Editor’s Note: This is Part 3 of a series, Breaking the Cycle: Oregon’s attempt at recovery.
PORTLAND, Ore. (KOIN) — For more than 3 decades, Oregon hasn’t been able to meet the needs of people with addiction and mental illness. The problem is visible every day with open-air drug markets, tents and RVs lining neighborhoods.
The real question is: How many more resources do we need – to meet the specific diagnoses – and the increasing severity of cases?
Now for the first time in the region, possibly even the state, groundbreaking work reveals real numbers that give us perspective on the true size and scope of these pressing problems – but more importantly, a roadmap to address them.
This study was conducted by Providence Center for Outcomes Research and Education in cooperation with Health Share of Oregon, CareOregon and Central City Concern.
Researchers analyzed claims data for nearly half a million people covered by Medicaid benefits in the Tri-County region. The information shows the number of Oregonians who have significant behavioral health and addiction challenges and are at high risk for homelessness.
The addiction, behavioral health, and healthcare organizations who crunched the numbers joined KOIN 6 News for a roundtable discussion to explain their findings:
Dr. Andy Mendenhall — The CEO of Central City Concern. CCC provides comprehensive healthcare, housing, and employment services in the Portland metro area. Dr. Mendenhall is board-certified in addiction medicine.
Mindy Stadtlander is the CEO of Health Share of Oregon, a coordinated care organization, providing physical, mental, and dental healthcare benefits to Medicaid recipients in Multnomah, Clackamas and Washington Counties.
Jill Archer is the Vice President of Behavioral Health at CareOregon. CareOregon helps more than half a million individuals on the Oregon Health Plan get behavioral health benefits—which include mental health and substance use treatment services.
Scope of Study:
- Study looked at all 460,000 Health Share members.
- Health Share serves 82% of Oregon Health Plan members in Clackamas, Multnomah, and Washington Counties.
Percentage of Behavioral Health Disorders overall:
- Of Health Share’s 460,000 members, 9% of adult members fall into at least one of the following categories: stimulant use disorders, opioid use disorders, and psychosis.
Disorders grew modestly amid the pandemic:
- Stimulant (Meth) Use disorder grew by 1%
- Opioid (Fentanyl) Use Disorder grew by 5%
- Psychosis grew by 11%
- Finding: increase in number of cases isn’t drastic, but the disorders are now more severe
Impact on Hospitals:
- People within the 9% of disorders represent nearly 40% of hospital admissions for Health Share adult members.
Frequency of ER visits:
Compared to the average Health Share member:
- People with psychosis are admitted to the hospital 3x more frequently.
- People with opioid (fentanyl) use disorder are admitted 5x more frequently.
- People with stimulant (meth) use disorder (with or without psychosis) are admitted 7x more frequently.
Impacts of homelessness on healthcare system:
Among people with those conditions – a severe mental illness, opioid use disorder, or stimulant use disorder – if that person is homeless or at risk for eviction, the rates of hospitalization increase by 12x.
Among people with stimulant (meth) use disorder – if that person is homeless or at risk for eviction, the rates of hospitalization increase by 14x.
Among those for whom we have indications that the person is homeless or at risk for eviction, the rates of hospitalization are 8x higher compared to all Health Share adults.
“We need real attention to this group of people,” Stadtlander said. “They are on our streets and in our hospitals. The data makes that clear. The healthcare system is not serving them.”
Roadmap for Recovery:
What is needed in the Tri-County region:
- 200-250 inpatient and residential treatment beds for the severely mentally ill.
- Residential treatment programs for people with mental health and substance use disorder needs.
- More outpatient behavioral health and addiction treatment program capacity.
- Several thousand more addiction treatment counselors, recovery mentors, and behavioral health clinicians.
- Care coordination for individuals across housing, physical, and behavioral health.
- New work systems bringing together health care, government agencies, and the criminal justice system.
- A system of behavioral health and substance use disorder care for the incarcerated population.