On November 8, City Club of Central Oregon and the Oregon Health Forum welcomed local experts working in the mental health field to discuss the challenges and wins Central Oregon is seeing in supporting mental health services for our community. Speakers included:

  • Holly Harris, Director, Deschutes County Health Services
  • Greg Lamont, Clinical Director, Juniper Mountain Counseling
  • Molly Wells Darling, Senior Behavioral Health Director, St. Charles Health System

City Club’s final forum of 2025 brought together a full room for a focused and practical conversation about mental health access in Central Oregon.

Board Chair Daisy Layman opened the event by welcoming members and guests to the Lucier Members Choice Forum, named in honor of City Club founding member Jim Lussier. She thanked sponsors and members for sustaining the organization’s work and encouraged continued support through membership, year-end giving, and the Central Oregon Gives campaign. She also previewed upcoming topics for 2026 including recreational liability reform, expansion of the county commission, and updates on the Bend Central District.

Oregon Health Forum joined as co presenter. Kim Crosby, Director of Operations, introduced the organization as a nonprofit committed to advancing health policy solutions through public dialogue. She noted that this was their first in person forum in Bend and invited attendees to explore their resource library and sign up for future programming.

Program co-chair Emily Boynton framed the discussion by emphasizing that the purpose of the forum was not to debate national political narratives or place blame on individual systems. The goal was to understand what access looks like in Central Oregon today, where the system breaks down, and how the community can support meaningful improvement.

Understanding the System and the Safety Net

Moderator Holly Harris began by outlining the structure of the behavioral health system in Oregon. She explained the roles of key entities including the Oregon Health Plan, Coordinated Care Organizations, the Oregon Health Authority, and the Community Mental Health Program. In Deschutes County, the CMHP serves as the safety net and is responsible for supporting individuals with the most complex needs. This includes people living with serious mental illness, co-occurring substance use disorders, chronic medical conditions, housing instability, and criminal justice involvement.

Harris referenced the 2024 Mental Health America report, which placed Oregon at number forty-two in mental health access. The ranking reflected progress from past years, yet Harris noted that the report is primarily measuring prevalence of mental health and substance use conditions rather than system performance. She explained that Oregon’s rates are influenced by multiple factors including rural geography, affordability pressures, and increased reporting and awareness.

Where Access Works and Where It Breaks Down

Harris described an uneven access landscape. Individuals with high acuity needs can often receive same day or next day appointments through the CMHP. However, when those individuals require a higher level of care such as inpatient psychiatric treatment or placement at the Oregon State Hospital, the system becomes strained because the number of available beds is insufficient.

Greg Lamont shared insights from the outpatient perspective. He noted that access often goes smoothly when primary care identifies concerns early and refers patients directly to the appropriate level of care. Challenges arise when clients move through multiple agencies, each conducting its own intake process. Lamont described a recent case involving a youth whose family believed they had been waiting for months. In reality, the delays were created by repeated assessments and transfers across agencies rather than long wait times within Juniper Mountain Counseling.

Molly Wells Darling outlined both strengths and gaps within St. Charles Health System. Behavioral health consultants embedded in primary care clinics can see patients quickly, sometimes on the same day. Yet specialty care has significant delays including three to four months for psychiatry and four to six weeks for therapy. She emphasized that collaboration with community partners has improved post discharge access and that many patients now receive follow up appointments within seven days of leaving inpatient care.

A major concern exists in youth crisis services. Central Oregon currently has no local inpatient psychiatric unit for children and adolescents. As a result, youth experiencing acute crises often remain in the emergency department for extended periods while waiting for placement elsewhere in the state. The region will see meaningful progress in April 2027 when a new fifteen bed youth psychiatric facility opens in Redmond.

The Impact of State Hospital Capacity and Residential Bottlenecks

Harris and Wells Darling both described the growing impact of limited access to the Oregon State Hospital. Most beds are now occupied by individuals involved in “aid and assist” proceedings, leaving very limited space for civil commitments. Patients who previously would have been transferred to the state hospital are instead remaining for months in short term inpatient units. These units were designed for stays lasting several days rather than several months.

Residential treatment is also difficult to access. Recent policy shifts placed acute hospitals later in the priority order for available beds, creating longer delays in transitions of care. Lamont noted that clinicians in outpatient settings are struggling to support individuals whose needs exceed the level of care outpatient services are designed to provide.

Crisis Care: 988 and the Stabilization Center

All panelists emphasized the significance of crisis resources. They encouraged attendees to keep two essential tools in mind:

988 – This is the Suicide and Crisis Lifeline and is appropriate for anyone experiencing emotional distress that exceeds their usual ability to cope. It is not limited to life threatening emergencies.

Deschutes County Stabilization Center
 This twenty-four hour walk in facility offers immediate support, clinical assessment, and short term respite for individuals experiencing behavioral health crises. The environment is calm, voluntary, and designed to divert individuals from jail or the emergency department. Harris highlighted that law enforcement can now bring individuals directly to the center, where they are checked in quickly and can receive care without entering the criminal justice system.

A dedicated mobile crisis team responds to calls routed through 911 dispatch and handles the majority of behavioral health calls that once resulted in a law enforcement response. Harris shared that approximately eighty four percent of these calls are now managed without police involvement.

Both Harris and Wells Darling encouraged the community to understand crisis services as one distinct part of a larger continuum that also includes outpatient care and hospital based treatment.

Funding Pressures and System Instability

Harris outlined multiple financial pressures that are limiting the system’s ability to expand. Coordinated Care Organizations are increasingly expected to deliver higher quality care without corresponding increases in reimbursement rates. State agencies are modeling potential budget reductions, creating uncertainty for county based services. Federal Medicaid changes will also require individuals to complete eligibility redeterminations every six months rather than every two years, which increases the risk of losing coverage despite continued eligibility.

Lamont added that agencies with Certificates of Approval operate under strict quality and documentation requirements without consistent financial incentives. This can make private practice comparatively appealing for clinicians and contributes to workforce shortages in public and high acuity settings.

Progress, Priorities, and What the Region Needs

Panelists identified several priorities for the region including crisis services, a stronger continuum of care, and expanded substance use disorder treatment. Harris reported upcoming additions that will bring forty new residential beds to the region over the next two years. These will serve both adults and youth and represent the most significant expansion of residential capacity in decades.

Wells Darling announced that St. Charles will begin offering Electroconvulsive Therapy locally for treatment resistant depression and related diagnoses. Until now, patients have had to travel outside Central Oregon for this treatment.

Panelists also discussed the importance of community education and training. QPR suicide prevention training is widely available through Deschutes County and the Central Oregon Suicide Prevention Alliance. The Bend La Pine School District highlighted its use of Care Solace to help families navigate mental health referrals.

Educators from OSU Cascades asked how universities can better prepare graduates for the workforce. Panelists encouraged advanced training in crisis intervention, suicide risk assessment, psychosis, and high acuity care.

Closing Reflections

Panelists ended with several key messages for the community. Know and share the available crisis tools including 988 and the Stabilization Center. Stay persistent when navigating the system, especially during intake processes that may feel confusing or slow. Support collaboration among county, hospital, and community partners because this cooperation is one of Central Oregon’s greatest strengths.

City Club Executive Director Amber Thacher closed the program by thanking attendees, panelists, sponsors, and Oregon Health Forum. She encouraged continued engagement as City Club prepares for its 2026 program calendar.