A task force of experts convened by Gov. Jay Inslee and King County Executive Dow Constantine has recommended actions that will create a continuum of care to increase the availability of mental health treatment in the community, decreasing the number of people who need to be hospitalized at a state facility.
Inslee and Constantine created the Community Alternatives to Boarding Task Force in August 2014 to address the statewide shortage of involuntary psychiatric treatment beds. The shortage increased the number of people detained for inpatient care in temporary placements – such as hospital emergency rooms – without adequate psychiatric care while they waited for a treatment bed to open. This practice is commonly referred to as psychiatric boarding. A Washington State Supreme Court ruled against that practice effective December 2014.
Inslee and Constantine discussed the task force findings today during a tour of the West Seattle campus of Navos Mental Health Solutions, which includes housing that helps people transition out of hospitalization and back to the community.
“We face a continued challenge throughout the entire continuum of care and the result has put an untenable amount of pressure on our state mental hospitals. It is clear that we must do more to reduce the number of people being sent to state hospitals who could be better served in the community,” Inslee said. “This task force has done important work to look at how King County and Washington state can partner together effectively to best serve patients in appropriate settings. While many improvements have been made in short order, we must also keep focused the long view and build a stronger, comprehensive mental health system. Both the state and counties play essential roles in ensuring people have access to mental health services.”
“The experts we brought together delivered exactly what we asked for: A comprehensive strategy to transform the mental-health system,” said Executive Constantine. “Now it’s time for us to turn these recommendations into action so the right treatment is available at the right time for those who need help.”
Steps already taken to increase access to mental-health care in the community include:
- Increased treatment bed capacity at several hospital locations, including Harborview Medical Center and Navos Mental Health Solutions in West Seattle
- Opened new evaluation and treatment facilities at MultiCare Health System in Auburn and Swedish Hospital in the Ballard neighborhood of Seattle
- With both new and expanded capacity, 47 additional beds are available now and 62 more beds will open in King County later this year or early 2017
- Dramatically increased the rate at which involuntary patients were placed into appropriate facilities for treatment
- Established structured guidelines for patient placement to match them to appropriate treatment settings
- Partnered with more community hospitals to care for involuntarily detained patients even under new, stricter guidelines from the state
A long-term strategy focused on prevention, early intervention and effective reentry
The task force developed more than a dozen recommendations that focus on prevention and early intervention, crisis diversion, increasing the number of community-based discharge options, and increasing capacity at all levels of care.
By intervening before a mental-condition escalates into a crisis, the state and county can reduce the number of people who need to receive treatment at Western State Hospital. And by increasing access to community-based reentry programs, patients can be discharged more quickly and free up limited bed space at state hospitals.
“There are so many innovative approaches to behavioral health in these recommendations,” said Chris Imhoff, a task force member and Division of Behavioral Health and Recovery Director for the state Department of Social and Health Services. “Our hope is that the work in King County will spread to the entire state.”
The task force members – which include representatives from hospitals, service providers, courts and public defense – will continue to work together to help the state and county implement their recommendations. The shared goal is to build the continuum of care so that appropriate treatment is accessible regardless of a person’s location.
“The collaboration happening on this task force is exactly what we need to improve care for people in crisis in King County and the rest of the state,” said Darcy Jaffe, Chief Nursing Officer at Harborview Medical Center and a task force member. “Our progress so far has been exciting, and we’re just getting started.”
“We are transforming our delivery of behavioral health in King County by creating more local options, said Jim Vollendroff, Division Director of the King County Behavioral Health and Recovery Division. “These local options will span the continuum of care from prevention and diversion to increased inpatient options for both mental health and substance use disorder services.”
The task force will continue to meet to problem solve issues related to treatment access and to move forward the recommendations from their report.