Oregonian Editorial Board, July 23, 2015

One of the big wins coming out of the legislative session this year is one that has received only modest notice: authorization for $20 million in lottery bond proceeds to be spent on mental health housing.

Mental health is one of those needs that can absorb millions of dollars like a sponge without showing any sign of saturation. But the commitment is a significant infusion of cash that addresses one of the critical missing links identified by many health advocates: Housing equals stability – the key ingredient for people with mental health issues to be able to manage their illnesses and lead productive lives.

That this would fall under the radar isn’t that surprising, however, considering the attitudes that Senate President Peter Courtney sees on a regular basis. While people readily agree that mental health care should be a priority, it’s much harder to get anyone to do anything, Courtney, D-Salem, told The Oregonian/OregonLive editorial board.

“People will talk about cancer and all these other diseases but they don’t like to talk about if their child has mental illness or their aunt or their cousin or brother or sister,” he said. “If we dealt with mental illness as aggressively as we deal with our physical illnesses, the effect on the workplace, the effect on domestic relationships, and on every day lives would be unbelievable.”

Credit Courtney for championing the effort and for the necessary horse trading to make it happen. The effort, also backed by Gov. Kate Brown, is “unprecedented” and reflects the state’s willingness to use bonds for housing in the communities where people live – not just for building central institutions like the Oregon State Hospital, said Chris Bouneff, the executive director for the Oregon office of the National Alliance on Mental Illness.

Now comes the hard part – figuring out how to use the money in communities throughout the state in the most effective ways. Here are a few guiding principles as the state and mental health advocates prepare to work out the details:

Make “one size does not fit all” the mantra: “Housing” must be defined broadly and with flexibility to serve the specific needs of a community. For example, in Roseburg, the community might best use the money to build “respite” housing for those experiencing a mental health crisis instead of parking them in jail. The idea here is that someone could benefit from a very short-term housing placement that allows them to regain some stability. Meanwhile, Portland advocates may see a bigger need in building more long-term housing developments that dedicate a certain percentage to those who have been referred by a mental health provider.

Track the progress of newly funded mental-health housing developments: The Legislature in 2014 authorized $5 million from tobacco settlement money to be used for mental-health housing. The money administered by Oregon Health Authority funded both long-term housing and rent assistance and several projects are underway around the state, according to Bouneff. The projects paired public dollars with private investment to stretch the pot of money, which is necessary when you’re talking about units costing as much as $100,000 apiece to build, notes Kevin McChesney, the regional operations director for Telecare Corp. and president of the Oregon Residential Provider Association. 

Don’t try to rush development if the expertise or capacity just isn’t there: While Courtney emphatically said that “it better get done,” the bill summary’s language smartly allows leftover money not spent during the biennium to potentially be available in the next. While the need throughout the state is high, communities should ensure that they are spending funds smartly, not just quickly.

Let expertise, not egos, shape strategy: Oregon Housing and Community Services is the lead agency, but the Legislature is directing it to work with Oregon Health Authority and mental health groups in funding housing projects. While OHCA has the expertise on housing, it needs to give mental health experts a strong hand in steering the effort. All of those involved need to work to avoid the “turf wars” that Courtney said have been problems in the past.

Build in clear ways to measure success: The $20 million is a significant investment, but the state will need to do more in the future to really start meeting the enormous demand. Planners need to select and attach metrics to projects that can show in concrete terms how the investment is filling the need and helping those with mental health illnesses. That success will be the best argument for future investments.