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Join the informed writers of The Times' editorial board in lively discussions at our blog, Opinion Northwest.

Topic: mental health

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September 15, 2014 at 6:32 AM

Rare good news for state mental health system

Since the state Supreme Court’s “psychiatric boarding” ruling last month, the news has been all bad for the state. The ruling requires Gov. Jay Inslee’s administration to find at least 145 new beds, or else patients who need involuntary psychiatric care could be cut loose, without treatment, to the streets.

The view from  the King County Superior court room at Harborview Medical Center where  involuntary commitment cases are heard. (Mike Seigal / Seattle Times)

The view from the King County Superior court room at Harborview Medical Center where involuntary commitment cases are heard. (Mike Seigal / Seattle Times)

That task is so big that the Department of Social and Health Services had to get an unusual 120-day stay on the court’s ruling. And it’s so expensive that Inslee authorized $30 million in un-budgeted mental health funding, just to get through 2014.

Last week, the state finally got some good news. DSHS got word that it obtained a waiver from what’s known as the “IMD exclusion,” an arcane 1960’s-era rule that bans Medicaid from paying for psychiatric hospitalizations in facilities larger than 16 beds.

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Comments | Topics: mental health, psychiatric boarding, state Legislature

August 25, 2014 at 6:02 AM

3-minute recap: Video chat on problems, solutions for Washington’s mental health system

In case you missed last Thursday’s Google+ On Air Hangout on mental health care here in Washington state, here’s a three-minute highlight video from the nearly 45-minute long online chat. [do action="brightcove-video" videoid="3744415667001"/] Watch the full replay and read The Seattle Times editorial board’s week-long series of editorials, which shine a bright light on the successes…

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Comments | Topics: mental health, psychiatric boarding, Seattle

August 18, 2014 at 6:20 AM

Busting the stigma of mental illness

In the course of researching for the “What’s troubling mental-health care” editorial package published in Sunday’s Seattle Times, I heard again and again stories of people with mental health disorders living full, healthy lives. These stories rarely make it into the paper, as they are shoved aside by tragedies linked to mental illness. Here are two stories, shared in order…

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Comments | Topics: bipolar disorder, mental health, mental illness

August 11, 2014 at 5:45 AM

With the end of psychiatric boarding, a new mental health crisis decades in the making

The state Supreme Court’s opinion on Thursday invalidating psychiatric “boarding” has thrown Washington’s already-messy mental-health system into chaos.

An estimated 350 very ill people across the state are currently being warehoused in emergency rooms, usually without treatment, because the state hasn’t funded enough psychiatric beds. State and county mental-health managers are scrambling to suddenly find beds for them. If they don’t, the patients could be cut loose, with potentially dire consequences, particularly to themselves.

King County mental health director Jim Vollendroff told me Friday morning eight people were in limbo. “We’re scrambling for those,” he said.

What’s disturbing is that Thursday’s ruling, In The Matter of The Detention of D.W., seemed to catch the state by surprise, with no advance planning.

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Comments | Topics: dshs, mental health

June 9, 2014 at 6:25 AM

How to prevent the next SPU shooting

The picture emerging of Aaron Rey Ybarra is crushingly familiar.YbarraCourt

A young man with documented mental health problems (he was twice evaluated for involuntary psychiatric hospitalization) who’d said he “wanted to hurt himself and others“; who hadn’t seen a mental health provider for months and appeared to be taking his medications sporadically; yet was striving for stability, with a new job and sessions at Alcoholics Anonymous.

The picture still needs to be filled out, and the policies to spin out of this tragedy should include a review of state gun laws. But I read Ybarra’s story as a call for an important mental health reform, largely neglected here in Washington.

Ybarra may have been a good candidate for what’s known as Assisted Outpatient Treatment. It involves court-ordered outpatient therapy, with intensive supervision of a treatment plan that can include housing and other help. Patients have to have a serious illness, including hospitalizations, and often have a history of noncompliance with treatment.

