Laurel sought counseling for her sons three years ago after discovering they’d been sexually abused by a family friend.

She wasn’t happy with the counselors they had until they were assigned to therapist Josh Lydon, but after Lydon left Compass Behavioral Health to start the independent company Roseburg Therapy, she said she ran into a barricade when she tried to keep him as their therapist.

(The News-Review is using pseudonyms for Laurel and her sons to protect the anonymity of sexual abuse victims.)

Laurel’s family has been through a lot. Her tone was flat as she described the problems they’ve gone through since the abuse was discovered.

Neil, 19, is depressed and on medications. Awhile back he was hospitalized after an episode in which he wanted to hurt himself and one of his brothers. Lydon is the only one that has been able to get him to talk, Laurel said.

Ben, 13, is out of control.

“He has not slept in his bed for two days, and I texted him yesterday, asking him if he was going to come home,” she said in an interview Tuesday.

The answer she received contained words too foul to be printed in the newspaper. But Ben has said he would like to resume seeing Lydon.

Laurel felt the boys’ previous therapists were too “wishy washy,” all talk and no substance. Lydon gives them real coping mechanisms, and he’s the only therapist the boys want to see, she said. She also said Compass appointments were scheduled a month apart, and her boys need to be seen more frequently. At Roseburg Therapy, they could be seen weekly.

But Laurel doesn’t have a lot of money. She’s divorced and she lost her livelihood after she was forced to close down her business, so her sons are on the Oregon Health Plan, the state’s Medicaid program. They’re members of the Umpqua Health Alliance, a coordinated care organization that manages care for most OHP patients in Douglas County. She said UHA denied their request to continue seeing Lydon because Roseburg Therapy is not “in-network,” meaning it’s not part of the organization’s network of providers. They’re appealing, and in the meantime, Lydon is treating them despite the uncertainty about whether he’ll get paid.

So is Laurel’s family’s experience typical, or is it an outlier? Some independent therapists outside of UHA’s network, including Lydon, told The News-Review that low-income mental health patients typically face month-long waits for appointments at in-network providers, and deal with frequent turnover of therapists. But UHA and Compass disagreed with that assessment. They said there are plenty of in-network providers to cover patients’ needs.

To put the issue in context, it helps to step back a few years.

Four years ago, the mental health system for low-income county residents was in crisis. The county government abruptly dropped its mental health program, giving 100 employees pink slips and giving up its mental health authority to the state. The state, along with local providers, scrambled to put together the Community Health Alliance, which limped along providing mental health services until 2016, when Adapt merged with it. The mental health program was re-branded as Compass Behavioral Health.

Since then, it has added providers, doubled the number of patients being served, and tripled the number of services provided each month, Adapt CEO Greg Brigham said. It’s also on the verge of signing an agreement with the Roseburg School District that will put counselors in 13 schools—a contract Lydon said he had hoped to win for his company.

According to Brigham, Compass is a real success story.

Compass recently started up a 24-hour-a-day mobile crisis unit for patients who are unable to care for themselves or are at imminent risk of harming themselves or someone else. People experiencing mental health problems that aren’t a crisis get a first appointment within two weeks, while those with more urgent needs are separated into two categories. The most serious, called “emergent” are seen within 24 hours 97 percent of the time. The next level, “urgent,” are seen within two days 89 percent of the time, Brigham said.

Statistics about how often existing Compass patients are seen or how high the therapists’ caseloads are weren’t available, but Brigham said the number of services provided indicates they’re being seen more frequently than in the past. He said caseloads would vary depending on how often individual patients needed to be seen.

There has been staff turnover at Compass, but overall, the number of providers has increased. Since November 2016, about 40 providers left, but 57 were hired, Brigham said. Compass services aren’t limited to individual therapy. They include psychiatric prescriptions and skills training—services many private therapy offices don’t offer.

“Now is every person getting every service they need, treatment on demand? I’m sure that there are times when we fall short, but there are limited resources, and I think they’re being used pretty efficiently here,” Brigham said.

Lydon doesn’t think so.

He served on the Compass youth and family team for two years and said his caseload there reached about 90 children — too many to give the level of service he thought they needed. Instead of regularly scheduling weekly appointments, he said he found himself performing a sort of triage to juggle who most needed to be seen quickly. Some, he said, fell through the cracks.

So Lydon opened Roseburg Therapy in March and brought in four therapists to work with him. About 70 of the organization’s 90 patients are UHA members. He said he needs to bring in more to earn enough money to retain his therapists. He said UHA won’t make Roseburg Therapy “in-network,” and has notified him it won’t pay for any more of its members to receive services there.

Lydon asserts that there are plenty of patients to go around, and additional therapists could ease any overcrowding at in-network providers, lowering wait times for patients and allowing them to be seen on a weekly, rather than a monthly basis.

