This morning, King County Executive Dow Constantine convened a coalition of city, county, and state elected officials to announce their intention to address what they called a "crisis" of insufficient behavioral health care in the region. At the press conference, elected officials and service providers spoke about the urgent need to join forces to fund crisis care centers, residential care facilities for people struggling with mental illness, and to invest in the workforce needed to care for those patients.
Constantine said those investments were badly needed, pointing out that more than 600 of the 1,530 people currently held in detention at King County's jail were involved in some form of behavioral health treatment. He also connected decades of insufficient funding for behavioral health to the rising homelessness crisis. According to Constantine, many of the 6,000 people the County categorizes as chronically homeless also struggle with untreated or under-treated behavioral health issues.
Constantine emphasized the plight of people who have no place to go in a crisis, but he provided few detailed policy solutions, saying he'd announce those alongside his budget proposal for next year.
The details he and other members of the coalition did provide centered on approaches that have failed us. King County Sheriff Patti Cole-Tindall acknowledged that arresting our way out of this behavioral health crisis wasn't an option. She said her office was "100% in support" of the coalition's effort and would adjust any of their operating procedures to accommodate whatever policies they propose. In the meantime, she said, her office will continue developing and implementing co-responder models to bring mental and behavioral health professionals along with deputies when responding to the increasing volume of 911 calls concerning someone in crisis.
King County Councilmember Girmay Zahilay said the coalition's new policies will not reinvent the wheel. He referenced his summer tour of Arizona's crisis response system and said he believes the County could replicate many best practices from that system. In his view, the status quo of behavioral health care in King County is "inadequate, deadly, and only getting worse."
Amid all the talk of "investments," no one could specify how much money the coalition will need to invest nor who would fork over the dough to do the investing.
Leo Flor, director of King County's Department of Community and Human Services, said that the County already pays for this treatment, but it does so in the least effective and most expensive way possible. He explained that the county waits to treat behavioral health issues until someone in crisis reaches the emergency room or gets arrested, which costs far more than addressing peoples' needs before an emergency strikes.
Simply using county jail funds to pay for the needed investments in behavioral health care isn't a viable strategy, according to Constantine, because it will take time to see results from investments. That means the County will need to find the money elsewhere.
Of course, all of the 24/7 crisis care centers in the world won't help anyone if they don't have qualified staff to care for people once they arrive. Naomi Morris, a nurse who works with patients who have behavioral health issues, said that the industry struggles to retain workers because of low wages and stressful working conditions. As a result, she said the coalition plans to develop policies that will attract more qualified workers with more competitive pay and support for the trauma they endure on the job.
State Representative Nicole Macri (D-Seattle) said that the state will have a role to play in implementing those policies. She said they could adjust the professional certifications the state issues to better match the kinds of workers who will succeed in this industry. Macri also discussed changing Medicaid billing codes for behavioral health services so that the state can extract the maximum amount of reimbursement from the federal government, which would in turn give service providers more funding to pay their workers higher wages.
Notably absent from the gaggle of elected officials crowding the podium was Seattle City Attorney Ann Davison. Although a spokesperson from her office said in an email regarding The Stranger's coverage of the City Attorney's High Utilizer Initiative that Davison supports "housing and treatment models" that help people with mental illness who repeatedly commit low-level crimes, I did not see anyone from her office at the event. This presser would have presented the perfect opportunity for her to make the case that we can attribute a large portion of the disorder on Seattle's streets to decades of insufficient funding for behavioral health care, but, alas, no one from her office seized the chance to do so. I wrote to the office for comment but did not receive an immediate reply. I'll update if I hear back.