Thank you for your feedback. I do rely on primary sources when available, and I’m happy to share them directly with you if needed. I try to keep articles relatively short and engaging for a broad audience, so some details, like the systemic issues you mention, are planned for future articles.
I appreciate you raising these important points, and I agree that reimbursement rates and practitioner retention are critical parts of this conversation. Your input helps shape the discussion, so thank you again for sharing.
The community care system is broken, and we need to reinstate facilities to care for those suffering from mental health issues. And fix the problems that led to the community care programs in the first place, and that is providing humane care, not just pumping people up with mind-altering drugs, electric shock "therapy" and what have you.
Hi Cyrus, not sure where you pulled this data from but all the dollars spent per capita by state shows Oregon in the middle of spending on mental health. I reviewed several studies and not once is Oregon at the bottom. Please show your data. Thank you. Deb
Suicide rates are higher in Oregon, but death from drug overdoses is not significantly higher. This is according to CDC numbers. I believe the problem is that school aged children are not learning methods to cope in society. Our children learn about sexuality, but nothing about how to be happy. Schools in Oregon are not supporting traditional morals and values that help kids grow up and achieve satisfaction as a result of having a healthy family life. Oregon has lower marriage rates when compared to other states.
A flurry of brain health incidents usually follows a flurry of Dumping.
Did you know that??
A patient has the civil right to wander the streets floridly psychotic until he reaches critical mass (imminent danger)
When you require danger before you will intervene, Untreated Schizophrenia will be happy to oblige.
““If you are building a system that is based on the idea that anyone can and eventually will recognize that they need treatment … it means the population of people who literally can’t because they have anosognosia are just invisible to the system,” said Lisa Dailey, the executive director of the national organization Treatment Advocacy Center.” Anosognosia is the main symptom that keeps almost half of people who have schizophrenia or bipolar from getting the treatment they need. They simply lack the ability to recognize that they are ill. In other words, they’re too ill to know they’re ill, due to the way their brain malfunctions.
Hello, I read over the members of the OHA Behavioral Health Committee and would like to suggest that those who are on the front lines of dealing with untreated severe mental illness are not represented on your committee. Specifically, police departments, families of those who have loved ones with severe mental illness, those who in addition to their brain disorder also suffer from anosognosia, the lack of insight into their illness, those with lived experience who are unable to attend due to languishing in Oregon's jails and prisons, the homeless, CAHOOTS, and other crisis response teams. Please see the two comments below, one from CAHOOTS and one from the Springfield Police Department retired police chief Richard Lewis "Theresa Boudreau, a crisis worker for CAHOOTS, thanked Wyden for his visit but reminded the gathering that improvements to public safety need more than expanded crisis response. "My perspective, being on the street, is that we could have 800 Cahoots vans and 1,000 workers, and that's great, except for not having a place to take them, not having the services that they need," Boudreau said. "And that's critical." Chief Richard Lewis - his comment to the KVAL article regarding the mentally ill person in crisis the department responded to - The reality is until the nation and Oregon wakes up and starts properly funding mental health, you're going to continue to see tragedies, and you're going to continue to see high profile police interactions when there should have been many interventions before that person gets there." I am respectfully submitting the five-part plan below that outlines real changes and request it be presented to the committee. It would be so appreciated.
More outreach without more services is like cutting more doors into an empty building.
Police are needlessly overburdened by the mentally ill abandoned by the mental health system A FIVE-PART PLAN TO ADDRESS SERIOUS MENTAL ILLNESS (SMI)
1. RECLASSIFY SERIOUS MENTAL ILLNESS (SMI)) FROM A BEHAVIORAL CONDITION TO WHAT IT IS, A NEUROLOGICAL MEDICAL CONDITION WHY RECLASSIFICATION IS IMPORTANT Reclassification will unlock more research funding and help eliminate discrimination in treatment, insurance reimbursement, and the perception of SMI as a “behavioral” condition. SMI is a human rights issue. NIMH ranks SMI among the top 15 causes of disability worldwide with an average lifespan reduction of 28 years. PRESIDENTIAL ACTION * Create a cabinet position exclusively focused on SMI. * Push for Congressional appropriations to include schizophrenia in a CDC program that collects data on the prevalence and risk factors of neurological conditions in the US population.
2. REFORM THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPPA) WHY HIPAA REFORM IS IMPORTANT Overly strict HIPAA laws make it extremely difficult for families and caregivers to partner in the treatment of their loved ones, resulting in important life-saving medical information gaps. By eliminating this barrier, family support will be strengthened, reducing the chance of relapse, homelessness, imprisonment, and death. PRESIDENTIAL ACTION * Work with legislators to change HIPAA law to ensure mental health professionals are legally permitted to share and receive critical diagnostic criteria and treatment information with/from parents or caregivers of SMI.
