City Club Report Rips Into County's Mental Health System

Portland Mercury:

Assembling a fairly scathing report after months of study, a City Club of Portland committee had some blistering words for the way Multnomah County doles out treatment to the mentally ill—accusing the county of muddy budgeting, poor communication both internally and with regional partners, and failing to properly assess whether its programs were actually working. The report was issued after more than year of close work with county officials, who invited committee members to advisory discussions and shared hundreds of pages of documents and data. And, harshness aside, it's a fairly fascinating read (non-wonks may want to reach for a cuppa coffee) on a worthy subject, especially with politicians and others increasingly pointing the finger at mental health whenever a police officer shoots someone. Needy individuals fall through the cracks, sometimes receiving no care or care at inappropriate levels and locales... Coordination among departments within Multnomah County that serve the mentally ill is poor. Financial resources (primarily Medicaid monies) flow through a multi-level system from the federal government, to the state, to the county, to those providing care in a system that is complex and opaque. It is impossible to distinguish direct costs for patient care from indirect costs for administration. Even worse, assessment of treatment outcomes is inadequate, so that the effectiveness of treatment cannot be ascertained. Committee members did pay lip service to the fact that much of the county's funding is tied up by Salem and Washington, D.C. And they took pains, at one point, "to praise the the dedication and commitment of those who testified, including both service providers and county administrators." But while county officials said they welcomed the review of their work on mental health, it's pretty clear they weren't happy with what emerged, especially in light of all the time they spent with committee members. County Chair Jeff Cogen's spokesman, David Austin, rather charitably called the report an "attempt" to study the problem and said committee members drew mistaken conclusions. For one, he says, the county has already begun reaching out to the state and other regional governments. [ Subscribe to the comments on this story ]

Read the full article here. Discuss below.