Oregon is the lowest ranked state for access to mental health services in the country, according to Mental Health America, a 110-year-old nonprofit dedicated to addressing and promoting mental health needs across the country.

In its 2019 State of Mental Health in America report, MHA ranks the state 51st out of all 50 states and the District of Columbia. It is also ranked 44th in the nation for youth mental health specifically. In these data sets, low rankings indicate a higher prevalence of mental illness and lower rates of access to care.

MHA reported 44 million American adults live with a mental health condition, which is about 18 percent of the adult U.S. population. Fifty percent of adults with a mental health condition experience their onset by the age of 14, but this number spikes to 75 percent by the age of 25, according to the National Alliance on Mental Illness, a grassroots organization dedicated to raising awareness and providing support and education on mental health issues.

According to NAMI’s website, “One in five youth live with a mental health condition (in the U.S.), but less than half of these individuals receive needed services,” and schools “play an important role” in “providing a unique opportunity to identify and treat mental health conditions by serving students where they already are.”

Aaron Grigg, mental health director at the Center for Human Development in La Grande, agrees that schools are in a special position to provide on-hand mental health care to youth.

“We know we need to do more to help kids develop resiliency, and one of the best places to do that is in the school setting because they’re easily accessible,” he said. “Rather than asking them to leave school to come to an appointment at our office, (us) being in the schools is really important (so we can) meet students where they’re at.”

The schools of Union County are no exception.

CHD is responsible for contracting most of the school counselors in Union County, but Greater Oregon Behavioral Health, Inc. is the coordinated care organization for the InterMountain Education Service District, which serves all school districts in Union County and several in Baker, Umatilla and Morrow counties, according to Mark Mulvihill, superintendent of IMESD.

Each of the six school districts in Union County currently have at least one mental health counselor, but that has not always been the case, and a closer look at the details reveals holes in mental health care coverage in the county’s schools.

Cove School District lacked a full-time counselor from the beginning of this school year until March when it was able to fill the position. Union School District’s counselor splits his time between the CHD school-based health centers in Union School District and La Grande High School, although Union Superintendent Carter Wells said CHD is currently looking for a full-time counselor for his district. For this reason, CHD’s school-based health centers offer mental health services only two days a week — Mondays and Wednesdays for Union, Tuesdays and Thursdays for La Grande.

Elgin School District will have a full-time counselor at its high school beginning May 1 after the position had been vacant since November 2018. The district recently hired a part-time mental health counselor at its elementary school, and Elgin Superintendent Diane Greif hopes the district can receive additional funding to eventually turn the part-time position into a full-time one.

“The high school counselor position was a big hole we needed to get filled, and we hadn’t had a counselor at the grade school for years,” Greif said. “We have a lot of kids who live in crisis — we have to be aware and mediate that.”

The superintendent also pointed to the fact that not having a qualified professional to properly care for students’ mental health needs pushes the onus onto unqualified teachers and faculty members.

“We’re not trained to be as effective with helping kids with mental health (as a counselor),” Greif said. “(Mental health care in schools) is becoming more of a necessity with changes in our culture and society.”

The issue of why the need for mental health services in schools has increased arose in a conversation The Observer had with Mulvihill, who said he has seen the percentage of students with mental health issues in rural Oregon rise over the 30 years he has worked in education.

“I think it’s the impact of poverty,” he said. “We’re seeing more poverty in rural communities, significantly more than what it used to be. The impacts of poverty on struggling families means stress in the home, inconsistency and trauma, which leads to kids dealing with it they best they can, but that sometimes (leads to) behaviors that aren’t appropriate.”

While the financial health of metropolitan zones in Oregon have rebounded from the Great Recession, which lasted from late 2007 to mid-2012, rural areas have not fared as well. A report published in 2016 by Save The Children, an organization dedicated to supporting “the most isolated and underserved children in rural America,” ranks Oregon as 24th in the nation for its rural child poverty rate of 21.6 percent. In comparison, the state’s urban child poverty rate that year was only 16 percent.

As CHD’s mental health director, Grigg has seen firsthand how the hardships of poverty — especially the issue of affordable housing — can negatively affect the mental health of children and their families, and CHD is doing what it can to offer support to the community.

“It’s interesting how much housing issues in this area can impact mental health. At least in La Grande, finding housing is a real challenge,” he said. “Even though we’ve seen an uptick in behavioral health needs, we’ve been investing a lot more into community based services to help support people. School is one of the most poignant ways we’re doing that.”

Grigg said one of the largest obstacles to hurdle with providing mental health care in Union County schools isn’t a lack of funds, but a lack of qualified professionals willing to relocate to the area.

“I think especially in rural communities, being able to attract qualified mental health professionals is a real struggle,” he said. “We do have some benefits such as financial incentives, but we also try to find people with some connection to the area so there is more of a chance of them sticking around here.”

Erin Rust, who works closely with community mental health programs through her position as a school-based health coordinator at GOBHI, said she “highly agrees” with Grigg.

“It’s very difficult in rural Eastern Oregon areas to get qualified mental health professionals,” she said. “There’s a very high turnover rate, which can make it tough at the mental health level when working in schools because youth (need) consistency.”

Grigg said he hopes to see more state and federal legislation pass in the near future to help strengthen mental health and community resources, especially in rural areas like Union County. Grigg said in mid-March, he personally testified for POP 402, a 2019 policy goal pushed by Oregon Health Authority to “expand mental health access in schools” and “invest in suicide intervention and prevention,” according to the agency’s 2019 budget presentation.

In Gov. Kate Brown’s November 2018 budget proposal for the following two years, she suggested $1.9 billion to be allocated for education. This isn’t enough for the 14 legislators of the Joint Committee on Student Success, however, as they hope to outline a separate funding plan for student wellness and wraparound services, according to policy recommendations made in early November 2018.

On the federal level, the Mental Health in Schools Act (HR 2319) would assist local communities and schools with mental health services by revising grant eligibility requirements and providing for comprehensive school mental health programs. However, this bill has not made any progress in the legislature since June 2017 when it was referred to the Subcommittee on Health.

Although it is unclear what the next phases of mental health care legislation look like, Mulvihill said the lack of mental health resources in schools — and subsequent student behavioral problems — has been the dominant topic of discussion at IMESD for the past two years, and if nothing changes, it will continue to be its focus.

“Even more than an issue, it’s a crisis. We’re seeing more kids with serious mental health issues and it’s demonstrated a lot in their behavior,” he said. “The school has more and more become the family unit for the kids.”

Contact Amanda Weisbrod at 541-963-3161 or email aweisbrod@lagrandeobserver.com.

Editor’s Note: This story has been corrected on April 10 at 1:25 p.m. A previous version of the story reported GOBHI as the main funding source for school-based mental health services in Union County, when in fact, funding for these services is sourced from a mix of state, grants, school budget and GOBHI funding, according to Aaron Grigg, mental health director at CHD.