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Behavioral health access, language barriers persist, new report finds

Low-income Oregonians still don’t have enough mental health and substance use treatment providers, and patients who need interpreters too often don’t get them, an independent state advocate reports
A room inside the Recovery Works NW's new withdrawal management facility on Southeast Foster Road in Portland, Ore. Most rooms are limited to two beds. | EMILY GREEN/THE LUND REPORT
June 25, 2024

Despite more state spending, low-income Oregonians still have trouble getting help for substance use disorders or mental health issues and those fluent in a language other than English face broader barriers to medical care. 

Those were the primary concerns identified in the 2023 year-end report from the Oregon Health Authority Ombuds program, staffed by advocates who field complaints from people covered by the Medicaid-funded Oregon Health Plan. 

The newly released report called on the health authority to identify treatment gaps for mental health and substance use disorder, while creating new payments to cover the added time and expense of medical interpreters.  

Oregon lawmakers approved $1.35 billion during the 2021 session in addition to more recent spending to improve the state’s lagging behavioral health system. 

However, low-income Oregonians still can’t get behavioral health care because coordinated care organizations, the state’s highly regulated regional Medicaid insurers, still don’t have enough providers in their networks, according to the report. Between 2020 and 2023, the Ombuds office saw its number of cases for Oregon Health Plan members with substance use or mental health issues nearly double, with an increase of 87%. 

“Oregon has insufficient statewide capacity for inpatient and residential mental health and substance use disorder services,” reads the report. “OHP members often struggle to find mental health professionals within their CCO network who are available.”

Not only that, but “the complexity of these concerns has proportionately increased,” it said. 

The report cited recent efforts by health officials and lawmakers to increase funding and services to help Oregon Health Plan members overcome language or cultural barriers. Still, Oregon Health Plan members more comfortable with a language other than English “remain overwhelmed by a system that is too often impossible to understand” or sometimes “receive poorer quality of care.” 

The report noted that sometimes these members are not given interpreters. They are also less likely to access specialty care and more likely to cancel dental appointments because of a language barrier. 

Officials in charge of the state’s Medicaid program have not yet issued a formal response to the report. 

You can reach Jake Thomas at [email protected] or via Twitter @jthomasreports