Mental health care going through seismic shift in our state

If you get cancer, you are likely to be sent to a state-of-the art hospital. But if you have a mental health crisis in Washington state, you could end up in a deteriorating hospital built in the late 1800s.

Now a seismic shift is taking place in how mental health is being handled. The Washington State Legislature is setting aside roughly $280 million for mental health programs for the next two years, and a growing group of stakeholders are helping to set the priorities.

The Washington State Mental Health Summit held at the Husky Union Building October 29 gathered nearly 600 participants, including law enforcement officers, healthcare providers, legislators, academics, social workers, parents and others.

“It is much more powerful to leverage an entire community toward a goal, rather than entrusting a select few to bring widespread change,” said Todd Crooks. He co-founded Chad’s Legacy Project in memory of his son. Diagnosed with a schizophrenic illness, Chad died by suicide at age 21. Todd and Laura Crooks are the driving force for the summit, which started two years ago with 100 invited participants.

Here’s a look into where the momentum is moving:

Mental health and the law: One in two Americans with a serious mental health illness will be arrested in their lifetime, said Jennifer Piel, associate professor of psychiatry and behavioral sciences at the University of Washington School of Medicine.

• Piel, who holds a law degree, is heading a new center at UW in mental health, policy, and the law. The center is seeking partners and hopes to help the state make data-driven decisions at the intersection of mental health and the law.
• The Redmond Police Department is among the first law enforcement agencies in Washington state to include a mental health officer on calls. The position is grant funded, but there is now a push to include funding for such officers across the state.
• There is also a big push to get people mental health help instead of putting them in jail or emergency rooms. The Seattle Police Department is beta testing a system that provides immediate information and linkage to the appropriate, available resource. The hope is to scale the program across King County and eventually statewide.

Perinatal mental health: Jürgen Unützer,  professor and chair of psychiatry and behavioral sciences at the UW School of Medicine, said that if he had a dollar for mental health he would spend it on pregnant moms because babies born to distressed mothers are at five times greater risk for mental health issues. More than 400 providers have been trained in preventing, identifying, screen and treating mental health conditions among new moms. Several counties now have representatives to reach out to certain populations, including teens and parents in recovery.

• Any healthcare provider in the state caring for a pregnant or new mom can receive consultation, recommendations and referrals to community resources from a UW psychiatrist through PAL for Moms.
• Providers across the state who are caring for new or pregnant moms can present a case of to a panel of experts through a program called the Moms’ Access Project  ECHO. Experts include UW Medicine perinatal psychiatrists, obstetrician gynecologists, maternal fetal medicine experts, advanced registered nurse practitioners, therapists and social workers.

Youth mental health: Nearly 100 Washington youth die by suicide every year. In that age group, rates of depression and suicidal behaviors have increased 35 percent in the past decade, said presenters.

• The state passed legislation to establish school mental health navigators and initiated a pilot project to bring mental health consultation to schools. Also, many grants have been funded to provide screening and training.
• Many of young people’s behavioral health issues are significantly influenced by external factors, such as housing, neighborhood environment and economic stability. Four sites have been chosen in Kitsap County, Snohomish County, Okanogan County, and King County to pilot a highly effective approach for engaging families in family conflict prevention and intervention services and increasing the availability of support resources.
• The Partnership Access Line  (PAL) supports primary-care providers caring for children and adolescents. UW Medicine and Seattle Children’s psychiatrists staff the line.

Mental health workforce expansion: In 2018, Mental Health America reported that 56 percent of adults in the state with a mental health diagnosis did not receive treatment of any kind. Of the adults who were actively seeking treatment, 24 percent reported being unable to obtain it.

• Major efforts are under way to integrate behavioral health into primary care, improve access to peer supports and develop a baccalaureate-level behavioral health specialist degree.
• A new Psychiatry Consultation Line staffed by UW Medicine psychiatrists helps prescribing providers caring for adult patients over age 18.

Related news: KOMO TV coverage of the summit.

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