Oregon ranks 50th in the nation when it comes to mental health care among all states plus D.C. We’ve been towards the bottom for years, and we are falling farther behind.

Oregon has more mental health workers per capita than almost any other state. But mental health is a very broad field, and that number doesn’t tell us much about whether we have the right kinds of providers.

It also doesn’t say anything about whether those providers are in the right place to meet our needs. This is a big part of why the situation is so much worse in rural areas, like District 31.

Our entire mental health system suffers from high turnover; this is especially true in community mental health. Combine that wit the fact that community health almost always pays less than other parts of the mental health system and you frequently find the least experienced providers caring for people with the greatest need.

Across the United States, we treat mental health as separate from general health. Here in Oregon, we’ve made the first steps towards correcting this, but we still have too many barriers between these kinds of care. Some of our largest public hospitals have great psychiatry programs, for example, but will take Medicaid for general health but not mental health. This is a huge barrier for the portion of our community that is most likely to need care.

The best overview of the state of mental health across the country comes from Mental Health America. You can read their State of Mental Health in America report, which breaks down both need and access issues in various ways.

There’s been a lot of analysis done on the crisis in Oregon’s mental health system.

Human Services Research Institute did a very detailed level of Multnomah County’s system. While some of it is specific to the county, and it won’t address the additional needs of rural areas, it is a very good overview of the problems faced by the state. The briefing and full report are available.