Oregon is in a crisis.
Among all states and D.C., the state ranks 51st in the country in mental health (2017). Youth mental and behavioral health ranks just as poorly; suicide is the second leading cause of death for young adults.
Families with young children face a growing wave of difficulties in providing safe, secure home lives: nearly 15 percent of Oregon children fell below the poverty line (2017); 44 percent of single mothers — and 17 percent of couples with children — experienced food insecurity in the past five years. We must acknowledge that these complex problems cannot be resolved overnight. Yet, there is hope. Oregon State University is in an interesting — and perhaps unique — place to lay the foundation for a better, brighter and healthier future for Oregon youth and families.
With its expertise in research on social issues and in community capacity building, Oregon State University has the opportunity to leverage the full breadth and depth of its work in the College of Public Health and Human Sciences to improve the mental and physical well-being of youth and their families statewide.
Through the university’s 36 county-based Extension offices, Oregon State has the ability to translate its expertise to deliver community-based programing in mental and behavioral health at the local level. This public health approach — vast expertise coupled with local program delivery — engages families, communities, government agencies and health care organizations in preventing health problems before they arise and in developing solutions to existing problems.
The college has the outreach, capacity, expertise and background to help the state undertake the necessary systemic change by improving access, services, coordination and ease of administration in health services at the local level throughout the entire state.
Oregon State University seeks to partner to create a leadership position to work with public health faculty in each county to develop local strategies to improve mental and behavioral health outcomes. Housed in the college’s Human Development and Family Sciences (HDFS) program, this position would provide leadership and implement local programming to improve health outcomes. Ranked among the top 10 U.S. programs, the HDFS program excels at using current knowledge and hands-on experience to improve the human condition by intervening during crises, helping people access resources and advocating for changes in systems that affect the lives of those in need. HDFS programs empower individuals, families and communities to thrive. Working with the new leadership position, college faculty will provide programming to help individuals and families meet their optimal development across their lifespans and in multiple and local contexts.
The 2015 "Behavioral Health Town Halls" report identified two consistent needs:
To better meet these needs, Oregon's Coordinated Care Organizations are integrating behavioral health with primary and dental care. The Community Health Improvement Plans for many counties include specific objectives related to mental and behavioral health. County public health departments dedicate resources to addressing mental and behavioral health needs.
We want to add to these efforts by contributing our academic expertise and leveraging resources of the College of Public Health and its Public Health Extension programs.
When children grow up in a safe and nurturing home and have opportunities to learn — and time to interact and build relationships with other children — they are more likely to reach their full potential.
Unfortunately, more than one in five youth experience three or more significant adverse experiences during their childhood, putting them at major risk for poor mental, behavioral and physical health and reduced life potential.iii
The need for a safe and nurturing home and community is especially true for youth with mental, behavioral and developmental disorders. Disorders such as anxiety, attention-deficit/hyperactivity disorder (ADHD) and learning problems often begin in early childhood and can affect lifelong health and well-being.
According to the CDC, about one in seven U.S. children ages 2-8 have a mental, behavioral and/or developmental disorder reported by a parent.
Oregon families with young and school-aged children face numerous difficulties in providing safe and secure home life. About 15 percent of Oregon children under age 18 fell below the poverty line in 2017, and 44 percent of single mothers and 17 percent of couples with children experienced food insecurity in 2013-15. Families of youth with mental, behavioral and developmental disorders confront personal, financial and neighborhood challenges more often than families of children without these difficulties. These challenges make it harder for some parents to give their child the resources they need to thrive.
The type of community that families live in may increase these challenges. Food insecurity, housing insecurity and poverty affect how families care for their youth, and these challenges occur as much or more often in rural communities. Parents of youth with mental, behavioral and developmental disorders in rural areas more often report having trouble getting by on their family's income than parents of children with these disorders in urban areas and report poorer mental health for themselves. Communities in high poverty areas lack amenities that promote quality of life, such as parks, recreation centers and libraries.
Community-based initiatives can help families overcome these challenges. Families of youth with mental, behavioral and developmental challenges can benefit from better access to mental and behavioral health care, programs that support parents and caregivers, and opportunities to learn, play and socialize.
Celebrating 150 years of serving the state, Oregon State University is a leading international research institution grounded in the land grant tradition of bringing research and teaching to bear on the most pressing challenges facing our state and our world today. Our faculty members are global leaders in their fields, improving human health and wellness, promoting economic growth and social progress, and advancing the science of earth ecosystems. Home to more than 31,000 students from all 50 states and 89 nations, OSU is the state's comprehensive research university and the university of choice for high-achieving and diverse students.
As Oregon's first accredited College of Public Health and Human Sciences, we take on our greatest challenges to health using science and community engagement to ensure health and well-being for individuals, families and communities in Oregon and beyond.
