In Our View: ‘Heavy Lift’ Worth a Look

According to the National Alliance on Mental Illness, more than 43 million American adults suffer from mental illness in a given year, and about 1 in 25 adults live with serious illnesses. All of that is pertinent as we acknowledge May’s designation as Mental Health Awareness Month and ponder Washington’s persistent difficulties in dealing with the situation.

Last week, Gov. Jay Inslee offered a plan to revamp the state’s mental health services, proposing a series of community treatment centers and lessening the burden upon large facilities — Western State Hospital near Tacoma, and Eastern State Hospital in Spokane County. Inslee recommended a five-year implementation and said: “This is a heavy lift. It’s an aggressive timeline. There are up-front costs that mean difficult budget decisions, and local communities will be called upon to do their part in assisting with siting and placement of facilities.”

Clark County should be eager to pitch in. Keeping patients closer to home, family, and friends can enhance treatment and facilitate more personal care that improves patient outcomes. But while legislators should consider the proposal, they cannot ignore larger issues regarding mental health in Washington. As a press release from the governor’s office says, more than $360 million in funding has been invested in state hospitals since Inslee took office in 2013. A combined 72 beds have been added, along with more than 750 staff positions.

In other words, throwing money at the problem has not been effective. Western State Hospital is in danger of losing $53 million in federal funding because of persistent shortcomings in patient care. The state also continues to accrue $3 million in monthly fines for its failure to provide timely treatment for criminal defendants deemed incompetent to stand trial.

These issues have lingered for years, and a failure to effectively address them is frustrating for taxpayers who demand accountability from state government. Most important, they reflect a failing that harms citizens struggling with illness. Despite frequent admonishments from the courts, the state has more than 200 patients awaiting evaluations.

Mental health treatment presents difficulties for all states, with changing mores routinely altering the system. In 1963, President John Kennedy signed the Community Mental Health Act, a law that supported local care rather than large state hospitals; but the bill declined to provide long-term funding for community centers. In 1981, President Ronald Reagan signed legislation transferring responsibility for care from the federal government to the states; but the accompanying block grant program has suffered from declining funding in subsequent decades.

Given this history and an increase in the need for mental health care in Washington and elsewhere, cynicism about Inslee’s proposal is understandable. The governor must demonstrate how the new plan marks a genuine improvement in patient care and not merely a proverbial rearranging of the deck chairs.

There are, indeed, foreseeable benefits from small, local care centers. For families of mental health patients, there is no question that a facility in Clark County would be preferred. But for a mental health system that routinely has fallen short of its goals, questions remain.

“We need to stop pouring resources into an outdated model,” Inslee said. “In most states, smaller community-based facilities are the standard of care, and Washington should go that route.” First, however, state officials must demonstrate that such a plan is a worthwhile investment.