Federal money may help Clatsop County expand mobile crisis response.
Clatsop Behavioral Healthcare, the county’s mental health provider, has a mobile crisis team available to help law enforcement handle crisis calls, but inadequate funding and staffing has kept it from being a more effective resource for police.
The county plans to invest some of the $7.8 million it is projected to receive in American Rescue Plan Act money to hire more clinicians.
Help may also become available through legislation led by U.S. Sen. Ron Wyden. The Oregon Democrat has pushed to enhance federal funding so states can expand on ideas like CAHOOTS, a crisis intervention program of the White Bird Clinic in Eugene.
“Under this approach, when there’s a 911 call dealing with someone experiencing a mental health crisis, CAHOOTS sends trained health professionals as first responders instead of just police,” Wyden, the chairman of the Senate Finance Committee, said in a statement at a committee hearing on mental health care in June. “Health care providers like it, law enforcement likes it. The American Rescue Plan included a billion-dollar down payment to help states build their own programs like CAHOOTS.
“Now the Congress needs to consider what comes next to build these programs successfully and make sure people are getting the help they need even after the immediate crises end.”
During a meeting with law enforcement, social services agencies and political leaders from the county and cities on Friday, Wyden said that while CAHOOTS is a model, it cannot be made into a cookie-cutter approach throughout the country.
The senator said he envisions flexibility and investment in multidisciplinary teams. The discussion on Friday, he said, was designed to hear from local leaders about what would be helpful.
Amy Baker, the executive director of Clatsop Behavioral Healthcare, estimates that 12 clinicians are needed to cover the entire county 24/7. The mobile crisis team has four staffers trained in mental health counseling.
“I think the challenge is that our funding is often based on population and not on acknowledging the necessary infrastructure that we need just to get the job done,” Baker said.
There was consensus that more funding is necessary to address the growing number of crisis calls on the North Coast. However, there were differing opinions on where to start.
Astoria Mayor Bruce Jones said the community needs a full-time shelter for people with behavioral health problems.
“Obviously, it would require some significant resources, which certainly the city of Astoria doesn’t have,” Jones said. “Nationally, locally, regionally, behavioral health treatment has been grossly underfunded for decades and that needs to change.
“And I would just add to that — that needs to not come at the expense of local law enforcement. Local law enforcement needs the resources it has to keep our community safe. So I would like to see the mental health deficits addressed with resources, not funding at the expense of law enforcement.”
Astoria Police Chief Geoff Spalding said many of the city’s crisis calls involve people who are homeless.
“And we talk about all the things we want to do for our homeless population and if we don’t address the mental health component of that, my personal feeling is that most of the other solutions aren’t going to be effective,” the police chief said. “And so for me, I think we really need additional resources to address a significant and growing problem in our city.”
Sheriff Matt Phillips said that because there are people who are unwilling to engage in services, some end up in the criminal justice system.
“And that’s a chance, I think, when we can maybe have an intervention,” the sheriff said. “We need to have resources to provide treatment to someone while they’re in custody. And certainly we’re having challenges with that process.”
Several people pointed to drug and alcohol abuse and the housing crunch as problems exacerbating the issue.
Josh Marquis, a former district attorney, said another problem is that almost all of the money for mental health services comes from the federal government.
“ ... the county puts in exactly zero money of its own into mental health,” he said. “That money comes from primarily federal and secondarily state funds. Now, on the other hand, asking the county to shoulder a big, big part of it would be unrealistic.”
Gearhart Police Chief Jeff Bowman said that while a model like CAHOOTS may be nice, it does not address the elephant in the room.
“The root problem is why are we dealing with them to begin with out on the street?” he said. “Whether they’re homeless or they’re not medicated or whatever reason — that’s the issue really that should be taken care of first. You can keep throwing money at us to take care of the immediate issue, but it doesn’t stop the bleeding. The bleeding stops way before that.”
In January, in an announcement meant to draw attention to the lack of mental health treatment options, Bowman said his officers would no longer respond to mental health calls unless there is an imminent threat of physical harm.
“There is no question that in an ideal world the very first dollar should always be for prevention — no question about it,” Wyden said. “The reality is what do we do when the world is not ideal?”