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Multnomah County Commissioner Sharon Meieran called on Gov. Tina Kotek today to take over the county’s beleagured mental health system.
“State law directs counties to act as the Local Mental Health Authorities (LMHAs) for their regions. For years, Multnomah County has not fulfilled this obligation on either a statutory or moral basis,” Meieran wrote in a letter to her board colleagues, Kotek and state officials.
“Throughout the past seven years of my term as county commissioner, I have expressed concern about this both publicly and privately, and have pushed for the county to do more. At this time, I have lost confidence that the county has the ability to fulfill its role as the LMHA and I believe that this requires intervention at the state level.”
Meieran noted constant turnover—”five Behavioral Health directors in six years and seven Health Department directors in seven years”—and a litany of failures, including record numbers of deaths in the county jail and on the streets, the lack of progress on a proposed Behavioral Health Emergency Coordination Network, and a lack of a plan to tackle the fentanyl crisis or youth mental health.
In an interview WW published earlier this week, Dr. George Keepers, longtime chair of psychiatry at Oregon Health & Science University, pointed to Oregon’s historic division of responsibility between the state and counties as a major reason the state has one of the least effective (although most expensive) systems of delivering mental health care in the U.S.
Related: The State’s Leading Psychiatrist Says Oregon’s Approach to Mental Health Is Wrong
Meieran’s call for a state takeover is in keeping with her harsh criticism of core county performance, a criticism that has grown even more pointed under the leadership of County Chair Jessica Vega Pederson, who defeated Meieran in a race for the top job in 2022. A state takeover would reverse decades of precedent, likely face major pushback from entrenched interests invested in the status quo, and take a long time.
Meieran is nonetheless asking Gov. Kotek, who directs the Oregon Health Authority, to do what OHSU’s Keepers says makes states such a Massachusetts far more effective than Oregon in the mental health area—centralize and standardize the delivery of services, rather than letting each of the 36 counties design its own system.
“At this time, the situation is not salvageable without external intervention,” Meieran wrote. “And I believe that the state must step in to ensure that our legal obligations under ORS 430.630 are met for the people we are meant to serve.”
County spokeswoman Julie Sullivan-Springhetti says Vega Pederson is focused on rebuilding the health department and hopes Meieran will join her in that effort and in developing and implementing a local mental health plan.
“Mental health services are stressed in Multnomah County and every other county in Oregon,” Sullivan-Springhetti says. “This is a statewide community problem, and the chair has been meeting with the governor and the mayor about how we can work together to increase secure residential and substance use residential treatment as well as other behavioral health services.”
Kotek’s office did not immediately respond to Meieran’s request.