Authority, says Oregon’s mental-health worker shortage stems from a variety of factors, all of which have remained relatively unaddressed until now. “One thing we’ve seen is that there has been an underinvestment in the behavioral-health workforce for decades and a lack of parity between behavioral health and the medical side of things, as well as an underappreciation for the emotional toll it takes,” Jones says. “These people are paid the lowest in our system, working with the most acute individuals, and navigating some of the most extremely challenging situations. This is definitely the worst it’s been for Oregon and all across the United States.” The mental-health worker shortage is not confined to Oregon. The National Center for Health Workforce Analysis released a 2023 report detailing the lack of behavioral- health care workers across the country. It found 59 million U.S. adults (23% of all U.S. adults) had a mental illness and nearly half of them did not receive treatment. The report went on to find six in 10 psychologists were not accepting new patients, and the national average wait time for behavioral-health services was 48 days. A forensic psychologist by training, Jones witnessed firsthand the impact of the COVID-19 pandemic on people living with behavioral-health issues — and the providers who served them — while working for Multnomah County’s Community Mental Health program. “For staff, moving around rapidly and getting folks connected to the services they needed became much more challenging,” Jones says. “What we saw was increasing isolation, which resulted in increased acuity of symptoms, and we saw an increase in substance abuse. We saw an increase in those seeking services, and for the folks left in the field, they were seeing caseloads that were beyond what they could manage. And yet, because I believe the hearts of people in this profession are so unique, I think that people just kept pushing and pushing and pushing, which of course can lead to burnout and can lead to folks leaving the job—in some cases — leaving the field entirely.” A June 2023 study of the causes of attrition in Oregon’s behavioral-health workforce, published in the journal Psychiatric Services, found five key themes that negatively affected the interviewees’ workplace experience and longevity: low wages, documentation burden, poor physical and administrative infrastructure, lack of career-development opportunities, and a chronically traumatic work environment. people of color in Oregon’s mental-health workforce. All of the funding earmarked for education stipulates that graduates commit to working in Oregon after graduation. And while the bulk of the OHA funds are geared toward students, 25% of the funding is earmarked for workplaces. “There are also retention bonuses and hiring bonuses, and significant funding that went directly to staff, while some of the funding also went to support indirect costs, such as improving the environment that we work in,” Jones says. “Maybe staff would be a lot more likely to stay at their job if they had a kitchenette to eat lunch rather than having to run around every day.” Cody Christopherson, a faculty member in the clinical mental-health counseling master’s program at Southern Oregon University, says the OHA funding has allowed SOU to increase its number of behavioral- health students by six students, or 25%. He says SOU and its students play a crucial role in serving the menta-health needs of the Rogue Valley. “SOU is by far the main source of behavioral therapists in the Rogue Valley and in our larger region as well. We’re using the grant to expand the number of behavioral- health care workers and expand access to behavioral-health care for the people who live here,” says Christopherson, who adds that he has seen the effects of the mental health care crisis firsthand in his own private practice. “I’ve talked to many, many people whose biggest barrier to getting appropriate medical care is just access. They just can’t get in anywhere. People are on waitlists and they don’t get a call back. I myself am a clinical psychologist in private practice, and I can’t call everybody back Christa Jones, director of behavioral health strategic projects at the Oregon Health Authority Cody Christopherson, a faculty member in the clinical mental health counseling master’s program at Southern Oregon University COURTESY OF CHRISTA JONES COURTESY OF CODY CHRISTOPHERSON Jones says the OHA’s $60 million investment is targeted toward students pursuing master’s and doctoral degrees, since she says graduates with advanced degrees are the most in-demand for the short-staffed workforce. Language in HB 2949 also requires OHA to provide funding — like scholarships and loan-forgiveness programs — that increases the number of Black, Indigenous and 29
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