department.

A man shouts on a street in the center. Across the city, a teenager can not leave their bed. Throughout Oregon, COVID-19 has harmed our individual and societal behavioral health. Eighteen months of stress, isolation and disorder have driven depression, drug use and violence throughout society.

Now, the behavioral health workforce that we have asked to respond to is below this historic demand. There are not enough alcohol and drug counselors, crisis workers, mental health counselors, peer support specialists or psychiatric doctors to provide services, resulting in waiting lists and fewer opportunities for people to get the help they need.

A survey in August conducted by the Mental Health and Addictions Certification Board of Oregon found that one in five certified behavioral health workers across the country either did not work or worked less due to poor pay, lack of support, and burnout. Behavioral health workers have seen more people with higher needs, which in some cases are aggressive and violent.

The mass emigration of workers is crippling on the care of Oregonians – from children to older adults, in homes and outpatient settings, for mental health and substance abuse. As of September, the number of beds available on mental health housing services has dropped by 25% in Multnomah County due to staff leaving their jobs and COVID-19 quarantines. Outpatient behavioral health services perform far worse: With vacancies and fewer appointments, access fell by 40% nationwide, according to the Oregon Council on Behavioral Health. Fewer than 30 housing beds are available for young people across the country, a drop of 70% from a year earlier.

This is unsustainable.

During the last legislative session, Oregon made historic investments in behavioral health, including funding to expand both staffing and capacity for behavioral health housing and housing provision. But these phenomenal opportunities cannot be implemented without a workforce.

Stress has long been shown to increase drug use, anxiety, depression, interpersonal violence and societal violence. The COVID-19 pandemic caused 18 months of persistent stress, exacerbated by forest fires and smoke, winter storms and extreme heat. Oregon saw a 40% increase in overdose deaths in 2020. Youth visits to emergency rooms for behavioral health crises increased by 30% nationally. First-aiders and care navigators are trying to connect people to mental health services, but the waiting lists are already three to four months long.

Throughout, frontline behavioral health workers have responded despite fewer 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, is asking the Oregon Health Authority to:

  • Provide immediate cash support to organizations struggling with the financial consequences of increased costs and insufficient revenue;
  • Deploy the National Guard to fill vacancies in housing programs;
  • Increase funding to recruit and retain staff;
  • Reduce administrative burden by suspending non-essential reporting and rules that delay recruitment and service delivery;
  • Publicly recognizes and values ​​the workforce.

We also need the help of the public. Urges the governor and legislators to increase the rate of compensation for this work. If you know a counselor, social worker, crisis assistant, peer support specialist or any other behavioral health worker, thank them. Buy them a cup of coffee. Give them a meal. Send them an encouraging note.

To our friends and colleagues working in the midst of this crisis: See you. We feel you. We are so 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 op-ed.

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