A system slowly cleans itself up
The pulse of the Multnomah County mental health system is perking up.
But Dr. Peter Davidson, whose job it is to revive the ailing department, is in the fight of his life. Davidson, a Harvard-trained clinician, is seeking to restore a departmental reputation sullied by accusations from within of discrimination and racism.
'These allegations are baseless and worthless,' Davidson said recently. 'And I must be doing a poor job of being a racist, because my spouse is of Asian descent and she is pregnant with our child.'
Honestly, I find no bigoted bones in Davidson's frame. And the county's human resources office, which investigated these allegations, seems to agree. Many of Davidson's peers also have cleared the county's top clinician of racial discrimination.
So why is Davidson, already saddled with the task of re-energizing the Multnomah County Health Department, also battling a serious public image problem?
The county's aggressive efforts to redesign its chaotic mental health system have resulted in layoffs and the elimination of top-level administrative positions. Because of the personnel changes and budget cuts, there are bound to be disgruntled employees. It is not surprising to see the man at the helm get the blame.
Furthermore, the mental health redesign efforts are making drastic, systemic changes in the way the department functions. Those changes are encountering heavy resistance from some county employees and outside providers who are bent on maintaining the status quo.
The plan is to slice $3.6 million from the budget in the next three years by reducing the need for hospitalization. Previously, the system had a smaller patient capacity and fewer treatment options. Inevitably, this meant that patients ended up in acute care and other high-cost services.
The new formula favored by Davidson and John Ball, acting director of county human services, and Diane Linn, chairwoman of the county Board of Commissioners, provides more dollars to outpatient systems that expand capacity and treatment options while being less expensive to maintain. It means fewer patients in hospitals and emergency departments.
News of the county redesign effort has a certain deja-vu-all-over-again feel, simply because past criticisms have stayed remarkably consistent. But on closer look, the slow speed with which the effort is moving is not because of the 'same old, same old,' but because for first time in a long while, county officials have found a formula that could truly work and are being understandably cautious.
My worry is that the culture of bureaucracy that can potentially confound these efforts permeates the agency's office like a bad odor. Petty gossip and innuendo among employees have replaced professional decorum.
Consequently, a mindless stream of racial accusations have created avoidable distractions. This should not be so. To continue along this path is to sidestep the paramount issue of making our mental health system work.
Seeing a system that affects the lives of thousands of citizens caught in the crossfire of some cynical means-and-ends conflict is more than dispiriting.