Oregon lacks over 3,000 behavioral health treatment beds, staff: Study

PORTLAND Ore. (KOIN) – A new study released by the Oregon Health Authority found several gaps in Oregon's behavioral health treatment bed system -- including a lack of thousands of beds and a need to prioritize workforce issues.

The Behavioral Health Residential + Facility Study follows up on a preliminary study from January which began after Oregon Gov. Tina Kotek directed OHA to commission the study in 2023.

According to the study, conducted by Public Consulting Group, Oregon needs up to 3,700 adult mental health and substance use treatment beds to close current gaps in service and meet projected needs in the future.

PCG said closing the gap in behavioral health care requires as much as $170 million every year for the next five years and the addition of 650 beds per year.

During the study, researchers found residential substance use disorder facilities have the highest bed count per capita at 1,418 total beds in Oregon, representing around 33 beds per 100,000 population.

Additionally, Oregon had 317 withdrawal management beds and one inpatient psychiatric facility with just under 100 beds.

Next, researchers learned the Portland metro and North Coast region had the highest number of beds at 1,921 beds, along with the most residential substance use disorder beds at 683. Meanwhile, the Columbia Gorge area had the fewest number of residential treatment beds, at zero.

Researchers noted Oregon needs to expand access to behavioral health services overall, especially for substance use disorder, culturally specific services, services in rural areas, and peer-based services.

Even if treatment facilities expand capacity, researchers found many vulnerable populations may remain underserved because of criteria exclusions. To serve more people, community partners interviewed in the study suggested establishing “no refusal” facilities to increase availability.

Along with treatment capacity, researchers said one of the major concerns among people in the behavioral health community was staffing.

According to the study, staffing issues have prohibited the facilities’ ability to operate at full capacity and retain staff. Researchers said addressing workforce issues needs to be a priority when considering expanding behavioral health bed capacity.

PCG estimates Oregon will need more than $835 million to address the state’s capacity needs. That total includes capital expenses and does not account for staffing or operational expenses.

“We don’t get to choose between adding beds and adding workforce. We must do both in order to make real change in our behavioral health system. It’s important to note that capacity in Oregon’s behavioral health system is dynamic, and the data in the report represent a point-in-time snapshot of one part of a broader continuum of care,” said OHA Behavioral Health Director Ebony Clarke.

“This report provides us with critical data to inform how we prioritize the creation of more treatment beds and it also underscores the broader understanding that we need to continue to invest in solutions that reduce the number of beds needed,” Clarke added. “We do this through investing in protective factors and earlier intervention -- additional community-based programming, crisis and outpatient programs, in addition to other supportive services -- to prevent people who are experiencing mental illness or substance use from progressing to a level of severity in their illnesses that would require treatment in a more acute setting.”

Before the report was finalized, OHA said state officials already identified several “priority” projects likely to bring community beds online in the next two years to address service gaps, along with an additional 356 mental health, substance use disorder, and withdrawal management beds, which are set to open by the third quarter of 2025 thanks to bills passed in 2021 and 2022.

In the last four years, the Oregon Legislature has invested more than $1.5 billion to expand behavioral health treatment capacity, increase provider pay, and stabilize the treatment workforce.