3. REPEAL MEDICAID’S INSTITUTES FOR MENTAL DISEASE EXCLUSION (IMD) WHY IMD REPEAL IS IMPORTANT IMD repeal will increase the availability of psychiatric inpatient beds. The IMD exclusion is not only discriminatory of those suffering from neurological brain disorders; it is a leading cause of our national psychiatric hospital bed shortage. It prohibits Medicaid payments to states for those receiving psychiatric care in a facility with more than 16 beds who are 21-65, the age group with the most SMI. PRESIDENTIAL ACTION * Work with legislators to repeal the IMD exclusion.
4. PROVIDE A FULL CONTINUUM OF CARE WHY A FULL CONTINUUM OF CARE IS IMPORTANT A continuum of care ensures that SMI patients receive early intervention at all stages of their illnesses, long-term care when needed, and follow-up treatment (medications and therapies) when they’re released. It reduces visits to jails, ER’s and hospitals, homelessness, and morgues. A continuum of care provides lifetime management. Fully fund and institute mental health courts and Assisted Outpatient Treatment programs. PRESIDENTIAL ACTION * Create federal incentives to states which are addressing a full array of inpatient, outpatient, and supportive housing care.
5. DECRIMINALIZE SERIOUS MENTAL ILLNESS (SMI) WHY DECRIMINALIZATION OF SMI IS IMPORTANT People suffering with other neurological conditions like Alzheimer’s and dementia can get treatment promptly without being kicked out of their homes to wander the streets until they are arrested and put in jail or prison rather than a hospital. Setting the bar so impossibly high for getting help ensures that a very large percentage will "disappear", making tragedy before treatment the status quo. These souls will disappear to the streets, jails and prisons, and the morgue. Serious mental illness is the only disease where the doors to treatment are shut unless a crime is committed. This is pure and simple discrimination with the disastrous results we see in our country today — homelessness, incarceration, the disintegration of families, and death. PRESIDENTIAL ACTION * Work with legislators to change “must be a danger to self or others” criteria. * Work with legislators to change involuntary commitment criteria, alleviating the subjective nature of “gravely disabled” and redefining it in objective terms based on scientific medical need for treatment. Psychosis, like a stroke, is a traumatic brain injury and needs immediate treatment for the best outcome.
The system is incredibly overloaded and disjointed. I have been told twice by two different sources at Lane County Behavioral Health that they release people into homelessness, but can "try to provide them with some supplies such as a tent and clothing." The fact that they're openly admitting to releasing the mentally ill to the streets is astonishing - it seems like that should be a criminal act.
Your post (I’m assuming you write your own posts, yes?) omits any sources for your statistics. Additionally, it misses something HUGE.
Access here on the coast is less about allocation of funds than the bigger systemic issue: insurance companies that will not pay practitioners a living wage. Better you should be looking into why we can't attract and hold therapists, psychiatrists, etc. in Tillamook County (read: they can’t afford to practice here) rather than rabble rouse with ledes like “dead last in mental health access,” a statement for which you’ve cited no source.
How much $ does the state feed to ineffective and unaccountable nonprofits? In Portland millions goes to support them yet there are no performance metrics or accountability. “Nonprofits” is a bad word in Portland as most are worsening our livability while lining their own pockets with tax dollars. Is it the same at the state level? Given the similarities of Portland and Salem politics I would unfortunately think it is.
“If you live in Portland or Eugene, the system’s flaws might seem like an inconvenience”
Are you kidding me? Have you walked around Portland? The streets are full of mental health failures. And we attract them from all over the country as there are no consequences for their behaviors nor treatment options or ways to protect the community at large for those with violent mental health conditions. Our lax commitment laws and commitment to allowing people to do whatever they want is a serious problem in Portland.
I have a feeling that mental health problems are also related to the near 20% drop out rate in Oregon is a huge punch to the gut when you can’t fit in well enough to get a high school diploma! The state solution of graduating students without having proficiency in reading, writing, and math levels will not help them feel secure in their abilities either. I know people who can’t read or who have barely basic math skills and they struggle to have confidence. My suggestion is that fixing schools will help in the future. As far as those currently struggling with mental illness in Oregon, Chris C Noel is right about throwing pharmaceutical products at mental illness is a knee jerk reaction by overworked medical professionals trying to keep on top of the overwhelming patient numbers. Counseling is a solution that takes time, but it is the most productive from my personal experiences.
