Ballots are out right now for King County’s proposed $1.25 billion levy to fund five “crisis care centers.” The ostensible reason for these centers is to provide walk-in facilities for people in mental health crisis to seek voluntary care. Given the statewide push in recent years to address mental health, especially as an alternative to incarceration in jails and prisons, the County and other supporters are promoting these centers widely.
But looking a little deeper uncovers systemic issues with the county’s proposal and a refusal to address root causes of harm towards patients in crisis.
For one, while admission at the centers is being framed as entirely voluntary, cops will be able to bring in people involuntarily and subject them to a number of forced “treatments.” And patients who come in voluntarily may not know that they can still be detained against their will.
Secondly, while the crisis centers are the focus of the levy, part of the revenue will also go towards assisting behavioral health care workers and to restoring the number of King County’s residential psychiatric treatment beds back to 355, the number of beds they had in 2018. The crisis centers themselves can act as transitional facilities to longer-term involuntary commitment.
Thirdly, while the funding for these centers is public, they will be operated by outside providers, including potentially by private companies like Recovery Innovations, Inc. (RI) and Connections Health Solutions (CHS). RI operates the “Evaluation and Treatment Center” for involuntary commitments in Fife, and it is set to run Lynnwood’s future crisis care center, where RI expects the police to be a “high utilizer” of the facility. CHS runs a “Crisis Response Center” in Tucson, Arizona, where, in 2020, the police brought in 42% of the patients.
Advocates for crisis centers and residential treatment frame these facilities as a more just and effective alternative to incarceration, including as a diversion from jails and prisons. But the truth is that psychiatric institutions are profoundly carceral.
Involuntary “treatments” can include forced medication, physical restraints, and detention in prison-like conditions, including solitary confinement. Counterintuitively, these coercive “treatments” result in longer hospital stays. Abuse of psychiatric patients and adverse outcomes are endemic, including sexual and physical violence from facility staff. And, just like in prisons, patients of color are much more likely to be institutionalized involuntarily than white patients, with Black patients facing the greatest disparities.
Psychiatric commitment also works hand-in-hand with the prison-industrial complex. And, of course, institutionalization itself is a form of incarceration, removing patient autonomy and isolating them from their communities and support systems. The system of residential treatment beds under Washington’s Involuntary Treatment Act is already broken—many treatment facilities are in severe disrepair, creating dangerous conditions for both patients and behavioral health workers.
None of these processes are centered around providing real care and healing for the patients involved; rather, they are concerned with behavior modification and patient compliance.
Understanding psychiatric “care” in the United States to be carceral is key to disability justice. Even our understanding of “mental illness” is rooted in colonialism, capitalism, systemic racism, ableism, and sanism. The health care industry frames mental illness as a matter of an individual’s biology rather than as a response to trauma, whether personal or systemic. The answers to helping folks in crisis are to both eliminate the causes of such crises—poverty, racism, homelessness, and other forms of scarcity—and to provide true care in community.
Proponents of the levy may say that, while seeking a liberatory future, solutions like these crisis centers are needed in the interim because psychiatric facilities are a better alternative to prison. But the idea that we need to choose between locking people in jail and coercing them into treatment represents a false dichotomy. Individualizing the issue into whether a new facility would provide preferable care to prisons and jails—institutions that aren’t even intended for treatment—places our standards in the gutter. And it ignores the fact that increasing the number of institutions we have that are based on coercive treatment exposes greater numbers of people to harm, while entrenching the dangerous falsehood that care and coercion are compatible.
Abolitionists frame proposals like King County’s as “reformist”—steps to “improve” our carceral systems that actually entrench us even further into those systems by funding and expanding their reach and mandate. If we know that a proposal for our future has harmful consequences, then our priority should be to prevent those harms.
Our argument in opposition to the levy does not deny the incredibly heavy toll that mental health crises have on individuals and their loved ones. Our opposition comes because we are also those people. And we know that the options being presented to us are dehumanizing at best, and we would rather work towards solutions addressing the root issues rather than continuing to funnel money towards quick fixes that further compound harm. We, as community members, cannot abdicate ourselves from our responsibility to each other.
Tax dollars should instead go to expanding available care that is truly voluntary and creating resources that allow our loved ones (and ourselves) to have support in healing, as well as funding programs that meet people’s basic needs and prevent them from going into crisis in the first place.
We’ve gone far down a rabbit hole of locking people away as a catch-all solution to our social issues. When we have an opportunity to at least avoid digging ourselves deeper, let’s take it. And we know that other models of care and healing exist, so we must work towards creating these spaces without relying on force, coercion, or state violence.
We don’t need more incarceration in King County, regardless of the name it goes by. Vote no on King County’s crisis care center levy, and help us work towards a future without incarceration.
p hardy is a lifelong learner and aspiring abolitionist organizer who deeply believes in a transformative community where people are able to thrive, participate according to their ability, and have their needs fully met. This op-ed was written on behalf of No New Washington Prisons (NNWP) in deep collaboration with many NNWP co-organizers. NNWP is a collective committed to prison and psychiatric abolition, collective power, community accountability, racial justice, and feminism.