Investing in quality mental health staff, housing and community-based intervention is the key to building the 21st century mental health system that best serves patients and their families.
By Rep. Laurie Jinkins
Mental illness touches my family and nearly every family in our state in some way. Every legislator, from every region of our state, has met families that our mental health system has failed completely.
Three years ago, when I became chair of the House Judiciary Committee, it was already clear to me our state’s mental healthcare “system” – and I use that term loosely – was broken. We were 47th in the nation in access to mental healthcare. Patients were being strapped to gurneys in hospital emergency rooms due to lack of sufficient beds in our state mental hospitals. In fact, our state was sued over this very practice and lost, making it unlawful to “board” patients in this way.
The Judiciary Committee is the legislative committee that deals with civil commitment and criminal mental health issues. Combined with my previous experience on the House Health Care Committee, I was in a unique position to help bring legislators from both sides of the aisle together to help turn this broken system around.
As I talked more with legislators working on mental health issues, both Democrats and Republicans, it became clear we all agreed on six fundamental things:
First, we have an obligation to improve mental healthcare in our state. The status quo is not acceptable.
Second, mental illness must be treated like physical illness. Just as diseases of the body should be treated before they become critical and life-threatening, so should diseases of the mind. This means catch the illness early, give appropriate treatment and support people in becoming healthier.
Third, our state mental health hospitals were not serving patients in the way they should.
Fourth, our mental health workforce was underpaid and frequently working in dangerous circumstances. This was preventing us from recruiting great mental health care providers, as well as keeping the good ones we have.
Fifth, our failure to adequately fund outpatient mental healthcare treatment in local communities forced people unnecessarily into our state hospitals and often people suffering from severe mental illness ended up in our jails – the worst possible place to get better.
And sixth, it shouldn’t take a court order to improve our state’s mental health system. We want to have a system that keeps people safe and supports recovery.
Once we realized that we agreed on these critical, fundamental points, we were able to move forward with solutions in a bi-partisan, bi-cameral way. (That means enough members of both parties and both houses of the legislature agreed to solutions, and legislation passed.)
In the 2015 and 2016 legislative sessions, we put more funding into mental healthcare for new patient beds, increased staffing at hospitals and reduced wait times for psychiatric evaluations. Additionally, a new CEO was hired at Western State Hospital. We also passed a law creating a joint select committee of representatives from the executive and legislative branches to oversee our state mental health hospitals and finally start fixing some of the problems.
The committee agreed on a set of preliminary recommendations for improving our state’s mental health system, sending the details to Governor Inslee in a letter last January. Those preliminary recommendations included prioritizing capacity at our state hospitals for forensic commitments – those patients whose mental illness makes them unable to stand trial or who have been found not guilty by reason of insanity. Meanwhile, patients who need involuntary commitment but haven’t committed a crime – known as civil commitments – should be moved out of these hospitals and to inpatient care in their own communities, where they have the local supports to help them experience a stronger recovery.
This year, we built on the approaches from the past two years, continuing to recognize that investing in quality mental health staff, housing and community-based intervention is the key to building the 21st century mental health system that best serves patients and their families. That’s why I’m extremely pleased our new state budget invests more than $177 million in improving Washington’s mental health system, including $60 million for increasing staffing levels and quality of care at our state hospitals, as well as funding to expand community-based capacity.
These successes haven’t gotten as much attention as education funding or the current ongoing battle over water rights and the state capital budget. But together, Democrats and Republicans are making significant headway in addressing the fundamental things we agree must be changed or improved in our mental health system. We’re moving in the right direction but have a lot more work ahead to build a mental healthcare system that meets the needs of families and communities across our state.
Laurie Jinkins is a public health official from Tacoma who serves as a member of the Washington House of Representatives from the 27th district.