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.
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.