Multnomah County's ability to help people with mental illnesses is limited and faces imminent risks, according to a new audit.
Auditor Jennifer McGuirk examined how Multnomah County treats people with serious, persistent mental illnesses who need long-term care. She was particularly interested in the agreement between Oregon and the U.S. Department of Justice to move patients out of large institutions such as the Oregon State Hospital and into small treatment homes.
McGuirk found that isn’t happening fast enough.
“The reality is, we don’t necessarily have all of those sorts of settings in place for people within our county,” McGuirk said.
The audit found more than half of the people who a judge decides need mental health treatment — that is civilly committed — are not receiving intensive services like individualized care.
"For those who do receive them, these intensive services seem to be working as intended for many people," said McGuirk.
From 2016 through 2018, around 700 people were civilly committed at least once in Multnomah County. McGuirk's audit found that people struggling with mental health problems were not receiving the "least restrictive setting" — a goal of the county's "Choice Model Program."
"It’s important for the county to provide adequate mental health services, especially for those with the most serious conditions. The fact that there were hundreds of people who were civilly committed but weren’t enrolled in Choice care coordination is concerning," said McGuirk.
In a letter responding to the audit, Multnomah County Chairwoman Deborah Kafoury, largely agreed with the audit's conclusions. She gave individual responses to each of the 11 recommendations, including how they're trying to expand individualized care.
"Division leadership is invested in providing quality services and is committed to quality improvement efforts," read the letter.
It said efforts are already underway to address many issues, from providing more individualized care to housing needs. It said the county has also been working with the coordinated care organizations to expand intensive care services.