Oregon Health and Science University and Legacy Health have officially submitted merger plans to state regulators. Behavioral therapists at Legacy unionized in anticipation of this to protect themselves.

Sixty behavioral health therapists at Legacy Unity Center for Behavioral Health have voted to join the Oregon Nurses Association.

They're also doubling the size of an existing bargaining unit at the hospital, which includes other mental health workers.

Legacy Behavioral Health Therapist Meaghan Wilkinson-Smith said she and her coworkers didn't know about a potential merger until they heard it on the news.

"It worried people that we were going to continue to have no information," said Wilkinson-Smith, "and just be kind of blindsided by whatever decisions and changes Legacy decided to move forward with."

Wilkinson-Smith said with the union, they hope to have a more standardized pay structure.

ONA and other unions representing workers affected by the merger say they support it, based on assurances from OHSU - including on job security, pay parity, and honoring union contracts.

Access to mental health has been an issue in Oregon. A Mental Health America ranking from 2022 placed the state third to last.

Wilkinson-Smith said the union will help her and her colleagues better advocate for patients.

"We hope that we'll have more of a voice in expressing the things that we think could be helping our patients before they get to a point of needing hospitalization," said Wilkinson-Smith, "but also afterwards, and what that looks like for them."

Wilkinson-Smith also said the union will give them more of a voice in Salem when it comes to state policies.

Along with mental and behavioral health specialists, ONA represents more than 220 nurses at Legacy Unity Center for Behavioral Health.

Researchers at the University of Michigan have found that Black students attending Historically Black Colleges and Universities and Predominantly Black Institutions experience better mental-health outcomes compared with their peers at other institutions, but challenges remain.

The Healthy Minds Network, based at U of M, partnered with UCLA, Wayne State, and Boston University, to conduct the study in collaboration with the UNCF Institute for Capacity Building and the Steve Fund. Akilah Patterson, a doctoral candidate at the University of Michigan's School of Public Health, led the research and said the study involved 16 HBCUs and two PBIs, with more than 2,500 students participating.

"About 45% of them are flourishing mentally," she said. "Most notably, we saw that 83% of HBCU and PBI students reported having a sense of belonging in their campus community, compared to about 73% nationally."

However, the data also reveals significant challenges. More than half of the students report that their financial situation is "always" or "often" stressful, and 78% of those facing financial hardships are also dealing with mental-health issues.

In light of these challenges, the study recommends that colleges and universities address unmet mental-health needs, alleviate financial stress, expand on-campus mental-health resources and strengthen student-faculty connections.

Patterson said she hopes the report also underscores the importance of fostering a strong sense of belonging on campus and the crucial role HBCUs play in students' lives.

"HBCUs have a very long tradition of being centers of excellence and academic achievement," she said, "but this work also highlights that there are some mental-health challenges that do need to be addressed on those campuses so students can very much thrive academically."

As of 2023, HBCUs enrolled approximately 293,000 students. While originally established to serve Black students, as of 2015, non-Black students constitute about 22% of enrollment, up from 15% in 1976.


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Diagnoses of mental health conditions in children and teens are on the rise, including in Indiana. But getting kids the help they need can be a challenge.

About one-third of Indiana high school students reported "experiencing poor mental health, most of the time" in a 2023 survey.

But Jeff Reiter - a psychologist with Whole Team, a group that provides technical assistance to primary care clinics - said many parents have trouble accessing both medication and talk therapy for their kids.

He said he thinks what is most needed is more support for primary care providers - which is where mental health problems often are first identified.

"So they're getting those medications from a primary care provider," said Reiter, "a pediatrician, a family medicine, family doctor or something like that. And these are providers who don't have a lot of time in their visits, maybe 15 minutes. They're not specialists - they don't get a ton of training in how to work with psychiatric issues in kids."

Reiter advocated for placing mental health professionals in primary care clinics, to make them more easily accessible to patients and their parents.

He said he also supports what's known as parent management training as a non-medication option for youth with mental health concerns.

Advancements in mental health treatment programs and medications have been helpful. However, these services can be out of reach for a patient with limited or no insurance coverage.

Reiter said he agrees the traditional psychotherapy treatment model can be costly - a factor he said he sees as part of the access problem. But he maintained there's a more relevant issue.

"The point is, there are much more flexible and accessible ways that mental health professionals can practice," said Reiter, "and that's really what we need to be encouraging if we're going to have any chance of reaching more kids."

A study published in 2023 found in Indiana, in one recent year, untreated mental illness was associated with more than $4 billion a year in costs to society.





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Nebraska mental health professionals worry the Trump administration's proposed $880 billion in Medicaid funding cuts would threaten progress the state has made in providing help to those who need it.

The reductions could have a dramatic impact on the 345,000 Nebraskans who rely on Medicaid as their only source of health insurance.

Aileen Brady, president and CEO of Omaha-based Community Alliance, said Nebraska has had recent success in getting higher Medicaid reimbursement rates for providers, and has expanded services.

She added that cuts would hurt people who need help the most - those struggling with mental health problems, people with disabilities, and kids.

"Nearly half of Medicaid enrollees in Nebraska are under the age of 20," said Brady, "and I think people need to understand that impact it'll have on our children in Nebraska - and that means our future in Nebraska."

A recent survey by the Centers for Disease Control and Prevention says at least 50% of American adults will need treatment for a mental health issue during their lifetime.

Brady said such steep cuts at the federal level would require dramatic cuts in services to Nebraskans, especially when considering the degree to which the state relies on the federal money.

"Fifty-eight percent of every dollar is a federal dollar, 42% of those dollars are state dollars," said Brady. "If those cuts would come into play, that $880 billion over a period of time, that's going to create a fundamental shift in how services are delivered - the shift of cost to the states - or it's going to result in a significant cut."

The Trump administration is following through on a campaign promise to cut federal spending across the board.