Thank you for your feedback. I do rely on primary sources when available, and I’m happy to share them directly with you if needed. I try to keep articles relatively short and engaging for a broad audience, so some details, like the systemic issues you mention, are planned for future articles.
I appreciate you raising these important points, and I agree that reimbursement rates and practitioner retention are critical parts of this conversation. Your input helps shape the discussion, so thank you again for sharing.
The community care system is broken, and we need to reinstate facilities to care for those suffering from mental health issues. And fix the problems that led to the community care programs in the first place, and that is providing humane care, not just pumping people up with mind-altering drugs, electric shock "therapy" and what have you.
Hi Cyrus, not sure where you pulled this data from but all the dollars spent per capita by state shows Oregon in the middle of spending on mental health. I reviewed several studies and not once is Oregon at the bottom. Please show your data. Thank you. Deb
Suicide rates are higher in Oregon, but death from drug overdoses is not significantly higher. This is according to CDC numbers. I believe the problem is that school aged children are not learning methods to cope in society. Our children learn about sexuality, but nothing about how to be happy. Schools in Oregon are not supporting traditional morals and values that help kids grow up and achieve satisfaction as a result of having a healthy family life. Oregon has lower marriage rates when compared to other states.
A flurry of brain health incidents usually follows a flurry of Dumping.
Did you know that??
A patient has the civil right to wander the streets floridly psychotic until he reaches critical mass (imminent danger)
When you require danger before you will intervene, Untreated Schizophrenia will be happy to oblige.
““If you are building a system that is based on the idea that anyone can and eventually will recognize that they need treatment … it means the population of people who literally can’t because they have anosognosia are just invisible to the system,” said Lisa Dailey, the executive director of the national organization Treatment Advocacy Center.” Anosognosia is the main symptom that keeps almost half of people who have schizophrenia or bipolar from getting the treatment they need. They simply lack the ability to recognize that they are ill. In other words, they’re too ill to know they’re ill, due to the way their brain malfunctions.
Hello, I read over the members of the OHA Behavioral Health Committee and would like to suggest that those who are on the front lines of dealing with untreated severe mental illness are not represented on your committee. Specifically, police departments, families of those who have loved ones with severe mental illness, those who in addition to their brain disorder also suffer from anosognosia, the lack of insight into their illness, those with lived experience who are unable to attend due to languishing in Oregon's jails and prisons, the homeless, CAHOOTS, and other crisis response teams. Please see the two comments below, one from CAHOOTS and one from the Springfield Police Department retired police chief Richard Lewis "Theresa Boudreau, a crisis worker for CAHOOTS, thanked Wyden for his visit but reminded the gathering that improvements to public safety need more than expanded crisis response. "My perspective, being on the street, is that we could have 800 Cahoots vans and 1,000 workers, and that's great, except for not having a place to take them, not having the services that they need," Boudreau said. "And that's critical." Chief Richard Lewis - his comment to the KVAL article regarding the mentally ill person in crisis the department responded to - The reality is until the nation and Oregon wakes up and starts properly funding mental health, you're going to continue to see tragedies, and you're going to continue to see high profile police interactions when there should have been many interventions before that person gets there." I am respectfully submitting the five-part plan below that outlines real changes and request it be presented to the committee. It would be so appreciated.
More outreach without more services is like cutting more doors into an empty building.
Police are needlessly overburdened by the mentally ill abandoned by the mental health system A FIVE-PART PLAN TO ADDRESS SERIOUS MENTAL ILLNESS (SMI)
1. RECLASSIFY SERIOUS MENTAL ILLNESS (SMI)) FROM A BEHAVIORAL CONDITION TO WHAT IT IS, A NEUROLOGICAL MEDICAL CONDITION WHY RECLASSIFICATION IS IMPORTANT Reclassification will unlock more research funding and help eliminate discrimination in treatment, insurance reimbursement, and the perception of SMI as a “behavioral” condition. SMI is a human rights issue. NIMH ranks SMI among the top 15 causes of disability worldwide with an average lifespan reduction of 28 years. PRESIDENTIAL ACTION * Create a cabinet position exclusively focused on SMI. * Push for Congressional appropriations to include schizophrenia in a CDC program that collects data on the prevalence and risk factors of neurological conditions in the US population.
2. REFORM THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPPA) WHY HIPAA REFORM IS IMPORTANT Overly strict HIPAA laws make it extremely difficult for families and caregivers to partner in the treatment of their loved ones, resulting in important life-saving medical information gaps. By eliminating this barrier, family support will be strengthened, reducing the chance of relapse, homelessness, imprisonment, and death. PRESIDENTIAL ACTION * Work with legislators to change HIPAA law to ensure mental health professionals are legally permitted to share and receive critical diagnostic criteria and treatment information with/from parents or caregivers of SMI.