“What I’m offering at the table is basically the providers. It’s not a provider issue, it’s just whether or not UHA as the payer, the predominant payer for most people’s health care in this county, will allow those providers to do their job. Right now they are not,” he said.

Family therapist Jody Howell worked at Valley View Counseling before joining Roseburg Therapy in April. Valley View is an in-network provider for UHA.

Howell said he felt overloaded at Valley View, where he said he was seeing about 45 patients a week, and he also hears from patients about long waits for care at in-network providers.

Howell said he spent years on committees at Valley View and when he worked for the state’s child welfare office before that. There were hours spent watching power point presentations at lunch meetings where people talked about how to improve mental health care in Douglas County, but nothing ever seemed to get done, he said.

He feels Roseburg Therapy is finally calling out the elephant in the room, saying clients would be better served by a bigger network.

“Look, here’s what you do. You just have another agency to handle more of the clients that you can’t. You share. You help the clients get their needs met now. That’s what you’re supposed to do,” he said.

Lydon is promoting a change.org petition stating that mental health services for OHP patients in Douglas county are “inadequate” and “inaccessible.” It had been signed by 106 people as of Friday afternoon.

Lydon also points to a 2017 Oregon Health Authority report on coordinated care organizations across the state, including UHA. It said most CCOs aren’t adequately monitoring whether their networks of providers have the capacity to “ensure timely access to all required services,” including mental health services. Another 2017 OHA report found that UHA was below benchmark on access to care generally (not just mental health care), and on followup after hospitalizations for mental illness.

Umpqua Health Alliance spokeswoman Kat Cooper, however, issued a written statement that said the organization has plenty of therapists available in its network already, and it routinely monitors them to ensure that even non-urgent mental health appointments are scheduled within two weeks. UHA contracts with 23 independent providers in addition to larger organizations such as Valley View Counseling and Adapt. UHA also operates two clinics on Harvard Avenue.

“Mr. Lydon has made repeated claims that he has spoken with several Umpqua Health Alliance members who are experiencing long wait times for appointments. We have asked him numerous times to provide us with these individuals’ names so that we can help connect them to services, but Mr. Lydon has thus far refused to do so,” the statement said. It also said members having difficulty accessing services should call 541-229-4842 to schedule an appointment.

Brigham said Compass has helped transform mental health services in Douglas County.

“I would say it’s probably very safe to say that there has never been better access to mental health services for mental health recipients than there is right now, ever in the history of this county, probably by a pretty good stretch,” he said.

Reporter Carisa Cegavske can be reached at 541-957-4213 or ccegavske@nrtoday.com.

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Senior Reporter

Carisa Cegavske is the senior reporter for The News-Review. She can be reached at 541-957-4213 or by email at ccegavske@nrtoday.com. Follow her on Twitter @carisa_cegavske

(12) comments

momoffive

KidMom-
I am sorry but I completely disagree with what you are saying. It's disturbing that your calling out an individual that is obviously fighting to help OHP member's and others that are in need of mental health services. My question would be where is your proof or evidence that Mr. Lydon is just a disgruntled ex-employee. Is it always about getting what we want in other's eyes, instead of seeing that someone is actually trying to make a difference in our community when it comes to mental health.
I am a mother of five and I have a child that goes to Fremont Middle School. My child has been bullied non-stop throughout the year and I even had meetings with the principal and guidance counselors with seem to be no help because my child still suffered. I called Compass to get my child in, but they didn't accept my insurance and I was referred over to Valley View and was told it would be over a month before they could get my child in to see someone. My child would truly benefit from seeing a real licensed therapist at school but from the sounds of it from the head at Compass/Adapt the contract that they are getting with the school district will be strictly for UHA card holders and I have commercial insurance so does that mean that there will be no counselor for my child to see because they don't carry state insurance? Why not open the door to other mental health providers and act like a team to fight the mental health problem in our county instead of being territorial? Our children are suffering with no end insight and UHA is too worried about their territory and not letting anyone else in. It's disgusting because there is no reason to shut out providers that want to help with this problem.
Please explain to me why mental health is still so bad in Douglas County if UHA/Compass/Adapt have enough providers to service all UHA members with mental health issues? That is the real question.

KidMom

Those with private insurance are able to get the same services that are offered to OHP members. Your child CAN see a therapist, even one based at the school as Compass/Adapt has the ability to bill many insurances. At least that is what I was told when I called to ask! I think there is more to Mr. Lydon’s “wanting to make a difference”. I know people who saw him when he was at Compass who did not care for him, didn’t think he was helpful, would say that he didn’t work for them. And I am sure that agency will not legally be able to into specifics or choose to go into specifics of his abilities (or lack thereof). T
Bit this doesn’t matter. I agree with you that there needs to be parity between the private insurance sector and OHP sector in what is offered, but I do not think that what Mr. Lydon is trying for is the answer - he’s looking out for his bottom line. He COULD be that provider for people with commercial insurance, but he’s focused just on this UHA/OHP issue. AND does he have the services that Compass offers?

