(Soapboxes are guest opinions from our readers, and anyone is welcome to write one. Bill Kroger is chairman of the Washington County Behavioral Health Council.)

Some 65,000 adults in Washington County could benefit from treatment for a mental disorder or addiction, but fewer than one in five will get help.

Some are in denial of their illness and don't want help, but cuts to the Oregon Health Plan and lack of other resources have limited the number of individuals who can be served or who can qualify for help. The problem is also severe among uninsured children in Washington County. One in five children experience a mental health problem each year that could benefit from short-term treatment, and one in 10 has an emotional disturbance that limits his or her ability to function within their families, at school or in community settings. Additionally, it is estimated that some 5,500 Washington County youth need alcohol and drug treatment.

Oregon ranks 32nd nationally in public expenditures for mental health services. The amount per capita is only 52 percent of California's expenditures and 62 percent of Washington State's. Clearly, there is need here at home.

Two years ago the Washington County Behavioral Health Council - an advisory body to the Washington County Commission and the Department of Health and Human Services, comprised of professionals in the field and lay volunteers - began to assess our community's needs in the mental health-addiction arena in an effort to focus attention on the most-pressing issues. The process was difficult as there is much need, but the council was able to choose the top five greatest needs for additional resources. They are:

n Restore and stabilize the Oregon Health Plan to reduce the number of uninsured residents.

n Increase resources for alcohol and drug treatment.

n Fund the development, training and support of the mental health work force in evidence-based practices.

n Fund employment services for the mentally ill.

n Improve resources for community-based services to help uninsured children.

The first two priorities - restoring funds for the Oregon Health Plan and increasing resources for alcohol and drug treatment - are self-explanatory. Uninsured residents do not have access to treatment, and as a result impose a burden on emergency room care, law enforcement, jails, and child welfare. In the area of alcohol and drug abuse, methamphetamine continues to be a serious problem. Treatment is one of the tools in fighting the meth epidemic, but resources have not kept pace with the problem.

Evidence-based practices (EPBs) are research-based practices proven to work, the best of the best, and the Oregon Legislature has directed publicly-funded programs to use them. But legislators failed to provide funding for workforce and program development, hence the implementation of EPBs is haphazard and inadequate. Funds to make the transition work will go a long way toward improving outcomes.

Among those with severe and persistent mental illness, fewer than 15 percent are able to compete for jobs on their own, but with supported employment programs, this number goes up to 70 percent. Jobs are the one major factor in improving the lives of these individuals, and society as a whole greatly benefits, too, when they are able to work.

Finally, improving resources for community-based services to help uninsured children is critical. More than one third of the children determined eligible for intensive mental health services in Washington County are not enrolled in the Oregon Health Plan's Managed Care program. State general funds for providing mental health services for these uninsured children is less than 50 percent of funds available for adult services.

This fall, the council held a breakfast for Washington County legislators and candidates to present these issues. Seventeen legislators and candidates attended, showing the high rate of interest among Washington County's delegation to the statehouse. Nine of these attendees will be in the next legislature. Support from the public encouraging our legislators to provide increased funding for mental health and addiction programs will go a long way toward helping our more fragile neighbors and thus all of us.

Also, members of the council are making short presentations and handing out a newsletter on the top five needs at various venues around the county. To learn more, contact the county Department of Health and Human Services at 503-846-4555.

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