Your (Unofficial) Guide to State-Sponsored Therapy in Oregon

There’s a way to get affordable mental health care that you might not know about. That’s Oregon’s mental health system.

If you qualify, you can get mental health care at a community mental health program for a small co-pay or a low sliding-scale fee. But even if you don’t qualify for services at a state-funded program, Oregon’s system can still give you information, referrals to affordable providers, and other essential help for free.

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If you’re in a hurry and want to get the most important information about what’s available in the Oregon mental health system and who it’s for, you can read our quick start guide below.

To learn more about public mental health services in Oregon, keep reading. We’ve done the research to uncover essential facts about who’s eligible, what services you can get, when to go, where to call, and how it works so you can decide if Oregon’s mental health system might be right for you.

Who Is Eligible?

You should consider looking into the Oregon mental health system if you (or a loved one) are having a mental health crisis, have a severe mental health condition, have Medicaid, or have a limited income.

Everyone in Oregon can use the state-funded mental health emergency response system. If you or someone you love is in crisis, you can call a state or local crisis line to get the help you need, quickly.

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Public mental health services are usually the best option if you’re having a mental health crisis and need help right away.

State mental health programs are required to provide mental health crisis response services and are one of the fastest ways to get care when you’re having a mental health emergency.

The people who answer state and local crisis lines can provide caring attention and support as they help you determine the best response to a crisis, whether it’s inpatient treatment or an appointment with a counselor.

Even if you’re not in crisis, you can call your local mental health hotline for information about affordable mental health services in your area. When you call, you can find out whether you might qualify for state-funded mental health services, schedule an assessment or intake appointment, or get free information about other affordable local providers.

Other parts of the system have stricter eligibility requirements. You need to have a serious mental health condition (a diagnosable condition that affects your daily functioning) or a limited income to qualify for public outpatient mental health care in many Oregon counties.

Community mental health programs (CMHPs) in Oregon are publicly-funded outpatient programs that primarily serve people with moderate to severe mental health conditions who have Oregon Health Plan (Oregon Medicaid). In addition to affordable therapy, CMHPs provide specialized and intensive services that aren’t available anywhere else or that are hard to find in private clinics.

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Community mental health programs in Oregon are great places to find specialized and intensive mental health services like case management and day treatment that can be hard to find anywhere else. These specialty programs can give you extra help when you’re dealing with severe symptoms.

Some funds are available in the Oregon mental health system for clients who are uninsured or underinsured. However, the number of uninsured clients a program can accept varies from county to county in Oregon. In some counties, CMHPs accept private insurance plans and offer sliding-scale fees to people who meet clinical eligibility criteria but don’t have Medicaid.

To meet clinical eligibility criteria in many counties, you need to have a severe mental health condition—a diagnosable mental health condition that puts you at risk of hospitalization or that otherwise significantly impairs your functioning. If you have a severe mental health condition, you may be able to get services at a CMHP even if you don’t have Medicaid.

Some Oregon county mental health programs and CMHPs can provide services for people with moderate conditions when enough funding is available, especially if you meet financial eligibility requirements.

Independent clinics that participate in the state mental health system can set their own eligibility criteria, which are usually less strict than the criteria for CMHPs.

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Medicaid (Oregon Health Plan) is a great way to access the public mental health system in Oregon. Not only do all programs in the public system accept it, but you can also use it to get services from many other programs and private practitioners.

Oregon expanded its Medicaid program in 1994 and accepted federal Medicaid expansion in 2014, so you’re eligible for Medicaid if your income is 138 percent of the federal poverty level or less. You may also qualify based on a combination of your income, your medical history, and your mental health condition.

If you’re not sure whether you’re eligible, it’s worth looking into. You can apply for Medicaid in person, by phone, or online. To learn more, you can go to a Department of Human Services office or fill out an online application on the ONE Oregon page or Healthcare.gov.

If you’re not sure whether you’re eligible for public mental health services in Oregon, the best way to find out is to call your local program or to go to a walk-in center for an assessment. Most CMHPs conduct free eligibility interviews in person or over the phone.

We encourage you to call or walk in even if you think a state-funded mental health program might not be the right fit for you. Even if you’re not eligible, or if the program doesn’t offer the service you want, they can probably still help you.

Community mental health workers are knowledgeable about local resources and will often give you free information or even referrals to other affordable providers nearby, including local non-profits that provide free or low-cost counseling.

