National Health Outreach and Engagement Conference 2024

Linnell, D, Brody, B, Breuner, N, Martin, A, Myers, A, and Phibbs, S.
Due to high prevalence of mental health conditions and poor access to behavioral health care,
Oregon ranks near or at the bottom of U.S. states for adult and youth behavioral health
outcomes, respectively. Since 2019, Oregon State University Extension has been working to
promote mental health and prevent disordered substance use and deaths of despair from suicide
and overdose with programs such as Coast to Forest, Farm and Ranch Stress Assistance,
Combating Overdose through Community-Level Intervention, and the AgriStress Helpline for
Oregon. Broadly, the work has involved education and training on evidence-based practices,
promoting local resources, convening cross-sector partners, and building workforce capacity.
In 2022, we conducted a needs assessment of public health and public safety leaders in the
Oregon-Idaho High Intensity Drug Trafficking Area. From 27 interviews we concluded that
there is a need and a desire for bringing all partners together to foster “a full-spectrum
collaborative effort.” With the present level of the SUD and fentanyl crisis, local partners are
overwhelmed by overdose response and inadequate treatment options; pausing to address
system-wide issues and “up-stream” prevention remains out of their reach. Extension is a
natural partner to provide support in this area with a long history of serving communities
through education, technical assistance, and convening partners for collaborative solutions.
To date, our team has assisted six Oregon rural and frontier counties with community planning
to improve behavioral health using a process adapted from SAMHSA’s Community
Conversations about Mental Health. This process was adapted from an evidence-based practice
developed by the U.S. Substance Use and Mental Health Services Administration. The process
takes diverse and committed participants from (1) sharing_experiences, through (2) building a
prevention-treatment-recovery system map and (3) assessing gaps in the system, to (4) planning
for action. The goal is to build on community strengths to address gaps, and to make informed
decisions about resource allocation.

Following the Conversations, counties have:
- Improved understanding of the local situation, including the prevention, treatment and
recovery activities and resources that exist, along with those that are missing.
- More knowledge of one another’s roles and responsibilities and stronger working
relationships.
- A written action plan that can be followed to address gaps and implement innovative practices.
- Formed coalitions, applied for and received new funding, and implemented additional
evidence-based practices.

In addition to these outcomes, we observed commonalities across the six conversations where
communities need additional assistance, including: training and technical assistance to
implement and adapt evidence-based practices in rural communities; and convening leaders
across sectors to facilitate deep, intentional discussions that enhance cross-sector coordination.
We also observed that most community resources are focused on crisis response, treatment and
recovery, while few resources are being allocated to primary prevention. This illustrates a need
for more support in prevention. By applying our expertise in health, education and facilitation
to address these needs, Extension can assist communities in making long-lasting, meaningful
change in behavioral health.