A System
in Crisis


A strong and equitable community mental health system can empower people to recover, heal and thrive.

But in Oregon, even as funding for community mental health has increased, care providers remain underpaid and overworked—and the most vulnerable Oregonians are paying the price. 

To understand what’s working and what’s not, we spoke with clinicians throughout the state, assessed outcomes for clients, analyzed financial data and researched working conditions at Oregon’s behavioral health agencies. The upsetting findings reveal a system in crisis, where billing targets and profits outweigh people’s needs.


Key Findings

Care providers juggle caseloads of 100 clients or more, making it impossible to provide consistent care.

Frequent Burnout
With huge caseloads and very little support, burnout is the norm, resulting in high rates of turnover.

Inconsistent Care
Clients regularly wait months for a follow-up appointment, and they’re forced to start over with new providers as often as every three months.

With stagnant pay and poor benefits, providers earn far less than other workers with similar levels of education.

More Funding, Poor Care
The six largest behavioral health agencies in Multnomah County have seen a 30% increase in funding in the past five years, but this increase in revenue has not resulted in better care.

Problems like these are why Oregon ranks 51st in the country for mental health outcomes, behind every other state and Washington DC.

Download The Unheard Voices to learn more about Oregon's behavioral health crisis White paper download


“[Erika] has seen dozens of treatment providers for challenges related to her mental health symptoms. She has shared multiple experiences of suddenly losing a provider she felt connected to, and how this has made her reticent to fully engage with treatment. Erika is only one example of a client who is making strides towards mental health recovery in spite of the system, and not because of it.”

— Behavioral Health Counselor, Portland


We aspire to a system that puts healing first — and we’re working toward concrete solutions to raise the standards of care.

Our Vision