In 1961, the State of Oregon established a Mental Health Division to work in collaboration with county governments to promote the development of a system of community mental health programs. This marked a significant change in the way that public mental health services were provided. Previously, most such services were administered through state institutions, which were rife with abuse. These and other efforts eventually led to the establishment of community mental health services in all of Oregon’s 36 counties.
The shift in Oregon mirrored national changes that culminated in the 1963 passage of the Community Mental Health Centers Act. (In fact, the passage of this act made new funding available to Oregon’s newly created community mental health centers.) These sweeping changes in how mental health services were delivered in the United States and Oregon created a new demand for master’s-prepared counselors ready to work in community settings. In response, Lewis & Clark established graduate programs for counselors and school counselors in 1972.
As the infrastructure for community mental health services solidified, more attention was paid to the professional preparation of counselors and therapists working in the field. In 1989, Oregon passed its first law requiring that counselors and marriage and family therapists become licensed in order to practice. The Oregon Board of Licensed Professional Counselors and Therapists (ORBLPC) was created January 1, 1990, to oversee the licensure process. The board’s responsibilities included establishing standards for licensure, administering a licensing exam, and developing professional ethical standards—for Licensed Professional Counselors (LPCs) and Licensed Marriage and Family Therapists (LMFTs). This was part of a growing movement toward the professionalization of counseling and its differentiation from other mental-health-focused fields, such as psychology and social work. The same year, a federal law was passed that allowed the services of psychologists and clinical social workers to be covered by Medicare. Nearly three decades later, the services of professional counselors are still not covered.
In the decades since community mental health programs took hold in the United States, services have proliferated to include everything from aftercare to day treatment to children’s outpatient services. Lewis & Clark’s counseling programs have similarly grown and matured to include specialized preparation of professional mental health counselors; marriage, couple, and family therapists; and school psychologists who work in settings such as mental health centers, schools, residential treatment settings, correctional facilities, and private practice, among others. Students and alumni serve diverse clients, including children; adults; families; veterans; those suffering from eating disorders; those suffering from addictions to alcohol, other drugs, and gambling; and others.
By the early 21st century, it was obvious that demand for mental health services in the United States far exceeded the existing capacity. In 2008, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity (MHPAE) Act was passed, creating “parity” for mental health and addiction benefits and medical/surgical benefits in private health insurance. In a floor statement, Representative Patrick Kennedy (D-RI), one of the chief architects of the new law, made the case for its passage on the grounds that “access to mental health services is one of the most important and most neglected civil rights issues facing the nation. For too long, persons living with mental disorders have suffered from discriminatory treatment at all levels of society.” Lewis & Clark’s graduate programs in counseling and therapy have long focused not only on imparting evidence-based skills and knowledge, but also on broader issues of equity, diversity, access, and social and economic justice.
As community needs and the professional identity of counselors and therapists have evolved, Lewis & Clark has kept apace with the changes. In 2012, the graduate school opened a state-of-the-art, community-based training facility near downtown Portland for students pursuing degrees in counseling and therapy. The Community Counseling Center provides affordable services for individuals and families, with a special focus on underserved communities throughout the Portland area. Through the center, counselors-in-training have outstanding opportunities to work with a wide range of clients and to learn how community clinics are managed.