State report says Oregon needs nearly 3,000 more beds for behavioral health treatment

The state will need more than half a billion dollars to increase the system that much, it says

By: - February 1, 2024 4:52 pm

Oregon needs nearly 3,000 more beds to adequately treat people in the behavioral health system, a state report found. The Oregon State Hospital in Salem treats hundreds of people in the system daily. (Oregon Health Authority)

Oregon needs to be able to treat nearly 3,000 more people to adequately meet the demand for  residential mental health and addiction treatment , an Oregon Health Authority report released Thursday found. 

That means Oregon needs nearly 8,000 beds in all, an increase of 70% from the 4,800 beds it has now. The current capacity includes care for people in adult foster homes, residential facilities, the Oregon State Hospital, psychiatric hospital care and other programs. Expansions currently planned for existing facilities will enable providers to treat nearly 5,200 patients. 

The report estimates it would take more than $500 million over at least five years to expand and set up new facilities. But that does not include operational costs and salaries. 

Gov. Tina Kotek ordered the Oregon Health Authority to commission the report. It hired Public Consulting Group, a private consulting firm headquartered in Boston that has done similar work in Washington and other states. 

“Too many Oregonians are struggling to get the help they need for a mental health or addiction challenge, and the state needs to lead with a strategic approach to addressing these gaps in health care,” Kotek said in a statement. “We need more resources, to be sure, but we also need better data so we can better serve Oregonians.”

The study takes into account the expected demand through the fall of 2025 and costs to add enough beds across different levels of residential care. The study did not look at outpatient behavioral health treatment needs. 

One of the biggest gaps is care for people who need residential addiction treatment. The preliminary estimates show the state needs another 1,160 to 2,170 more beds. That’s about twice the state’s current capacity of nearly 1,610 beds. Residential programs provide the most intensive and structured environment, with 24-hour observation, monitoring and treatment. 

The report comes as the Legislature prepares to start the 35-day short session on Monday, which will focus largely on how to address drug addiction and expand access, including residential services. As part of a wide-ranging proposal, lawmakers are working to identify shovel-ready projects that can help people who need addiction treatment in a residential setting. 

But the findings in this report – and a more detailed final version scheduled to be released in June – will guide the state’s work well beyond the short session. 

The report gives the state a roadmap as lawmakers plan ahead, said Rep. Rob Nosse, D-Portland and chair of the House Committee on Behavioral Health and Health Care. 

“This is information we’ve needed for a long time,” Nosse said in an interview. “Yes, it’s a big number and we’ve known we’ve needed a lot more for a long time. But now we are getting some actual information about how do we make progress.”

Heather Jefferis, executive director of the Oregon Council for Behavioral Health, said the report’s numbers will be helpful as the state works to improve the system.

We’re really pleased to see numbers because those numbers are really, really critical for us to develop a strategic plan to get where we need to be as a state,” Jefferis said in an interview. “We’re very excited about this progress. It’s extremely important.”

The findings come after the Oregon Legislature has put more than $1.5 billion towards expanding the state’s behavioral health system in the last four years. Addressing the state’s mental health and addiction crisis requires involves more than simply building facilities to house people. The state has a shortage of behavioral health workers, for example, which can make providers reluctant to plan expansions. 

The state’s spending so far has been on residential services, increased provider rates and incentives for the workforce.

“We now have clear and reliable preliminary benchmarks to pursue a sustainable multi-year funding and program effort to ensure every person in Oregon with a serious substance use disorder or mental illness can get the care they need,” OHA’s Behavioral Health Director Ebony Clarke said in a statement. 

The health authority said it is working to get more projects up in the next couple of years to address critical gaps and has identified potential ways to pay for projects that can open in a short time. 

“Our goal is to ensure that no one who needs and wants care for a mental health or substance use disorder should be turned away from lifesaving treatment,” Clarke said.

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Ben Botkin
Ben Botkin

Ben Botkin covers justice, health and social services issues for the Oregon Capital Chronicle. Ben Botkin has been a reporter since 2003, when he drove from his Midwest locale to Idaho for his first journalism job. He has written extensively about politics and state agencies in Idaho, Nevada and Oregon. Most recently, he covered health care and the Oregon Legislature for The Lund Report. Botkin has won multiple journalism awards for his investigative and enterprise reporting, including on education, state budgets and criminal justice.

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