Last year, Multnomah County spent $93.4 million a year on mental health services, serving 38,000 county residents.

That's a big portion of what the county health department does, but it's difficult even for top county officials to determine how effective the services provided are.

Last year, Commissioner Sharon Meieran, an emergency room physician, brought in a consultant, the Human Services Research Institute, for an evaluation.

HSRI interviewed 139 stakeholders in the system over six months and produced a 132-page draft report.

The findings describe a system in which those being served are trapped in a complex maze of overlapping regulation and administration, served by overworked, underpaid staff who don't reflect the diversity of their clients or provide sufficient community-based peer support.

“Our stakeholder engagement process reflected widespread views that Multnomah County lacks a vision–shared a cross all major system stakeholders–
that can be translated into action,” the consultants found.
Kevin Fitts, the executive director of the Oregon Mental Health Consumers Association said he was glad the county commissioned the report and that included a recommendation for the creation of a director-level position for a person who’d experienced a mental health condition but he hopes to see people held accountable for the system’s shortcomings.
“When do they announce who is getting fired for their responsibility in
managing, overseeing, and funding contracts for a system that creates such a lousy product for most people who seek services from the mental health system?” Fitts asked in a statement.
The county is now soliciting feedback on the draft report and will finalize it late next month.