You can find the numbers for your CMHP, affiliated clinics, and local and regional mental health hotlines in the directory below.

Where Do You Call to Get Started?

The best way to learn more about state mental healthcare in Oregon is to call the state mental health hotline or call your local community mental health program directly. You can find contact information for Oregon CMHPs, affiliated clinics, and local crisis lines in the directory in the next section.

There are also many numbers you can call for help no matter where you are in Oregon. You can find the numbers for statewide helplines and hotlines in the information box directly below.

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The statewide Oregon mental health crisis hotline is 988.

The Crisis Text Line for the state of Oregon is 741741.

For help and referrals for mental health and many other needs, you can call 211.

The National Alliance on Mental Illness (NAMI) Helpline is 1-800-950-NAMI (6264).

For mental health support and information, you can reach the non-emergency NAMI Oregon Helpline by calling (503) 230-8009 or (800) 343-6264.

For emotional support or help finding a provider, you can call the Behavioral Health Support Line at (800) 923-4357.

If you just need to talk to someone, you can talk to a peer any time of day by calling the 24/7 Oregon Warmline at (800) 698-2392.

You can contact the Health Systems Division of the Oregon Health Authority by calling (503) 945-5772 or (800) 527-5772.

Public mental health services in Oregon are managed on the state level by the Behavioral Health Services program within the Health Systems Division of the Oregon Health Authority. For general information about Oregon’s system, you can contact HSD at (503) 945-5772 or (800) 527-5772.

However, you’ll probably get the best results by calling your local community mental health program directly. You can find the number for your CMHP in the directory below.

Oregon Mental Health Directory

Public outpatient mental health services in Oregon are provided by community mental health programs. Most counties in Oregon have their own CMHP but some CMHPs serve multi-county regions, especially in the less densely populated central and eastern areas of the state.

Most CMHPs provide services directly, and some collaborate and contract with independent private programs to provide state-funded mental health services. For example, most publicly-funded mental health services in Multnomah County are provided by independent agencies that work with the public system.

You can find the websites and contact numbers for community mental health programs, affiliated clinics and agencies, and local crisis lines in the directory below.

If you need information after hours or aren’t sure whether you’re experiencing a mental health crisis, it’s okay to call a crisis line for help. The staff who answer are trained to quickly figure out what you need and can tell you what steps you need to take to connect with the right services.

Also Consider: Federally Qualified Health Centers

Federally qualified health centers (FQHCs) are another great way to get affordable publicly-funded mental health services in Oregon.

These federally-funded programs provide cutting-edge care in places where good primary healthcare was once hard to find. Most provide integrated care, meaning you can get primary medical and mental health services at the same location.

Each FQHC accepts Medicaid and Medicare and offers low sliding-scale fees if you don’t have insurance. Their eligibility requirements are generally less strict than the requirements for the state-funded system.

You can search for FQHCs near you by using the online search tool on the U.S. Health Resources and Services Administration website.

Troubleshooting Guide

The state mental health system is complicated and can be confusing to navigate. If you’re having any issues, we’re here to help. Here are some of our solutions to common problems you might experience.

If you’ve run into a problem that we haven’t addressed, don’t give up. Call someone at the program (or a state or local mental health hotline) and tell them what’s going on.

You’re much more likely to get the help you need when you advocate for yourself and are persistent. Tell the person you talk to what you need or what problem you’re having.

If they don’t help the first time, call them back and tell them. If you keep calling and keep calm and focused, you should eventually get through to someone who can help you.

Deep Dive: How Does the System Work?

To understand Oregon’s mental health system, it helps to understand how it started and how it’s changed since then.

Public mental health services have been around for a surprisingly long time. But for over a hundred years in America, the only way to get them was in a psychiatric hospital.

In the 1960s, Americans started thinking differently about mental health care. Conditions in psychiatric hospitals were getting worse and new medications made it possible to provide mental health treatment on an outpatient basis.

In response, new laws were passed that required state and local governments to establish community mental health programs as alternatives to institutionalization for people with serious mental illness. The most important was the Community Mental Health Act, which President John F. Kennedy signed into law in 1963.

DEEP DIVE

To learn more about what the public mental health system was like in the early days—and how psychiatric inpatient care has evolved since then—you can read our article “Do Insane Asylums Still Exist? The Surprising Past and Present.”

To learn more about what inpatient mental health treatment is like now, and the differences between how it works in general hospitals and specialized psychiatric facilities, you can read our article “How Inpatient Mental Health Treatment Works.”

