Commentary: State sets a new course for mental health care

With funding and policy, state lawmakers cooperated to rebuild a behaviorial health system that works for all.

By Norma Smith

For The Herald

Every day, we hear about the numerous deficiencies of the political process. They can be more than disheartening when creating obstacles to problem solving. However, one largely untold story is how Washington state legislators, Republicans and Democrats, have come together to strengthen the mental and behavioral health safety net for those who are suffering.

The past failures of our system have been well-documented by this paper and others, but a new course is being charted and significant new investments are being made. I hope a brief retelling of my two-and-a-half year journey in this space will be an encouragement to you.

Early in the 2017 legislative session, my colleague, Rep. Strom Peterson, D-Edmonds, and I were asked to work on the behavioral and mental health portion of the capital budget. This is the budget in which facilities are built and significant investments are made in communities, schools, parks and more.

We began a deep dive to learn from agencies, providers and other legislators about the extent of the problems that existed and what actions we could take to turn the system around. Our constituents’ experiences and our own life journeys with those affected illuminated our efforts.

While there were significant investments in the 2015-17 operating and capital budgets, management obstacles had eroded the efficacy of the efforts being made. A lack of a single directional vision, as well as a lack of coordination, were serving as daunting impediments to progress.

It became clear we had an opportunity to leverage the capital budget to help address the statewide crisis, so we set to work. Bringing together operating and capital budget writers from both sides of the aisle helped inform and refine our shared vision to build out a community safety net across the state. We dedicated funding for increased local treatment services, as well as housing and services for the chronically mentally ill. We also worked to provide investments and support to address the ongoing challenges in our state-run facilities.

Everyone who came together to tackle this challenge was steadfastly committed to learning from the past. Yes, we were dealing with dollars, bed counts and service models, but this was about so much more. We wanted to bring hope to those who felt stigmatized and isolated, to help struggling families trying desperately to save their loved ones; to see one another and to do for others as we would hope they would do for us in our time of need.

Our efforts culminated in spring of 2018 with a $180 million investment in mental and behavioral health in the 2017-19 capital budget. It represented an historic level of funding for our community and state facilities, and served as the foundation for this year’s work.

A significant setback came during the 2018 interim, when Western State Hospital lost its federal certification, and $53 million in funding. That development underscored the vital importance of accelerating our momentum. During the this year’s session, we again sought input from experts, agencies and providers, and developed strategic investments that will be deployed over the next three budget cycles.

One important part of the solution will be the creation of a new training facility operated by the University of Washington. This facility will be dedicated to educating a new generation of individuals who will invest their hearts, lives and careers into those who are hurting, helping them regain hope for their futures. Dr. Jürgen Unützer, chairman of the Department of Psychiatry and Behavioral Sciences at the UW School of Medicine, provided legislators with the insight and inspiration needed to make this a reality.

On April 28, the Legislature approved the 2019-21 capital budget, which included a record $308 million to improve and expand our state’s mental and behavioral health safety net. Over the next several years, we will be building out needed community capacity across the continuum of care, as well as the UW training facility, a new state hospital and other investments in facilities that are part of the state’s long-term plan.

There is much more to do, but these first steps in the journey toward a common vision reflect good work, an informed diligence and caring hearts that are in tune with the needs of our communities. We must now continue moving forward while holding one another accountable to make this vision a reality.

Rep. Norma Smith, R-Clinton, has served in the Washington state House of Representatives since 2008. She is the assistant ranking Republican on the House Capital Budget Committee and ranking member on the Innovation, Technology and Economic Development Committee.

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