Washington lags most states in mental health care

The OlympianMay 23, 2014 

The tragic consequences of this state’s inadequate mental health treatment facilities played out again last week, this time in the United General Hospital in Sedro-Woolley.

The hospital kept a 13-year-old boy, who was having a serious mental health crisis, in an emergency room bed for two weeks. After an involuntary treatment hearing, the court ordered the hospital to release the boy without treatment.

It’s a scenario too often played out in Thurston County and across the state. Almost every day, mentally ill people are boarded in hospital emergency rooms because the state has an acute shortage of psychiatric beds.

By state law, hospitals must provide an evaluation for involuntary commitment within 12 hours. But it frequently doesn’t occur, and patients are either detained in ER beds awaiting treatment, like the Skagit Valley boy, or released to the streets without any treatment.

Neither option is acceptable.

The problem requires the Legislature to fund the construction of more 16-bed Evaluation and Treatment facilities, and also the ongoing cost of providing care. State lawmakers have been moving too slowly on this issue.

The outcome of a case to be heard by the state Supreme Court in June could hurry the Legislature along.

The high court has expedited an appeal of a lower court decision in Pierce County that said detaining people in ER beds without providing treatment violated their civil rights. Ten individuals joined the action against the state and Pierce County.

The state and Pierce County are expected to argue in part that the remedy is legislative and state lawmakers are making progress.

However the state Supreme Court decides this case, the burden is on the Legislature to substantially increase mental health funding, especially the construction and operating of additional Evaluation and Treatment facility beds.

The ultimate responsibility rests with the federal government. Forty years ago it deinstitutionalized mental health care, closed too many psychiatric hospitals and has never supplied communities with sufficient funding to provide treatment.

But that doesn’t excuse the state of Washington. We rank near the bottom of all states in providing access to psychiatric care. Our 10.5 beds per 100,000 ranks us 47th.

The 2014 Legislature approved funds to operate three new 16-bed Evaluation and Treatment facilities, including the addition of one to serve Thurston and Mason counties. But lawmakers didn’t pass a capital budget, so it’s unlikely all three will open until after next year’s biennium budget.

It’s a disgrace to leave people in crisis in emergency rooms around the state. It’s even worse to send them back onto the streets without treatment.

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