JoshLydon

Kidmom- I don't know why you have to resort to attacks and smears. It seems you feel wronged in some way and may have some interest in not having further providers treat OHP members. Or maybe it is just me? Do you have a connections or work for one of these entities that are suppressing access to mental health services? Roseburg Therapy is more than me, it is a team of therapist with a common mission. The four other therapists can only take OHP. I see both OHP and private insurances. Their jobs are on the line because of UHA's decision. Would you not advocate for their jobs, for mental health access? You seem to have some sort of resentment that shades your perceptions of what this dispute is about. Please be an advocate of parity, of mental health access for all. I wish you well kidmom.

momoffive

I know that my child CAN see a therapist with the insurance I have because I found one outside of Compass/Valley View. The one thing you aren't mentioning while telling me that commercial insurance holders get the same services offered as OHP members, is if the counselors going to schools are fully licensed or are they interns? If they are fully licensed then yes they can accept my insurance, but if they are interns then they only can service OHP members. You seem to know a lot about Compass, so it seems you are connected somehow, especially attacking Mr. Lydon's character. I have friends that have actually been to Compass and I have friends that see Mr. Lydon also. I have never heard anything negative towards Mr. Lydon and was referred to him by multiple friends stating, "he is a counselor that really cares about what you are going through and works hard to help find what can help us through our problems". It's very unfortunate that someone as yourself can read this article and come up with the conclusion that there are ulterior motives as to what Mr. Lydon is trying to accomplish.
In life I have truly learned that unless you have met an individual personally then, it is very unethical to be bashing someone and giving your opinion of them without even knowing them. Everyone has fabricated stories to their liking, so do you honestly know who Mr. Lydon truly is as a therapist or are you gossiping using someone else's "supposed" experience? I am not going to judge anyone at all unless they do something that is unethical. What I took from this article is someone who is wanting to find a solution to help a county (Douglas) that is drowning in mental health with no end in sight. My son has a great therapist now and even though he is not seen at Roseburg Therapy or by Mr. Lydon, I will still support others that are trying hard to make a difference in our county and help those that are struggling with mental health issues. UHA needs to stop with these barriers and start letting other providers in to help with this mental health problem which is out of control.

JoshLydon

Kidmom- I am desperate because services are being suppressed. There are 9 schools and their students who are not going to have access to onsite therapy services next year because of UHA's decision. I don't know if you care about the mental health of the community but I do. It is not a loophole that I am exploiting. I was in-network for almost two years and it is presently being decided on whether I was legally and ethically removed. So are you calling the mother whose children have been suffering a liar? Did you not see the state created reports that are facts? I have been trying to collaborate with Adapt, UHA and Roseburg School district but was met with them burning the bridge. What you are seeing is the reason for why mental health services in Douglas County are inadequate. Am I supposed to not fight for my clients who are in need of mental health services and don’t want poor treatment?

KidMom

Mr. Lydon, you were not in-network, the agency that employed you was. I am sure you have definitely burned your bridges and are desperate for support to keep your business running and support your family. I am not calling anyone a liar, but I am saying that there are a myriad of factors- that you are well aware of- that effect the ability of a youth or family to make effective change in the circumstances of their lives. Good luck Mr. Lydon.

KidMom

This article reads like a disgruntled, ex-enployee is retaliating against his former employer with a lot of rumor are “reports” from people and no facts to back it up. Mr. Lydon is mad because his plan to fund his business plan was foiled because he was attempting to create a “loophole” in the OHP/Medicaid system with UHA and was blocked. I imagine he is quite desperate especially as he continues to burn bridges with the very people he needs to collaborate with.

windylift

Thank you for helping people get the information they need. Great stuff as usual. Keep up the great work!!! https://mcbooks.vn/

Mogie

Why is it that spammers are the only ones with nice stuff to say about articles?

Rockyboy

We can't have efficiency and decent, humane coverage for people. That would be "socialistic," i.e., not enough money in fatcats' pockets in the current healthcare cartel scam.

Mindful2

Adapt/Compass may have improved access but the question is, is it enough? Another question is what motivates Umpqua Health Alliance to limit providers if there is even a question of access issues? OHP members: you have the rights to a mental health assessment within 2 weeks from a provider. Don't settle for less. Don't settle for monthly treatment. The pressure of competition is what brought OHP mental health services to all the schools in Roseburg School District. Now lets see if they will let everyone at RSD access mental health onsite or are they going to discriminate against private insurance or those who would like to keep their non-compass provider and still receive onsite mental health services at the students school. Favoritism and monopoly come to mind while people suffer.

Mindful2

Here is the petition - https://www.change.org/p/ohp-mental-health-services-in-douglas-county-are-inadequate-and-inaccessible?recruiter=883877633&utm_source=share_petition&utm_medium=copylink&utm_campaign=share_petition

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