Our Human Development and Family Studies program is ranked among the top 10 in the country.
We're also growing. Since 2009, we have added more than 40 new faculty members, who train the next generation of public health and human sciences professionals and advance science through teaching, research, scholarship and creativity. These faculty, including 12 who are endowed, support a growing student body in a world in which three times the number of current public health graduates is needed to meet the needs of the future. The college is a standout among other schools and colleges of public health because outreach — in the form of the OSU Extension Service — is built in. In addition to being one of only a handful of schools of public health at a land grant institution, it is one of the only schools of public health with this level of connection to communities.
As a land grant university, Oregon State is the people's university, reaching every county in the state through county-based OSU Extension Service faculty. A public health approach engages systems, families and communities in preventing health problems and developing solutions for existing problems.
The Family and Community Health program supports communities in addressing their citizen's needs, while 4-H promotes positive youth development, including the Youth Advocates for Health program. This network of locally based expertise serves as a ready platform for leveraging a broader community- based campaign to improve mental and behavioral health across the state.
The Hallie E. Ford Center for Healthy Children and Families was established in 2011 to promote the development and well-being of children, youth and families through research that influences practice. Its four research cores draw faculty from across the college and Extension to address early childhood, youth and young adults, parenting and family life, and healthy eating and active living. The center's holistic and interdisciplinary work has far-reaching consequences for Oregon and beyond.
Researchers are currently working on topics such as improving self-regulation in young children and adolescents, understanding how to reduce youth risk behaviors, and promoting healthy adolescent transitions. In collaboration with OSU Extension, the Hallie Ford Center sponsors the Oregon Family Impact Seminar for state legislators and agency leadership on topics of current relevance to legislators (e.g., housing, childhood obesity, poverty).
Parents and other caregivers of children play a crucial role in shaping child development. Extension Family and Community Health, in partnership with the Oregon Parenting Education Collaborative (OPEC), provides access to education, support and resources to strengthen families and communities across the state.
For example, the middle school years can prove challenging for all families, particularly families already experiencing other stressors of unemployment, poverty or housing insecurity. Middle-schoolers are often beginning to experience the stressors of independence and social isolation, while still strongly connected to their families, schools and peers as resources for managing these stressors. Effective programming for parents, schools and peers can support positive mental health development in Oregon's youth.
Trained community-based resource workers can refer and coordinate with local resources and facilitate access to health systems if needed. For other communities, depression among socially isolated older members may be a major concern. Community health workers can work with local partners to identify existing resources, increase activities for more social integration and coordinate resources including transportation as needed.
Parenting Education | Statewide hub network (early childhood risks and family environments) | Shauna Tominey
Statewide early learning network | Megan McClelland
National 4-H Positive Youth Development/Thriving Model for Adolescent Development | Mary Arnold
Disability and Inclusion | Gloria Krahn
Health services research | Jangho Yoon
Measurement | David Rothwell
Health care design and delivery | Karen Volmar
Physical activity | Kathy Gunter
Youth exercise and nutrition through technology and digital life | Siew-Sun Wong
School readiness | Megan McClelland
Early childhood | Bobbie Webber
Self-regulation in young children | Megan McClelland
Self-regulation in youth | John Geldhof
Risk behavior in youth | Peggy Dolcini, Kari Lyn Sakuma, Marie Harvey
Building Resilience in young families facing adversity | Shannon Lipscomb
Young children and families | Bridget Hatfield
Health Equity | Numerous faculty
Oregon State University is developing a multi-pronged approach to promote the mental and behavioral health of youth and families at the community and policy levels that strategically leverages our resources.
Utilizing the Oregon State Extension Service platform in counties throughout the state, we propose engaging with communities to
One strategy is to identify, hire and train community members to work as community health workers with specialty training in mental and behavioral health. These workers can be added to the staff of county-based Extension offices to work in their communities on mental and behavioral health issues, having full access to the resources and support of local and state Extension services and Oregon State faculty. Regional health professionals and campus faculty members can be hired to provide support and expertise to local workers.
Based on the successful parenting education hubs for young children, we propose developing, evaluating and implementing virtual family education resource centers to address the communication and other parenting needs of families with youth.
We propose developing and implementing an Oregon Poverty Index that provides poverty metrics tailored for Oregon policy-makers and community planners.
Our goal is to increase community capacity through training Community Health Workers on mental and behavioral health, with specific attention to supporting capacity building within communities.
We need central planning and supervisory faculty to collaborate across the systems entities at the state level and promote coordination across county-based mental health facilitators. Evaluation and dissemination of the successful strategies would be part of the supervisory faculty responsibilities, as would teaching to promote a prepared workforce.
A Thought Leadership Forum would convene key state groups with national experts to assess, coordinate and plan actions addressing mental and behavioral health of youth and families.