Even before the pandemic, the system for responding to mental illness and substance use disorders in Washington was strained.
“It doesn’t have sufficient resources and it can sometimes be difficult for people to get constant, timely help,” Rep. Nicole Macri, a Democrat who represents parts of Seattle in the Washington state legislature, told a forum on Thursday.
The system has struggled to respond to the surge in behavioral health needs over the past two years, which affects income levels, age and race, she said. First time people seek help find it difficult to find services. Patients leaving healthcare facilities, especially young people, cannot find safe and secure housing to continue their recovery.
On Thursday, at a virtual event hosted by The Seattle Times Mental Health Project and the Seattle King County League of Women Voters, policymakers, advocates, and people with a history of mental illness and substance use disorders discussed historical and systemic issues. that prevent people from accessing appropriate and adequate care. The panellists also discussed possible solutions to these problems and what needs to be done to make them sustainable and effective.
Here are some takeaways from the conversation. (Check out the event replay above.)
People seeking care need greater access to culturally competent resources, and health care providers and government officials need to understand the critical role that race plays in treatment.
“One of the most important steps on my own journey was the ability to access Native American resources through Native American-led organizations,” said Sharaya Lane, acting program manager for the non-profit Philanthropy Northwest.
Lane, a member of the Lummi Nation who is also black, said her own experiences of receiving mental health care in a safe and familiar environment, such as the Chief Seattle Club, a nonprofit, indigenous-led housing and social services organization, helped her feel better. comfortable and connected. She noted cases of police killing people, especially people of color, when police were called in for help in a mental health crisis, including Charlene Lyles, who was killed in Seattle.
“It could literally mean life or death for some people if racial justice lenses are integrated into these programs and how they unfold in crisis situations for communities of color,” she said.
Challenges in recruiting, training and retaining a diverse mental health workforce prevent people from accessing health care.
The number of people licensed to provide mental health services is limited, and recruiting and retaining people in the field was often difficult due to the extremely high burden on clients, low pay from insurance companies and high cost of training programs.
Jim Vollendroff, senior policy and advocacy adviser for the University of Washington’s Department of Psychiatry and Behavioral Sciences, said he often hears about students who “start working in the public behavioral health system, burn out quickly and change jobs.”
In an effort to increase the availability of behavioral and mental health care, states and universities are exploring the possibility of supporting internships and peer-based programs that use people who are self-guided in the system to help others, Vollendroff said.
Mental and behavioral health was chronically underfunded.
One of the major challenges for the publicly funded behavioral health system is that it is chronically underfunded not only in Washington state but nationwide, said Isabelle Jones, King County’s deputy director of mental health.
Community mental health organizations are almost entirely dependent on Medicaid funding, which is the payer of last resort and almost always the lowest tier of funding, she said.
“Behavioral health is generally underestimated in our country and we are not investing in it because we have other parts of our health care system,” she said. “Until we can actually invest heavily in mental health, we will have to overcome gaps.”
Patients with severe mental illness require extensive support beyond medical services.
The crisis response system needs to be more purposefully integrated with organizations that provide social support and appropriate cultural ties. Recovery means access to housing, social connections and more, but providing and connecting these services remains a challenge for the state.
Macri maintains a “housing first” philosophy that providing the homeless with stable housing can help reduce the severity of other related problems.
“Take someone to a stable place,” she said. “When you do this and surround people with services, care and community, many of the problems people face when they are homeless – health problems, acute behavioral health symptoms – really start to disappear. A sense of the well-being and community of people, as well as the ability to strive to do what they want to do in their life, is really starting to take shape. “