When it comes to mental health services in Central Oregon, advocates say one word describes what must happen in the future: more.

Over the past decade, the range of services available to Deschutes County residents struggling with mental illness has more than doubled. Today, a person who falls ill can very likely get all the necessary help right in town.

But health professionals say it’s still not enough.

“I think everyone is super busy, and they’re doing the best they can,” said Molly Wells, the administrator of Sage View Psychiatric Center. “But we need more.”

Today, Central Oregon has two residential treatment homes, several adult foster homes, a variety of permanent or long-term housing for people with mental illness, as well as a secure facility and Sage View. Deschutes County also has a team of professionals who pay regular visits to clients, some of whom live on their own.

But the future of these and other services hinges on state funding and a continued emphasis on keeping the mentally ill in their home communities and close to their families, friends and support networks.

Linda Hammond, the interim director of the state’s addictions and mental health division, said her office will continue to support local programs like those in Deschutes County.

“The goal is to really get people’s needs met as early as possible so there are more local resources that fit people before they get into too high a level of crisis,” Hammond said. “As we manage and help recognize and organize around an individual’s needs, then we also are looking at developing local resources for varying levels of need.”

Hammond said it’s important to ensure the current facilities are being used properly so people aren’t staying at a higher level of care than necessary and that there are lower-level facilities available for those who need them.

However, says Hammond, “resources are such that I wouldn’t tell you there are enough facilities to meet everything we need. Whether that’s more at the lower level or intermediate (level of care), we will continue to evaluate that.”

While Hammond can’t say what facilities might be necessary in the years to come, she knows one thing: The state needs more affordable alcohol-and-drug-free housing.

“If people can be in a safe environment with supports brought to them, then a lot more can be served in their community,” Hammond said. “But if they’re living in a crime-ridden neighborhood, they’re so vulnerable and so at-risk that they often end up back in the system.”

That’s certainly important in Deschutes County, where many who are able to leave supported housing can’t afford to do so on their modest incomes.

“People need subsidized housing,” Deschutes County Behavioral Health Director Scott Johnson said. “Eighty percent of the housing here is not viable.”

Others think the greatest need in Central Oregon lies elsewhere.

Bob Joondeph, the president of Disability Rights Oregon, believes that spending more on children’s mental health can reduce the high long-term costs of mental health care and steer people away from the criminal justice system.

“We need to be getting support for families who identify problems with kids. We need to be getting early identification in the schools and get the services to those kids,” he said.

Linda McCoy, who serves on the board of Central Oregon’s chapter of the National Alliance on Mental Illness and whose son struggles with mental illness, said there still isn’t much help available locally for juveniles.

“If they’re younger, they end up over the mountain,” she said.

That, according to Deschutes County Deputy District Attorney Lillah McBride, means local kids with mental illness often end up in the justice system.

“Jails and law enforcement are the default, especially for kids,” she said. “The juveniles all go to detention.”

Over and over, said Eileen White, another NAMI board member, she hears the same story from families: A troubled person threatens all day to commit suicide, goes to the hospital, gets checked out and then released, comes back home and repeats the cycle.

Though most agree there’s still much to be done to have a truly community-based program available for those with mental illness, the state may expand its hospital offerings in the Willamette Valley.

In recent years, the state has replaced much of the Oregon State Hospital and plans to open a new state hospital in Junction City. The 2007 Oregon Legislature authorized more than $450 million to replace the decrepit Oregon State Hospital in Salem with a 620-bed facility, which opened in 2011. No new bond funding was approved by the Legislature this year for the Junction City facility, but state officials have $20 million available to get some work going on the property. The state hopes it will open in 2014. The Junction City hospital was originally slated to have 360 beds, but a 2011 study suggested that the facility be built for 174 patients.

Some worry that funding for a new state hospital will divert money from local projects.

Joondeph said his group opposes the construction of a state hospital in Junction City.

“We believe that Oregon has chronically underfunded community mental health services,” he said. “We did advocate strongly for improvements to the state hospital. It was a long planning process looking at what should be done because of the decrepit conditions in that hospital.”

At that time, he said, Disability Rights Oregon advocated to have inpatient mental health services spread across the state. That’s because it’s a best practice for people in need of inpatient care to be as close to family and support services as possible, he said.

“Our model would be that, for example in Central Oregon, there would be both robustly funded community mental health services to avoid hospitalization in the first place, or if that becomes necessary, someone not be sent over to the Valley in order to receive those services,” Joondeph said. “There would be services available.”

For now, Deschutes County behavioral health specialist Travis Sammon said his office can do more with less money than state hospitals. And he’s willing to look at new ways of delivering health care to his clients.

“If we’re going to provide better care for a lower cost, we have to get creative,” Sammon said.

While Sammon believes his Assertive Community Treatment team, which delivers medicine and does regular check-ins with clients living around the county, has been successful in keeping people living independently and getting the care they need locally, the future of the program is uncertain.

“It’s hard to say, because a lot of it depends on AMHI funding,” he said. “We have a positive foundation and a lot of good outcomes and improvements. But we need funds there to be able to build on.”