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Published: Wednesday, May 7, 2014, 12:01 a.m.

Compass Health unable to replace psychiatrist at Snohomish location

SNOHOMISH — A shortage of psychiatrists in the public health system is driving a change at a clinic here.
Compass Health, a nonprofit that provides mental health and chemical dependency services, is losing the psychiatrist at its location in Snohomish.
The clinic's psychiatrist is set to transfer to another Compass location. The nonprofit plans to replace the doctor with an advanced registered nurse practitioner in June.
“I feel like I'm having my entire program yanked out from under my feet,” said Cole Younger, a patient. “They think it's safe to have the mentally ill not see a doctor.”
Younger, of Baring, is a level-two sex offender registered in King County. He was convicted in 1996 of first-degree rape of a child. Now he's working on his sexual deviancy issues at the Snohomish clinic.
“I want to make sure I never have another victim,” said Younger, 45.
Compass Health CEO Tom Sebastian said there's a shortage nationwide of psychiatrists in the public system.
Compass is constantly recruiting specialists but was unable to find one to fill the vacancy in Snohomish, he said.
“It's one of our major challenges,” Sebastian said. “Psychiatrists are our most scarce resource.”
Because Snohomish is a small clinic, only one prescriber is needed. A nurse practitioner can prescribe medications.
A psychiatrist earns about 35 percent more than a nurse practitioner, he said. It actually costs Compass more to hire nurse practitioners because insurance reimbursements for doctors are greater.
“There are no cost savings,” Sebastian said. “That's not what's driving this.”
Sebastian believes not having a doctor at every clinic poses no safety risk to patients or the community. Psychiatrists are one part of a patient's treatment team, which includes therapists, case managers and sometimes a peer counselor. In the four counties it serves, Compass employs nine psychiatrists and 11 nurse practitioners.
Patients who are dissatisfied with the change can make a complaint or file a grievance. Sebastian said the nonprofit will work with each person to find a solution.
“We try to be as flexible as we can,” he said.
The Snohomish clinic, one of a dozen countywide, serves about 300 clients.
Compass Health has locations in Island, San Juan, Skagit and Snohomish counties. The majority of patients are low-income and eligible for Medicaid. Some are criminal offenders enrolled in a program to help them transition back into the community after being incarcerated.
Younger said he has come to trust his providers at Compass, where he believes he's made progress. Other programs he has tried have not worked well for him. He said his lack of trust stems from being sexually and physically abused as a child.
Younger is also dealing with other problems, including a history of substance abuse, post traumatic stress disorder, social anxiety and agoraphobia, a condition that causes him to be afraid of crowds and public spaces.
“I'm a hermit,” Younger said. “I get scared when I leave home.”
Younger admits to using drugs when he committed the sex crime. He said his treatment has helped him stay sober.
At Compass, he said, he has found professionals he can count on to see him though his bad spells. He fears that without a psychiatrist to oversee his medications, his progress will diminish.
“I don't want to be that person,” he said. “I've kept on the straight and narrow because I get to work on my issues with my psychiatrist. If they take that away from me I'll have nothing.”
Amy Nile: 425-339-3192; anile@heraldnet.com.
Story tags » SnohomishMental health

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