New York has a program, known as “Kendra’s Law,” with about 2,500 people, at a cost of $32 million, according to a New York Times story, but it is estimated by Duke University researchers to save about 50 percent per-patient off state Medicaid costs because patients didn’t go to expensive hospitals nearly as often.

From the Duke study, which included New York and surrounding counties:

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Comments | Topics: assisted outpatient treatment, gun culture, legislature

March 12, 2014 at 6:20 AM

Another important mental health reform… gets delayed

Doug Reuter is most likely leaving Olympia Wednesday morning a frustrated man.

Doug and Nancy Reuter (Bettina Hansen / Seattle Times)

Nancy and Doug Reuter (Bettina Hansen / Seattle Times)

He and his wife Nancy moved to Olympia from Texas this winter to lobby the Legislature on a mental-health reform bill they believe would’ve saved their son’s life. The Joel Reuter bill, as it’s become known, passed the House 96-0, due in large part to their amazing advocacy.

It simply would allow family members to seek judicial review if a mentally ill loved one is denied emergency psychiatric hospitalization. Right now, there is no means to contest a denial by the gatekeepers of involuntary commitments. As Doug Reuter points out, supposedly progressive Washington ranks 49th in the nation for community psychiatric beds, and is an outlier on this issue too. Forty-five other states already allow judicial review, which the Reuters used to get their son help in Arizona.

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Comments | Topics: legislature, mental health

December 16, 2013 at 6:00 AM

Chaining mental health reforms to gun control is a failed strategy

The serial tragedies of gun violence perpetrated by young men provoke two responses, depending on which adjective you focus on: gun or mentally unstable.

A memorial in Newtown, Conn., one year later. / ASSOCIATED PRESS

A memorial in Newtown, Conn., one year later. / ASSOCIATED PRESS

I ranted in October that proposed public policies to address recent shooting incidents got lost in the shouting about the first adjective. Democrats, led by Senate Majority Leader Harry Reid, were culpable because they wouldn’t decouple mental health improvements from the gun issue, believing, I suspect, that is the only way the latter will pass.

Well, something happened last week that gives me hope.

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Comments | Topics: democrats, gun control, mental health

November 22, 2013 at 3:25 PM

Cold reception for Gov. Jay Inslee’s plan to bid out state mental health system

UPDATE: At right is the Department BH timelineof Social and Health Services’ timeline for opening the mental health system to competitive bidding (click on it to expand). It includes a long window for public comment and an even longer phase-in process. From what I’m hearing from providers, consumers and lawmakers since this original post, the public comment period is going to be rough.

ORIGINAL POST, Nov. 22, 3:25 p.m. – A sharp exchange Thursday between Gov. Jay Inslee’s human services director and the longest-serving state senator was a preview to an upcoming Legislative debate about Inslee’s plan to open Washington’s outpatient mental health system to competitive bidding.

Testifying before a Senate committee, Kevin Quigley, secretary of the Department of Social and Health Services, unveiled Inslee’s plan (here’s a one-pager on the plan) to respond to federal pressure to reconfigure the mental health system beginning in 2016.

DSHS Secretary Kevin Quigley

DSHS Secretary Kevin Quigley

Inslee’s proposal calls for the state, beginning as soon as next April, to open the state’s mental health and substance abuse treatment services to competitive bidding, likely drawing interest from private managed care firms. Bids would be accept by region. One potential model could include physical health care in the bidding as well.

If this sounds dry, think of it this way: Inslee is talking about one of the biggest privatizations of state services ever, with at least $750 million a year in spending and care for 135,000 severely ill people at stake.

And he wants lawmakers to do it this Legislative session.

That’s going to be a tough sell, given the reception Quigley got Thursday.

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Comments | Topics: Jay Inslee, Jim Hargrove, mental health

October 18, 2013 at 6:00 AM

Catch mental health problems early

  In the vast arena of public education, the part least understood or addressed well is mental health. Think about it. Schools remain vigilant about ensuring students perform well academically. Immunizations are legally required and periodic check-ups for hearing and vision remain even as school systems have cut back in many areas. These things are appropriate because they directly impact students in the classroom. Mental health…

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Comments | Topics: barack obama, children, congress

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