Many state mental health programs trace their origins back to the 1960s when these important changes started to happen. Oregon is no exception.

Oregon established its state Mental Health Division in 1961. By the time the federal Community Mental Health Act was signed, Oregon was already operating a few community mental health clinics.

However, Oregon did not pass its own state Community Mental Health Programs Act until 1973, and it lagged behind other states in establishing a full statewide community-based mental health system.

Even as Oregon shut down or reduced the size of its state institutions, it did not adequately fund or build community-based mental health programs and other alternatives to institutional care.

Despite the unflattering portrayal of state psychiatric hospitals in movies like One Flew Over the Cuckoo’s Nest, which was filmed in Oregon State Hospital in 1975, the State of Oregon continued to rely primarily on institutional care over the following decades.

Any progress the state had made in funding and establishing alternatives to inpatient facilities was reversed after the 2001 recession led to community mental health program closures across the state. These cuts and closures only worsened after the 2008 recession.

DEEP DIVE

Public mental health services in Oregon are managed and overseen on the state level by the Behavioral Health Services program within the Health Systems Division of the Oregon Health Authority.

Services are provided by a network of about 30 community mental health programs. Each of Oregon’s 36 counties has a mental health crisis line and a CMHP assigned to it. Most CMHPs directly provide mental health services, while others contract with local non-profit programs to provide community-based mental health services.

In the last decade, advocates filed several lawsuits in state court and federal court over Oregon’s handling of mentally ill inmates and its failure to fully fund or establish community-based alternatives to institutional care. Oregon’s hospitals have also sued the Oregon Health Authority over inadequate state inpatient capacity.

State officials recognized the problem and started taking measures to address the gaps in the system in the late 2010s, including consulting with experts on how to improve the system and building new crisis infrastructure.

After these preliminary steps, the state made a historic investment of $1.35 billion to transform its behavioral health system in 2021. That historic budget increase focused on developing more crisis resources and expanding the mental health workforce.

New funding and initiatives have further expanded crisis services. Oregon has added more mobile crisis teams to cover more counties and launched the statewide 988 crisis hotline in 2022. Oregon is also funding several community mental health initiatives in an effort to reduce reliance on inpatient hospital services for people in crisis.

You can use these new state services to get the care you need. If you’re in crisis or need mental health care and aren’t sure what to do, you can start by calling 988 or a state or local crisis line—the people who answer know how the system works and will help you get where you need to go.

Conclusion

According to the Substance Abuse and Mental Health Services Administration, only 43 percent of people in Oregon who have mental health conditions get treatment for them. Many of them qualify for public mental health services but don’t know about them.

You can make a difference by reaching out and connecting with local mental health resources to get the care you need. If you’re not sure whether you qualify for Oregon state mental health services, call your local community mental health program or a state or local mental health hotline. You may find out you can get mental health services through your CHMP or that there’s another affordable option nearby.

The most important thing is to get started—the help you need may be only a call or click away.

Are You Thinking of Online Therapy? Start Here to Get Matched with a Licensed Therapist Right For You.

Therapy with No Waiting Rooms or Driving. Take a quick quiz about your preferences and needs and get matched to a therapist in as little as 48 hours.

Your (Unofficial) Guide to State-Sponsored Therapy in Oregon

Are You Thinking of Online Therapy? Start Here to Get Matched with a Licensed Therapist Right For You.

Have you been in therapy before?

Quick Start Guide

Who Is Eligible?

PRO TIP

Use the State System When You're in Crisis

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Check Out the State System If You Need Specialized Services

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Check If You're Eligible for Medicaid

Where Do You Call to Get Started?

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Important Numbers in Oregon

Oregon Mental Health Directory

Oregon Clinics and Crisis Lines

North Coast and Willamette Valley Clinics and Crisis Lines

Portland Metro Area Clinics and Crisis Lines

Southwestern Oregon Clinics and Crisis Lines

Central Oregon Clinics and Crisis Lines

Eastern Oregon Clinics and Crisis Lines

Also Consider: Federally Qualified Health Centers

Troubleshooting Guide

Problems and Solutions

Deep Dive: How Does the System Work?

DEEP DIVE

For More Information

DEEP DIVE

What Is the Structure of the Oregon Mental Health System?

Conclusion

Are You Thinking of Online Therapy? Start Here to Get Matched with a Licensed Therapist Right For You.

Have you been in therapy before?

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