Psychologists, social workers and chaplains have descended upon southwest Oregon from across the U.S. this month to help residents of Roseburg come to terms with the aftermath of a community college campus shooting that killed ten people and left many other traumatized. But as professionals and spiritual advisors host grief counseling and prayer sessions, it’s becoming increasingly clear that until the Oct. 1 massacre, Douglas County was struggling to provide the mental health services demanded by community members.
While some of Roseburg’s poorest residents say they got the care they needed through Medicaid-funded health plans, there are no psychiatrists within the community who accept patients with private health insurance or who pay out-of-pocket, according to a local physician. And for years the mental health services available to the community have been shrinking.
In 2007, Mercy Medical Center in Roseburg closed its behavioral health unit, which was the only inpatient mental health option for most people in Douglas County. Telecare Recovery Center opened a 10-bed inpatient center in 2008, but it closed within two years, citing staffing shortfalls. And last year the cash-poor Douglas County government tried to surrender responsibility for mental health care to the state before ultimately assigning that role to Community Health Alliance, a tiny nonprofit founded in 2014 that had $244,527 in assets when it filed taxes for the first time earlier this year.
Dr. Robert Dannenhoffer, a Roseburg pediatrician who has been a part of healthcare recruiting efforts in the community, cautions that two separate mental health issues are in the spotlight after the Umpqua Community College campus: Whether the community could have done more to identify and address the perpetrator’s mental health needs before he brought a gun to school, and how well served the rest of Douglas County will be by the services available after the shooting.
“If you had a mental health clinic on every corner, open 24-7, would that have changed anything?” Dannenhoffer asked. “If you had one on every corner, it wouldn’t make a difference. If he’s like other shooters we have seen, people are focused on the wrong things. The kid in Newtown, Connecticut, had access to mental health resources – he just didn’t go for them. If you’re angry and dysfunctional, you are not necessarily seeking treatment.”
Meeting community needs
At a vigil two days after the shooting, chaplains from Billy Graham’s Rapid Response Team circulated around the edges of a crowd of hundreds, while Red Cross representatives provided information about how to arrange time with trained professional crisis counselors. Mental health professionals were standing by at two Roseburg locations to work with walk-in patients, and several trained therapy dogs were deployed last week to serve students returning to campus for the first time, and to comfort firefighters and medics who responded to the shooting.
“We’ve got people coming in from around the country to help, but they are going to leave in about two weeks,” cautioned Carol Gross, a Red Cross mental health and disaster expert who traveled to Roseburg,
and warmed residents of the town to brace for those resources to be withdrawn. “It may seem like you’re forgotten.”
When that happens, Jane Baker, pastor at Faith Lutheran Church in Roseburg said she’s worried that her parishioners will again face long waits to receive inpatient care, and will have to travel great distances to seek psychiatric intervention.
“I hope, in some ways, this is a wake-up for this community, because Douglas County lacks mental healthcare, hugely,” Baker said.
"There are no psychiatrists in town that take private insurance,” Dannenhoffer said. “If someone has Medicaid, there's somebody to see them. But if they have private insurance, they have to go way out of town."
Indeed, several people facing extreme mental health challenges while living in poverty told The Lund Report they were able to get the care they need.
“It’s pretty good getting in for care, as long as you keep your appointments, they help you,” said Kerry Cronquist, age 56, who said he has a schizophrenia diagnosis, and depends on Social Security Disability to pay his subsidized rent in Roseburg Rescue Mission housing.
"I've got the healthcare and the mental health that I go to, and the mission here helps," Cronquist said.
Another Roseburg Rescue Mission resident, Greg Sherman, said that when he sought a psychiatric evaluation through Umpqua Health Alliance, the Douglas County coordinated care organization, he found the process easy to navigate.
"All I had to do was ask a doctor, they referred me to a psychiatrist, it's pretty easy. All I had to do was make the effort. Most people maybe don't,” Sherman, 24, said. "It was going to be two months, but then I called around to other places and they got me in to somebody that day."
But for people with traditional health insurance face different challenges, said Baker, the Lutheran pastor.
“We have the VA here, but even that, it takes months to get in. If you have money, you have insurance, all of those things, if you call a local therapist here, it’s six to eight weeks to get in,” she said. “If you are suicidal, it can still take three weeks to get in. I mean, really? This is a huge need down here, for mental health providers, for inpatient places.”
People seeking inpatient mental health treatment often must travel to Portland or Eugene, Baker said. “That’s one of the single biggest issues facing this community – lack of mental health care.”
And that lack ultimately comes down to a workforce recruiting issue, Dannenhoffer said.
A longtime resident of Roseburg, Dannenhoffer praises the small, close-knit community where he raised his children. But he also notes that those children did not stay in town when they grew up – and he says that many new medical school grads prefer to live in cities instead of a small town. Those who are willing to live in a community like Roseburg are often married to other professionals who can’t find work locally, themselves.
“The VA is trying to recruit like crazy, the state is trying to recruit like crazy,” Dannenhoffer said. "The mental health workforce is an enormous issue. The VA is trying to recruit like crazy, the state is trying to recruit like crazy. It’s a problem we have not been able to solve."
As Douglas County works to recover from the losses of the Oct. 1 Umpqua Community College shooting, that problem is yet again in the spotlight.
Courtney Sherwood can be reached at [email protected]. Follow her on Twitter at @csherwood.
I find it more than unfortunate that these shootings are almost always linked in the media to a lack of mental health care. This continues to promote the stereotype that mental health problems frequently lead to gun violence, which has been proven again and again not to be the case. Most gun violence is committed by individuals with no mental health diagnosis whatsoever - something like 96% of shooters are "sane" by our modern definitions, despite the colloquial tendency to call them "sick" or "nuts." I will also point out that other Western democracies have very similar rates of "mental illness" but much lower rates of violence. So it follows that mental illness is NOT the cause of our gun violence epidemic, and more mental health treatment will not solve it.
Additionally, the article implies that the presence of psychiatrists or other mental health care would have prevented this from happening. This neglects the sobering reality that many of the mass shooters were already receiving mental health treatment prior to their rampages. This includes the Columbine shooters, Kip Kinkel, the Red Lake Minnesota shooter, the Batman shooter, the V-Tech shooter, at least one and probably both of the Fort Hood shooters, and Adam Lanza, just to name a few. The Germanwings pilot was also receiving treatment from a psychiatrist at the time of the event. There is no guarantee that "mental health treatment" in any form will reduce or eliminate the threat of violence from any individual.
Violent attacks are unpredictable and idiosyncratic. Attempts to leverage these horrific events to try and increase funding for mental health services are disingenuous and tend to exacerbate stereotypes about violence and the mentally ill. It's time to disconnect from this odious theme and find a more honest and less destructive way to advocate for more and better mental health services in the USA.
Steve McCrea