Mental health changes proposed

From The Oregonian, May 5, 1992

Mental health services in Multnomah County — which were decentralized a decade ago — should be centralized again.

That’s the recommendation of a citizen task force that studied the county’s mental and emotional disabilities service system for nearly four months. County commissioners are expected to approve the recommendation at their regular meeting Thursday.

“The stakes are high for all of us, especially the clients we want to serve,” said county Chairwoman Gladys McCoy.

Joseph S. Gallegos, the task force chairman and director of social work at the University of Portland, said the group concluded that it was critical to clarify the responsibilities of the county and the agencies providing direct mental health services.

Currently, six agencies that contract with the county provide case management services for about 1,800 people a year and investigate about 3,000 people referred for commitment, of whom about 10 percent were committed for inpatient mental health care. Crisis lines answer about 24,000 calls a year.

Overall, state, federal and locally funded services total $31 million annually.

With Measure 5 cutbacks anticipated in state and local funding — and with the state’s plan to reduce commitment beds at Dammasch State Hospital — Gallegos said the county must take a more direct role in management of the mental health system.

Specifically, the task force recommended that the county assume direct operation of the involuntary commitment program, which determines which patients are hospitalized for care. It also said the county should itself provide services for some clients — such as those with alcohol, drug or criminal problems in addition to their mental disabilities — whom community subcontractors are unable or unwilling to treat.

Gallegos said the county also should expand the existing Mental and Emotional Disabilities Advisory Council and give it authority to do long-term planning. The new committee would include representatives of mental health consumers, parents and advocates for those with mental or emotional disabilities, community service providers, citizens, law enforcement officials and a representative from the Housing Authority of Portland.

The task force also called for an “operations group” to review day-to-day issues of concern to the county and its subcontractors.

Liam Callen, director of the Garlington Center in Northeast Portland, told commissioners last week that he and other mental health agency personnel objected to the county’s plans to directly provide mental health services and to reclaim operation of involuntary commitment investigations.

“The direct services are an absolute mistake,” he said. “I think it will cost more money for us.”

He applauded the planning recommendations, however. “I can’t oppose this report because I think that’s such a strong part of it,” he said.

In addition to the Garlington Center , county mental health subcontractors include Mt. Hood Community Mental Health, Mental Health Services West, Southeast Mental Health Network Inc., the Delaunay Mental Health Center , the Center for Community Mental Health and 12 others.