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DHS news release

(The Oregonian published this guest opinion on Oct. 12, 2004.)

Facing Oregon's mental health challenges


By Jonathan Ater

A 21-member task force is recommending to Governor Kulongoski 50 ways to strengthen Oregon's public mental health system. The good news is that most of these recommendations can be accomplished without big new dollars.

No question, we can’t get the whole job done without more money.

But the task force concluded that, even without full funding, Oregon can create a simplified, coordinated public mental health system.

The time is now. In Oregon, 250,000 adults and children annually experience some form of mental illness. Many of these folks don’t get the treatment and support they need to live productive lives. When society fails these people, we all lose .

It may surprise you that up to 20 percent of Oregon's prison and jail inmates experience mental illness. Six out of 10 kids in juvenile corrections have mental disorders.

It doesn’t have to be that way.

Mental illness is treatable, often at very little cost. But mental health needs the same sort of attention as diabetes and other serious physical ailments.

With reasonable help, most people with mental illness can lead successful and productive lives. Without prevention or treatment, the costs are incalculable.

Last year, a presidential commission called America’s mental health system "a patchwork relic." We can change things in Oregon and build a system which is accountable for outcomes and prevention.

What can we do without asking the Legislature for money? For starters:

  • Let's buy prescription drugs in bulk and make them available as needed.

  • Let's link up local mental health agencies in every county with local law enforcement and jails.

  • Let's see that police statewide receive training in how to work with people in crisis.

  • Let's get leaders of separate agencies working with the same clients to talk to each other.

  • Let's beef up pre-release planning that includes ensuring inmates leaving prison have access to food stamps or other benefits to which they're entitled, so they don’t recycle back to jail.

  • Let’s create community housing and crisis centers to relieve the overcrowding, misuse, and financial costs of expensive hospital beds.

  • Let’s manage "smart" and reward positive outcomes rather than bureaucratic momentum.
These are some examples of the initiatives identified by the task force. We know that Governor Kulongoski and his leadership team can make change happen.

Meanwhile, we should ask the Legislature to join the majority of states that put psychiatric needs on a par with physical needs in private medical-insurance plans. Actuarial experience in other states suggests that the cost of treating mental and physical ills equally, known as parity, is less than the social costs we pay if we don't. It is penny wise and pound foolish not to pay for early treatment and prevention of mental illness.

Mental illness is the leading cause of disability in the United States, at huge cost to individuals, their families, and society. We can change this in Oregon. The task force report lights the way.

Jonathan Ater, partner in the Portland law firm Ater Wynne LLP, was co-chair of the Governor's Mental Health Task Force.