Following the compounded crises of 2020 through 2022, Oregon saw a sharp increase in mental health challenges — including depression, anxiety, substance use and suicide. The state continues to rank near the bottom nationally for mental health outcomes due to the high prevalence of mental illness and substance use combined with low access to care. Rural and coastal communities face the greatest disparities.
Oregon State University Extension Service professionals are uniquely positioned to respond. Embedded in communities across the state, Extension faculty and staff serve as trusted resources and can help bridge gaps in access to mental health education and support services.
These efforts have helped OSU Extension strengthen community-level response to mental health and substance use challenges — equipping professionals and partners across the state to offer informed, compassionate support when it matters most.
To meet these urgent needs, OSU Extension partnered with the OSU Center for Health Innovation to launch the Coast to Forest project. Funded by four federal grants — including two from the U.S. Department of Agriculture and two from the Substance Abuse and Mental Health Services Administration — the $1.5 million initiative builds on existing community strengths and addresses gaps in educational, preventive and systems-level responses to Oregon’s mental health and opioid crisis.
A key component of Coast to Forest is Mental Health First Aid training — an eight-hour, evidence-based course that introduces participants to risk factors, warning signs and common mental health conditions. The training uses role-playing and simulations to help participants recognize symptoms, offer initial support, and connect individuals with appropriate professional, peer or self-help resources. Participants also learn to respond to conditions such as depression, anxiety, substance use disorder, trauma, bipolar disorder, eating disorders, schizophrenia and psychosis. The course provides a five-step action plan to guide crisis response and referral.
Dusti Linnell, associate professor of practice in OSU Extension’s Family and Community Health program, leads the statewide training implementation. As of December 2022, 32 trainings had been held across Oregon, reaching 409 participants. Among them, 105 Extension employees — nearly one-quarter of the statewide workforce — completed the course, strengthening their ability to respond to clients, community members and colleagues experiencing mental health concerns or crises.
Survey results show that participants increased their knowledge, awareness and confidence in supporting individuals facing mental health and substance use challenges. From pre- and 30-day post-training evaluations:
- 81.5% reported increased awareness of emotional symptoms such as depression, irritability or excessive anxiety
- 77.8% reported increased confidence in recognizing signs of a mental health concern or crisis
- 77.8% reported increased confidence in offering basic support to someone in distress
- 73.1% felt more confident helping someone connect with available resources
- 74.1% reported greater awareness of physical symptoms, such as changes in appearance or behavior
- 85.2% noted increased awareness of concerning thoughts, such as self-blame or suicidal ideation
Training participants also reported a decrease in stigma. Forty percent said they were more willing to accept someone who had received mental health treatment as a close friend, and 24% said they were less likely to think negatively of someone because they had received care.
Satisfaction with the program was high. In 30-day follow-up surveys, 84.6% of participants reported being satisfied with the training, 80.8% found it useful in their daily lives, and 76.9% found it useful in their workplace.
Beyond training, the Coast to Forest team has expanded its reach through community programming and new tools. With leadership from Linnell and contributions from OSU graduate student Rachel Culp, the team is finalizing a Mental Health Emergency Response Tool designed to guide Extension personnel in supporting communities during crises. The project also organized Prevention Week activities in multiple counties, created and distributed county-specific mental health and substance use resource guides, and launched a statewide web library of mental health resources.
In partnership with rural radio stations in Eastern Oregon, the project developed nine public service announcements addressing suicide prevention, opioid use, and local support services. These aired more than 150 times and featured voices of trusted community figures, including a pastor, law enforcement officers and health professionals.
Together, these efforts have helped OSU Extension strengthen community-level response to mental health and substance use challenges — equipping professionals and partners across the state to offer informed, compassionate support when it matters most.