The Oregon Secretary of State Audits Division revealed this month that the state's mental health system is failing children and families at a time when they need it most.

An audit report listed failings that ranged from a chronic workforce shortage to lack of performance measurements, which prevents the Oregon Health Authority from catching shortcomings in its own work.

The report arrives as impacts of the COVID-19 pandemic take a toll on many Oregonians' mental health. Among those who suffer the most from the frayed system of care? Children.

Auditors discovered high turnover among mental health staff, which sometimes retraumatizes patients. "Are you leaving too?" is the question a direct care supervisor said she often hears children ask her staff.

The report says employees leave because of low pay and a high-stress work environment—and the high turnover puts a strain on the staff members who stay. (Staff also reported not getting support from management who have made it clear they are replaceable.)

In-depth training is required to efficiently improve children's mental health issues, but various OHA mental health staff told auditors that new hires are not receiving the proper training to help high-risk children. This puts staff at risk from traumatized children who can become aggressive and violent in an instant.

Oregon statutes also contribute to the problem, with vague requirements that allow loopholes. COVID-19 has affected OHA's budget, but figures show that for years, OHA has dedicated a very small percentage of available funding toward behavioral prevention.

The audit states that OHA does not have a strategic plan in place nor does it have specific goals, but the report made a list of 22 recommendations for the OHA. Without a strategic plan or a way to track progress, the mental health system will continue to fail children and families.

OHA responded by agreeing to all 22 recommendations made by the auditors and set a target date for implementing each one.