Fed up with high number of suicides in the Tri-Cities, senator fights back

A rash of teen suicides in the Tri-Cities led a state lawmaker on a mission to figure out what was wrong with mental health care for children in Washington state.

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The result is legislation that could help bring down one of the barriers to getting help for children, at the doctor’s office.

Senator Sharon Brown says she was heartbroken when she heard about the high number of suicides in her area.

“In the Tri-Cities there have been way too many suicides,” she said. “One suicide is one too many. In Benton County alone in 2015 there were — just for kids between the ages of 15 to 24 — seven suicides. And in Franklin County there were four suicides.”

In that same year, if you include adults, there were 51 suicides just in the Tri-Cities.

The American Foundation for Suicide Prevention says suicide was the second leading cause of death for people (ages 10-34) in our state in 2016. It was the eighth leading cause of death overall. A youth suicide prevention group in Seattle says two children kill themselves every week in our state.

Brown decided it was time to have a community sit-down to figure out what was going on. She met with mental health professionals, police, parents who’d lost kids to suicide, and family doctors. One of those doctors brought a small but significant barrier to light; specifically involving the nearly 900,000 children on Medicaid in our state.

That doctor had embedded a mental health care professional in his practice, so that during a wellness check or other visit if he felt there was a need for a child to receive mental health care, doctors could do it right there on the spot. The problem: Medicaid wouldn’t pay for a patient who saw two doctors at the same place during the same visit. Instead, the doctor would have to refer children to psychologists or school counselors, which really cuts down on the chance that they will ever get help.

“Let’s say that a kid is having some sort of struggle in their life. That child would have to either fess up to mom and dad and say I’m struggling, or raise their hand in class and say, hey teach I need to see a mental health professional — if there is even one available on their school grounds,” Brown explained. “Let’s say a child goes through those steps. Just trying to get that appointment with a mental health professional, if you have to do it outside of school, you could wait as much as six months to get in to see a mental health professional.”

So the aforementioned doctor who had embedded a mental health care professional in his practice had a question for Brown.

“The doctor reached out to me and said, look, is there something we can do with the health care authority so that we can work on this coding issue,” Brown said. “Because the state has mandated that we integrate behavioral and mental health by 2020. I’m in my practice, I’m trying to do it and I’m not allowed to do it because these codes are getting bounced back and I’m not getting paid.”

And that’s when Brown teamed up with Senator Steve O’Ban to come up with the Youth Behavioral Health Protection Act. The proposed bill eliminates the payment obstacles keeping children on Medicaid from seeing a mental health care professional during their primary care visit.

So what about non-Medicaid patients?

“I’d say the same thing,” Brown said. “We need to reach out to our private insurers and make sure that as we move toward integration of behavioral and mental health that doctors are getting paid. We need to make sure that those barriers are coming down.”

For now, the bill is focused on kids with Medicaid coverage. After an amendment in the House, it will include all those with Medicaid — including adults.

Brown says the state health care authority supports the plan. She says she plans to sign off on the House amendment and get this over to Gov. Jay Inslee – who she expects will sign it.

But is it enough to save lives?

“Absolutely,” she said. “I’m hoping, gosh, if I could save one life with this legislation that will have really, I think, sent a message that it’s really about reducing the barriers to care, reducing the barriers to access to mental health services.”

Brown says this is just a small step in what she hopes will become a larger conversation on what can be done at the state level to curb the high rate of teen suicide in Washington.

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