Columbia River Mental Health Services celebrates 75th anniversary

In 1942, what was then called the Clark County Guidance Clinic occupied space on the fourth floor of the courthouse under the leadership of librarian Eva Santee, who was concerned with “juvenile delinquency.” It’s a term that’s since been retired. Children with challenges are called at-risk youth.

Terminology has changed over the past 75 years and that agency’s name has changed, too. Today, it’s called Columbia River Mental Health Services, Clark County’s largest and oldest provider of behavioral health services.

The nonprofit serves adults and children at seven locations: the main clinic off Fourth Plain, clinics in Battle Ground and Hazel Dell, a 32-bed residential treatment facility called Elahan Place, the Clark County Youth House and an office in Washougal. There are 200 employees, 140 directly serving clients and 60 in administrative and support positions.

The name is still up for debate and CEO Craig Pridemore has been hesitant to purchase a new, permanent sign for the main campus. There’s been talk of changing it to Columbia River Behavioral Health Services to incorporate both the mental health and substance abuse treatment services that are provided. The main campus is also home to the 400-patient methadone clinic.

“We’ve also talked about it as a stigmatizing thing. People don’t want to say, ‘I’m going to Columbia River Mental Health,’ because they are afraid people will assume they’re mentally ill and that sort of thing,” Pridemore said. “So, we’ve talked about changing the name again to decrease any stigma that might be out there. There’s a big debate about whether to do that because there’s a lot of people who say, ‘No, we’ve got to destigmatize this and we should be leading the fight.’ ”

Columbia River Mental Health Services took off in the ’80s when the institutions closed and there was a big push to destigmatize mental illness, Pridemore said.

“I don’t know that it’s changed enough,” he said. “I encounter it very frequently.”

Wealthy businessmen still talk to him in hushed voices about the challenges their family members face. And, many people with mental health issues still go undiagnosed and untreated.

Last year Columbia River Mental Health served 4,674 people, including 773 youth.

Those with severe issues can have a hard time holding down a job that provides private insurance. About 89 percent of funding is through Medicaid. This year’s budget is about $13.5 million.

The budget hasn’t really increased since 2013, Pridemore said. In July, negotiations begin on the rate all behavioral health agencies are reimbursed through the state. Pridemore would like to be able to offer more competitive salaries and the community needs a behavioral health crisis triage and stabilization center in Vancouver. Ideally, he’d like it to be on a grassy lot behind the main clinic. It’s currently home to a community garden.

Stable and strong

Columbia River Mental Health Services has a tumultuous history in which the agency at times struggled with finances and its public image.

The last major crisis, Pridemore said, was in the late ’90s when many executives left and formed Community Services NW — what’s now probably the agency’s biggest competitor.

“When you talk to folks at other agencies, it’s as if everybody in the behavioral health system at one time or another worked for Columbia River,” Pridemore said.

He recently had lunch with an executive from Portland-based Cascadia Behavioral Healthcare who used to work at Columbia River Mental Health Services in the ’80s.

These days, Pridemore thinks the agency is doing well. It’s financially stable and there are plenty of clients.

“I think agency morale is doing real well. We’ve got a good solid management team,” he said.

Partnering with other behavioral health providers and homeless service agencies has helped build public trust of Columbia River Mental Health Services. What behavioral health providers do is believed to reduce costs for jails and hospitals.

In celebration of the agency’s 75th anniversary, Columbia River Mental Health Foundation — the agency’s separate fundraising arm — is hosting a Cinco de Mayo Fiesta and Fundraiser at WareHouse ’23. The foundation funds behavioral health services for youth and covers funding gaps for clients who otherwise wouldn’t be able to afford services.

The gala kicks off the Hopes and Dreams Grant Program to fill those gaps and help cover other client needs. That could mean covering someone’s medication costs, utility bill or rent, paying for clothing for an interview, or helping pay the fees to get their driver’s license back.

Case managers will submit funding applications this month, a committee will review the applications and the first round of funding will go out at the end of June, said Deanna Pauli-Hammond, president of the foundation. Currently, there’s $25,000 available primarily raised through a luncheon in September. Friday’s fiesta will be a big fundraiser for the program, too.

Pauli-Hammond hopes that the grant program will grow and eventually be used communitywide, rather than just within the agency.

What the agency looks to do with the grant is a step toward greater care integration: Making sure people have their housing and food needs met as well as their mental and physical health.

“It makes it much easier to provide them with care if they’re not stressing about all of those other things in life,” Pridemore said.

The move toward fully integrated managed care has been a “huge reform” that Columbia River continues working on. The last year has been more focused on administrative and fiscal integration. Pridemore said while mental health and chemical dependency providers are collaborating, there’s still work to be done bringing physical or primary care into the fold.

“The system as a whole, I think, is moving really slowly,” he said. “I’m hoping the next year’s is really going to focus on actual care integration.”

The rationale behind it is that medical professionals should be working together to accurately diagnose and treat patients.

Recruit and retain

Columbia River Mental Health Services has long struggled with employee turnover. It’s something that Pridemore knows well as he served as interim director twice before being hired permanently in 2014.

“That’s our No. 1 challenge as an agency is workforce — recruiting and retaining quality workforce,” he said.

Some people come to Columbia River Mental Health right after college and work for a few years to get licensed and then leave for higher-paying jobs with government, private businesses or insurance companies.

“They make more money and work with clients who are not quite as challenging,” Pridemore said.

Clinicians at Columbia River Mental Health tend to serve people with severe mental illnesses, such as psychosis and schizophrenia, whereas other medical practices may serve people with lower levels of depression and anxiety.

Registered nurse Ann Pollock has worked at Columbia River Mental Health Services since 2006, making her one of the more senior employees. She started out as director of the locked inpatient unit and now meets with clients between their appointments with nurse practitioners.

“I work in an environment that truly looks at the whole person. It’s more than just taking meds,” she said.

Although the agency has always been client-centered, it’s grown more collaborative; mental health and substance abuse treatment providers work together more, as teams, she said. While generally the goal is to get people to a recovery point where they don’t need regular help, some clients have severe needs and may be in treatment for the rest of their lives.