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Opinion Northwest

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

Topic: mental health

You are viewing the most recent posts on this topic.

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:


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.


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.


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.


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…


Comments | Topics: barack obama, children, congress

June 11, 2013 at 6:16 AM

Will state budget make mental health ‘boarding’ crisis worse?

Corrected version

The state Legislature’s embrace of Medicaid expansion has the potential to revolutionize mental health care in Washington State.

But the transition into Medicaid expansion will be rocky. Exhibit A & B are the House and Senate budgets now pending in Olympia. Each assumes Medicaid expansion will reduce the need for so-called “state only” mental health funding. For King County, the House Democrats’ budget reduces state-only funding by about $5 million in the 2013-15 biennium; the Senate assumes closer to $8 million.

State-only money covers services that Medicaid will not, including short-term psychiatric hospitalizations in facilities with more than 16 beds. That’s a particular problem in King County, because it depends heavily on Navos in West Seattle and Fairfax Hospital, which are too big to get Medicaid reimbursement.

And access to inpatient psychiatric care is already disastrous in King County. As I’ve written, and the Times has editorialized about, each night dozens of patients are “boarded” in emergency rooms because there’s no place else for them to go. The numbers are staggering – 2,160 patients in King County alone were boarded – in conditions a Pierce County Superior Court judge recently ruled were unconstitutional.


Comments | Topics: Medicaid expansion, mental health

May 29, 2013 at 6:30 AM

CDC: One in 5 American kids has mental disorder

(Donna Grethen/Tribune Media Services)

(Donna Grethen/Tribune Media Services)

One in five U.S.  kids  currently has a mental disorder.  That is a lot of kids and the number has been rising for more than a  decade, according to a Centers for Disease Control and Prevention report,  “Mental Health Surveillance Among Children.”

Even scarier, only 21 percent of these children are getting treatment because of a shortage of pediatric sub-specialists and child and adolescent psychiatrists, reports The Washington Post. The Post article points to troubled children living in rural and urban areas as the most likely to be under served because of the shortage and because few new doctors are specializing in pediatric mental health.

It should go without saying that 20 percent of people ages 3-17 undoubtedly places some of them here, making this a local issue that would benefit from attention by local schools, county and state governments.

The CDC relied on federal studies, medical insurance claims, public health reports, telephone surveys and other research from 2005 to 2011 for its first comprehensive look at the mental health status of children.  One CDC-cited study found that from 1997 to 2010, mood disorders were among the main causes of hospital stays among children. The analysis of insurance claims found a 24 percent increase in children hospitalized for  mental health and/or substance abuse between 2007 to 2010. Psychotropic drug use by teens increased over the same period.

This is a major public health issue and its prevalence, early onset, and impact on the child, family, and community is costly. The CDC estimates annual costs of $247 billion spent on health care, on services such as special education and juvenile justice, and for decreased productivity. Families without medical insurance often turn to public schools and community health organizations for help, underscoring the challenges faced by those institutions. Broadening access to mental health services is a clear need but the Washington Post story points out the difficulty of doing that with so few doctors and mental health professionals available. resources.


Comments | Topics: ADHD, Autism, centers for disease control and prevention