New research shows key failures in Portland Metro’s community mental health system

(Portland, Ore.) – With Oregon ranked as the worst state in the country for mental health outcomes, a group of community mental and behavioral health workers today released a white paper that examines key failures in Portland Metro’s community health system. The Unheard Voices report was compiled by the Solidarity Alliance of Social Services (SASS), behavioral health professionals working to improve client care and the working conditions of caregivers in the behavioral health industry and AFSCME Council 75, a union representing 27,000 public service workers across the state of Oregon.

“We are a community that cares. We came to this work because we believe in helping people recover and heal,” said Karen Hixson, Member of SASS. “This report shows that in Oregon, clients are moving toward recovery in spite of the system, not because of it. Many of these issues stem from the fact that too many workers on the front lines aren’t being heard or supported.” 

In the Portland metro area, the vast majority of behavioral health work is performed by contracted agencies, the majority of which are local non-profits. Based on the results of a 2017 survey, The Unheard Voices outlines the experiences of behavioral health professionals working in Portland’s behavioral health system.

Key findings from the report include:

High caseloads and poor access to services: Behavioral health professionals report routinely being assigned caseloads of up to 110 clients. They also report that clients are forced to wait four to six weeks for follow up appointments, creating critical delays in care that have real effects on the lives of their clients.

High levels of turnover and inconsistent client care: Behavioral health professionals also reported that excessive caseloads and poor workplace conditions create high levels of burnout, resulting in a high level of turnover throughout community behavioral health agencies. High rates of turnover among providers can lead to inconsistent care for clients. A study found that turnover inversely correlated with behavioral health outcomes.

Low wages and poor benefits: The average behavioral health professional makes far less than workers with a similar level of education. While the administrative budgets of community mental health agencies have risen in the last 5 years, the median hourly wages of occupations in the behavioral health industry have not kept pace with inflation. A study by the National Association of Social Workers found that turnover rates were 40% at private agencies compared to 19% at government agencies.

“We are caring for the most vulnerable members of our communities,” said Ana Diodati, SASS member. “Many have experienced trauma and violence, and struggle to afford food and housing. Recovery is critical to their survival. They need a system that works – and that’s what we’re fighting for.”

In response to the challenges outlined in The Unheard Voices, SASS and AFSCME launched United We Heal. This new campaign is aimed at creating a community mental health system that will help clients recover and heal.

“We are coming together as a movement, lifting our voices and the voices of our clients to call for a system that puts healing first,” said L Pearson, SASS member. “By improving working conditions, we will raise the standards of care for those who are counting on us.”

Key priorities for United We Heal include:

1.     Reasonable caseloads and staffing ratios;

2.     Meaningful development of worker skills; and

3.     Adequate wages and benefits

“Oregon has failed in how we view, treat and fund recovery and mental health—and when people can’t heal, communities suffer,” said Lielah Leighton with AFSCME Council 75. “To improve the system, we have to uplift the people who do the work.”

To view full report and learn more about United We Heal, visit:

Susana Betancourt