OHA: Oregon needs 3,700 mental health, substance abuse treatment beds, closing gap could cost $170 million a year

SALEM, Ore. (KTVZ) – Oregon needs up to 3,700 adult mental health and substance use treatment beds to close existing gaps and meet future service projections, according to a final Oregon Health Authority study of the state’s behavioral health continuum of care.

The findings are part of an assessment that Governor Tina Kotek directed the OHA to commission last year. The report was produced by Public Consulting Group, a public sector solutions implementation and operations improvement firm that has produced similar studies in Washington and other states.

The findings inform an ongoing funding and implementation effort that state leaders are committed to pursue, which could take several biennia to complete, according to OHA's news release, which follows in full:

According to the final Behavioral Health Residential + Facility Study report, closing the gap could require investments of as much as $170 million per year over the next five years and the creation of approximately 650 new beds per year.

The final report includes a new five-year funding recommendation that recognizes the importance of:

• Increasing the behavioral health workforce to support expanded capacity.
• Improving access to mental health and substance use disorder support services to help individuals stay within their communities.
• Expanding supportive and transitional housing opportunities.

State health officials will continue to work with Governor Kotek and the Legislature to apply the study’s findings and guide investments toward closing the gap in treatment services.

“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 said. “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.”

The final report follows the draft preliminary report released in February.

At the direction of OHA, the final report reflects updated data for the facilities within scope for this study. Although there is no perfect methodology for determining the appropriate number of high-acuity beds in a behavioral health system, PCG used state and national data sets, findings from peer-reviewed literature and surveys of treatment facilities to estimate mental health and SUD treatment bed capacity and needs within the continuum of care. PCG worked at the direction of OHA to include Oregon-specific data.

Even as the report was finalized, state officials were moving quickly to supplement capacity and have already identified several short-horizon “priority” projects, which are likely to bring community beds online within the next year or two and to address what are considered critical service gaps. OHA is working to publish a dashboard later this summer that will track and highlight progress toward new beds coming online.

Over the past four years, the Oregon Legislature has invested more than $1.5 billion to expand behavioral health treatment capacity, raise provider payment rates and stabilize the treatment workforce. Oregon’s current capacity shortfall would be even greater without these investments.

According to the report, recent legislative investments from HB 5202 (2022) and HB 5024 (2021) have supported the creation of 356 new licensed mental health residential beds (exclusive of adult foster homes), SUD residential, and withdrawal management beds, which are under construction and scheduled to open by the third quarter of 2025.