County heightens focus on mental illness treatment

EVERETT — In a county where the largest mental health facility is the local jail there is little doubt that the systems serving people living with mental illness need improvements.

Last year newly appointed Snohomish County Executive John Lovick called for volunteers to identify ways the county can better help those affected by mental illnesses, such as schizophrenia, bipolar disorder and depression.

Lovick said the catalyst to create the work group came from numerous conversations with constituents. People often raised concerns about issues around mental illness and the county’s response. Mental illness affects the entire community, Lovick said.

“We wanted to look at ways we could improve services to that precious community,” he said. “We want those living with mental illness and their families to know that they’re not alone.”

Licensed practitioners, including psychiatrists and therapists, were recruited from the private and public sectors. Thirteen people met three times to discuss gaps and potential improvements. The panel recently provided their recommendations to Lovick. The report is available on the county’s website.

None of the suggested improvements came as a surprise, said Ken Stark, the county’s human services director. He oversees the county’s programs for mental health, substance abuse and homelessness.

“The needs, gaps and wants recommended coincide with what the research has been telling us,” Stark said. “We are working on every one and we’ll continue working on every one. None of it will be easy. It will all take time.”

The panel broke off into four different work groups: marketing and communication; health insurance coordination; mental health court; and mental health system capacity and coordination.

Chuck Wright, a private therapist from Mill Creek, was part of the work group. Improved mental health services aren’t a panacea, he said.

“We need to be realistic about what we can and cannot do,” he said.

A person’s basic needs, such as food and shelter, must be met, Wright said. However, a conversation between public and private providers resulted in some mutual concerns that need addressing, he said.

The recommendations ranged from improving existing county systems, such as expanding the 211 call center, to tackling more complex issues such as advocating for private insurance companies to provide universal coverage for some treatments, such as family and group therapy. The panel also recommended improvements to the county’s mental health court, and exploring a possible expansion to include felony cases.

Some of the improvements will be more difficult to achieve, Stark said.

There is a maze of funding sources, policies and laws that may dictate how fast, or how slow, some of the proposals can be implemented, he said.

While some of the panel’s improvements won’t happen overnight, Lovick is convinced the county can make some changes fairly quickly. He pointed to the panel’s suggestion about expanding the hours of the phone system that can connect people with mental health services.

The work group recommended that the North Sound 211 phone line operate around the clock to give people an access point day or night. The hours of operation Monday through Friday were expanded in January. The panel recommended that the phone service operate 24 hours a day, seven days a week. They also suggested additional training for call takers in such areas as crisis intervention. The phone number also should be more widely advertised, the panel concluded.

Stark said other current long term county proposals would address some of the panel’s recommendations.

For example, the work group concluded that there needs to be “step down” alternatives to jail, hospitalization or emergency rooms. Patients may be better served in a triage center or short-term transitional housing. Unfortunately, a lack of resources often means that people wind up in jail or in emergency rooms, putting pressure on those systems and often costing significantly more to taxpayers, Stark said.

Sheriff Ty Trenary has been vocal about the challenges the jail is facing because a lack of community resources for people living with mental illness.

He has said the community can’t afford to use the county lockup as a de facto hospital for people living with mental illness who are facing minor, nonviolent offenses.

Some mentally ill people are released from jail with no place to go, no money and limited medication, Stark said.

The county is considering revamping the Carnegie building next to the jail to provide 20 beds of transitional housing, along with space for mental health and chemical dependency services, employment training and other social services.

The idea is help prevent people from “floating around from one system to the other,” Stark said. “It’s also the right thing to do.”

Lovick said he is determined that the county move forward with the recommendations and not simply shelf the report.

“We’ll take the first step and then the next step,” he said.

Diana Hefley: 425-339-3463; hefley@heraldnet.com.