In April, Oregon state Rep. Janelle Bynum wrote a letter addressed to Gov. Kate Brown.
She said that the state’s mental health care system was failing communities of color.
“The inequities that communities of color have faced by the COVID-19 crisis has only expanded the need to create better-supporting structures for them. Our communities are struggling on multiple levels, including economically and with mental and physical health,” the letter reads.
Bynum proposed several policy solutions that she said would bolster counselors of color, and make culturally competent resources more accessible.
“Communities of color need viable options for healing,” she wrote.
Rep. Janelle Bynum, D-Clackamas, attends an Oregon House session on Monday, April 29, 2019, in Salem. Bynum is working on legislation to address Oregon's struggling mental health system.
Laurie Isola / OPB
Oregon is consistently ranked one of the worst states in the country when it comes to access to mental health care. Fewer than one-in-five mental health care providers in the state are people of color.
Oregon has had problems with the way it recruits and licenses mental health care clinicians, particularly among practitioners of color. Dr. Nathaniel Brown, an assistant professor at Lewis and Clark College who specializes in counselor education and supervision, said that in order for Oregonians to tackle systemic issues, they must grapple with Oregon’s racist history.
“Oregon is predominantly white as a state, and you can’t run from that,” Brown said. “You can look and see the number of providers that are located in the state of Oregon. And when you look at it, you can see who’s in the majority, who’s not in the majority.”
In comparison to his home state of Georgia, Brown said Oregon doesn’t have enough graduate schools and programs that offer mental health counseling.
“When you don’t have enough educational programs and you’re not recruiting a diverse group of individuals through those institutions … you end up recruiting the same type of people,” Brown said.
Dr. Nathaniel Brown is an assistant professor of professional mental health counseling at Lewis and Clark College in Portland, Ore.
Nina Johnson / Courtesy of Dr. Nathaniel Brown
On top of the required education, counselors in Oregon are required to complete 2,400 supervision direct hours with clients. In comparison, the state of Washington only requires half that. Therapists often have to pay for those supervision hours themselves.
Brown said that some mental health care workers live on salaries of $30,000 to $40,000 a year. He says that is not enough money to cover costs of living, pay for supervision hours and pay back student loans in a timely way.
‘We have too many clients who aren’t being served.’
Andrea Redeau is a Portland therapist who specializes in racial trauma. When she first started her practice, she was overwhelmed by the number of Black Portlanders reaching out asking for help.
“I had a big flood of POC clients, Black clients who wanted a therapist,” she said.
Redeau had to turn people away because her schedule was too full. She tried to find other therapists of color to refer people to, but they were few and far between. She would look through photos of other Portland mental health clinicians on the online directory Psychology Today, trying to find anyone who might identify as a person of color that she could refer people to.
“We have people who want support, who want to use a BIPOC therapist who understands their individual struggles,” Redeau said, “and there’s not enough therapists to see them.”
In 2017, that led Redeau to create the group Clinicians Of Color Community & Consulting, or C4PDX. It’s a collective of therapists of color in the Portland area that can offer support to one another and help clients find a therapist of color.
Since Redeau created C4PDX, not much has changed systemically, she said. All of the therapists in the collective are now full, and they’re still having to turn away people of color looking for care.
“It doesn’t change the underlying problem that we have,” she said. “We don’t have enough BIPOC therapists to serve the amount of BIPOC community that needs support.”
Redeau believes that part of the problem is that there aren’t enough therapists of color in private practice, as opposed to agencies.
Graduate schools in Oregon tend to encourage mental health care students to work in agencies, Redeau said. One of the appeals is that agencies sometimes cover the cost of supervision hours. In private practice, therapists are responsible for paying for their own supervision hours.
When therapists of color are in agencies instead of private practice, that can make it harder for clients to access them, Redeau said. It can be difficult to request a specific therapist in an agency. So if someone is specifically looking for a therapist of color, they might not get one.
“While there are a good number of social workers out there who really do want to serve the BIPOC community … the downfall is that they’re in agencies and it’s really hard to access them,” Redeau said.
She wants to see the state provide more resources for Black therapists to set up private practices.
“I believe it is the responsibility of our institutions to help us do that,” Redeau said. “We have too many clients who aren’t being served.”
Working on legislative solutions
Since Rep. Bynum wrote her letter calling for action back in April, the need for mental health care has only increased. On top of the pandemic, there have been months of protests for racial justice in Portland, and thousands of Oregonians were displaced by wildfires.
In a draft request Bynum recently submitted to the state’s legislative counsel, she proposed a number of solutions for the 2021 session.
One of them is reducing the number of direct supervision hours required for counselors by half. Other ideas include employers covering supervision costs and the creation of a $5 million fund to cover supervision for mental health practitioners in private practice.
Bynum also wants to establish a $50 million fund to increase access to mental health care for communities of color and a $40 million fund to recruit and retain clinicians of color through pipeline development, scholarships, stipends and loan repayment.
Dr. Nathaniel Brown agrees with Bynum’s proposed initiatives.
“She’s right on the money. Let’s just be real: You can’t do mental health work for free,” Brown said. “If mental health is such a really, really important priority for this state ... why wouldn’t we want to spend money on mental health?”
Bynum says her work is part of a much bigger goal.
“I’m working for Black peace,” she said. “And that means peace of mind. ... When you can’t get any peace, you find it very difficult to be productive, to be at your very best," Bynum said.
"That’s why having these mental health supports in the communities, especially for Black Oregonians [is important]. That is why I do the work that I do.”