The following is presented as part of The Columbian’s Opinion content, which offers a point of view in order to provoke thought and debate of civic issues. Opinions represent the viewpoint of the author. Unsigned editorials represent the consensus opinion of The Columbian’s editorial board, which operates independently of the news department.
A new state-funded inpatient mental health facility — a first for our region — is proposed for a site near the Bagley Downs neighborhood south of Highway 500 and north of Fourth Plain Boulevard. The Department of Social and Health Services is seeking public input through Aug. 28.
In light of the universally acknowledged need, we citizens should urge quick approval of both the concept and the site.
We might well ask what took the state so long. The 800-bed Victorian-era Western State Hospital in Lakewood has a well-publicized record of conditions unsafe for staff and patients. Washington ranks 47th among states for capacity to provide mental health services and requires hundreds more beds, according to DSHS. Progress until recently has moved at a glacial pace.
Finally, beginning in 2016, and urged to action by penalties under the Trueblood court settlement, the Inslee administration initiated a new direction for the 2019-21 behavioral health budget to build behavioral facilities within communities, and to support them with mobile crisis teams.
Washington has not been alone among states in failing the mentally ill and their families. Correcting decades of inaction is a nationwide challenge with deep roots. President Kennedy, whose sister suffered in an inhumane mental institution, favored patient de-institutionalization. Envisioning a better path, he signed a bill just a month before his death in 1963 to build mental health centers in communities. Without his leadership, they were never built.
A second idealistic vision — that new anti-psychotic medications would replace hospitalizations — also disappointed. Meanwhile, public sentiment turned against old-style mental hospitals portrayed in the influential 1975 movie “One Flew Over the Cuckoo’s Nest.” In the absence of alternatives, jails and street corners became the nation’s hospitals.
In the 1980s, President Reagan, a believer in federalism to spur innovation, shifted mental health funding to block grants to each state, where it remains.
So it is up to Washingtonians to solve this problem.
The private sector is not suited to spearheading this task. PeaceHealth’s 11-bed inpatient behavioral unit closed in November 2018 for repairs and may not reopen, and Telecare’s for-profit 11-bed facility for evaluation and treatment closed in August 2019. Without a steady stream of qualified paying patients, and a profitable fee structure, neither was sustainable.
DSHS is now on the right track. The Vancouver facility, if approved, will offer 90- to 180-day stays to patients judged to pose a threat to themselves or others. Many of our community’s most challenging behavioral cases fall into this category at some point.
On April 28, at Fourth Plain Boulevard and Stapleton, William Abbe was a threat to himself and others and was shot to death by police officers. In his final hours, Abbe had four encounters with the police for minor infractions, clearly behavioral. Tragically, the Adult Mobile Crisis Unit was not summoned, and police officers arriving on the scene were presented with an impossible problem.
The Abbe case begs for earlier intervention by trained professionals with access to a treatment facility. An individually designed, in-patient stay followed by outpatient treatment that is supported by professionals, family, and friends has a likely better outcome.
Progress, albeit slow, is finally coming to the mental health crisis. Another hopeful indicator is the expected opening in August of Vancouver’s Lifeline Connections’ Crisis Triage & Stabilization facility. Initially it will offer several dozen “23-hour chairs” for short-term needs, with more services to follow.
Submit comments on the proposed DSHS Vancouver facility at tinyurl.com/y75nf2dv. This is a good start.
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