3. REPEAL MEDICAID’S INSTITUTES FOR MENTAL DISEASE EXCLUSION (IMD) WHY IMD REPEAL IS IMPORTANT IMD repeal will increase the availability of psychiatric inpatient beds. The IMD exclusion is not only discriminatory of those suffering from neurological brain disorders; it is a leading cause of our national psychiatric hospital bed shortage. It prohibits Medicaid payments to states for those receiving psychiatric care in a facility with more than 16 beds who are 21-65, the age group with the most SMI. PRESIDENTIAL ACTION * Work with legislators to repeal the IMD exclusion.
4. PROVIDE A FULL CONTINUUM OF CARE WHY A FULL CONTINUUM OF CARE IS IMPORTANT A continuum of care ensures that SMI patients receive early intervention at all stages of their illnesses, long-term care when needed, and follow-up treatment (medications and therapies) when they’re released. It reduces visits to jails, ER’s and hospitals, homelessness, and morgues. A continuum of care provides lifetime management. Fully fund and institute mental health courts and Assisted Outpatient Treatment programs. PRESIDENTIAL ACTION * Create federal incentives to states which are addressing a full array of inpatient, outpatient, and supportive housing care.
5. DECRIMINALIZE SERIOUS MENTAL ILLNESS (SMI) WHY DECRIMINALIZATION OF SMI IS IMPORTANT People suffering with other neurological conditions like Alzheimer’s and dementia can get treatment promptly without being kicked out of their homes to wander the streets until they are arrested and put in jail or prison rather than a hospital. Setting the bar so impossibly high for getting help ensures that a very large percentage will "disappear", making tragedy before treatment the status quo. These souls will disappear to the streets, jails and prisons, and the morgue. Serious mental illness is the only disease where the doors to treatment are shut unless a crime is committed. This is pure and simple discrimination with the disastrous results we see in our country today — homelessness, incarceration, the disintegration of families, and death. PRESIDENTIAL ACTION * Work with legislators to change “must be a danger to self or others” criteria. * Work with legislators to change involuntary commitment criteria, alleviating the subjective nature of “gravely disabled” and redefining it in objective terms based on scientific medical need for treatment. Psychosis, like a stroke, is a traumatic brain injury and needs immediate treatment for the best outcome.
The system is incredibly overloaded and disjointed. I have been told twice by two different sources at Lane County Behavioral Health that they release people into homelessness, but can "try to provide them with some supplies such as a tent and clothing." The fact that they're openly admitting to releasing the mentally ill to the streets is astonishing - it seems like that should be a criminal act.
Hi Cyrus,
Your post (I’m assuming you write your own posts, yes?) omits any sources for your statistics. Additionally, it misses something HUGE.
Access here on the coast is less about allocation of funds than the bigger systemic issue: insurance companies that will not pay practitioners a living wage. Better you should be looking into why we can't attract and hold therapists, psychiatrists, etc. in Tillamook County (read: they can’t afford to practice here) rather than rabble rouse with ledes like “dead last in mental health access,” a statement for which you’ve cited no source.
Cyrus,
How much $ does the state feed to ineffective and unaccountable nonprofits? In Portland millions goes to support them yet there are no performance metrics or accountability. “Nonprofits” is a bad word in Portland as most are worsening our livability while lining their own pockets with tax dollars. Is it the same at the state level? Given the similarities of Portland and Salem politics I would unfortunately think it is.
“If you live in Portland or Eugene, the system’s flaws might seem like an inconvenience”
Are you kidding me? Have you walked around Portland? The streets are full of mental health failures. And we attract them from all over the country as there are no consequences for their behaviors nor treatment options or ways to protect the community at large for those with violent mental health conditions. Our lax commitment laws and commitment to allowing people to do whatever they want is a serious problem in Portland.
I have a feeling that mental health problems are also related to the near 20% drop out rate in Oregon is a huge punch to the gut when you can’t fit in well enough to get a high school diploma! The state solution of graduating students without having proficiency in reading, writing, and math levels will not help them feel secure in their abilities either. I know people who can’t read or who have barely basic math skills and they struggle to have confidence. My suggestion is that fixing schools will help in the future. As far as those currently struggling with mental illness in Oregon, Chris C Noel is right about throwing pharmaceutical products at mental illness is a knee jerk reaction by overworked medical professionals trying to keep on top of the overwhelming patient numbers. Counseling is a solution that takes time, but it is the most productive from my personal experiences.