Gov. Inslee unveils $675 million plan for state mental health care

Hundreds of additional treatment beds for those with mental health issues, investments in existing and new state hospitals, and a new teaching hospital: All that is part of Gov. Jay Inslee’s $675 million dollar proposal for the state’s mental health care system.

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The state has invested $900 million dollars in recent years to help improve Washington’s mental health care system — but it’s not enough.

Lawmakers on both sides of the aisle have made it clear the state’s mental health care system is a top priority this legislative session, with some calling it this session’s “McCleary,” referencing the massive undertaking of court-ordered state education reform more or less resolved in the previous session.

Gov. Inslee is saying the new investments he’s proposing will help transform Washington’s mental health care system, moving the state away from a crisis approach to a more prevention-centric focus.

“We know that mental health needs touch every family ultimately in the state of Washington, and we know that great things can happen for these families and these people when they get the care they need in circumstances that meet their needs, and when they get it in a timely fashion,” Inslee explained.

But getting care in a timely fashion has been a major issue at state hospitals, especially Western State. In 2014, the state Supreme Court found Washington was unconstitutionally leaving patients in places like emergency rooms where they did not get proper treatment, namely because of the shortage of bed space.

In a separate class action lawsuit recently settled by the state, known as the Trueblood case, the state agreed to make major changes to deal with inmates with mental health issues left lingering in jails as they wait for competency services.

Western State Hospital has been also been plagued with staff shortages, safety issues and long waits for incoming and outgoing patients.

“We have people who are ready to discharge from Western and Eastern State Hospital who are ready to get back to their communities. They had a good result [and] they’re getting a lot better, but there’s no place for them to go to have any sort of supported housing, so we have this huge blockage in the system,” Inslee said.

“As a result, we can’t get people into our state hospitals, and we have people languishing in our county and city jails who can’t get into our state hospitals. We need to unplug this system,” he added.

The governor says his proposal will address all of that. Among other things, it invests about $56 million dollars for improvements at Western and Eastern State hospitals, to help reduce the risk of patients harming themselves or others, which has been a major issue at Western State with an increase of attacks against staff members.

The proposal begins investing in the design for a new 500-bed state hospital, with construction starting in 2023.

Inslee’s plan would also begin spending on his previously-announced five-year vision to move civil commitment patients out of state hospitals.

“We want to provide the mental health care system closer to where people live, in their communities, places that are closer to their places of work, to their friends, to their family, to their churches, rather than just large institutions. And we plan to do that by opening a number of [mostly] state-operated facilities,” Inslee said.

This proposal veers away from his original vision which was for multiple 16-bed state-run facilities spread out across Washington for civil patients.

Under this plan, there would be nine facilities, four with 16 beds, two with 48, and three with 150 beds. Locations would be decided later, and Inslee acknowledged there would need to be community discussions ahead of time, but hoped locals would be willing to have such facilities in their backyards.

 That’s where Inslee’s plan hits a snag, with GOP state lawmakers like Senator Steve O’Ban, who strongly support smaller community-based facilities, but does not want them operated by the state.

“I’m very concerned about making these all state-run, because I don’t think that will make it for us a system where we can be innovative (and) develop some really good best practices in this area,” O’Ban explained.

“I’m going to probably be pushing back pretty hard on that,” he added.

One of the major problems has been a shortage of psychiatrists and other trained staff. Inslee’s proposal calls for a variety of investments to tackle that.

“I’m excited about the new creative ideas that we’ve come up with to provide scholarships with people to get them to come into the mental health care system earlier. We’re going to get talent and we’re going to keep them, and when they come out we’re going to make sure they work for the state of Washington,” Inslee said.

The governor’s proposal includes design money for a new teaching hospital for mental health care professions in partnership with the University of Washington, a facility that would eventually also include needed beds.

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It also includes $4 million dollars to hire more mental workers right now.

The legislature will have to approve all of the proposals in their own budget, for a process that begins next month.  We will learn more about how Inslee plans to pay for the $675 million mental health proposals as well as his clean energy package when he unveils his full budget proposal Thursday.

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