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Feb. 5, 2023

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In Our View: Mentally Ill Need State’s Aid

Lawmakers appear poised to make meaningful strides after ignoring issue

The Columbian
Published:

After decades of ignoring the problem and after an embarrassing rebuke last year from the state Supreme Court, Washington lawmakers appear poised to make meaningful strides regarding mental health care in the state.

Early in this year’s legislative session, the House of Representatives passed — with a bipartisan 83-15 vote — an emergency supplemental budget proposal that would quickly inject $21 million into the state’s inpatient psychiatric system. The money would open 45 beds at Western State Hospital in Lakewood and would contribute to the opening of nearly 150 psychiatric beds at community hospitals.

The urgency for such action became evident last August, when the Supreme Court ruled that Washington’s practice of “psychiatric boarding” was unconstitutional. The practice, which had become common because of a lack of available psychiatric beds in the state, would have patients in need of mental health care often being held in regular hospitals that were ill-equipped to tend to their needs. In writing the unanimous opinion, Justice Steven Gonzalez noted that state law “does not authorize psychiatric boarding as a method to avoid overcrowding certified evaluation and treatment facilities.” According to several studies, Washington ranks last or near the bottom among all states in terms of psychiatric beds per capita.

The result is a quagmire for the mental health system, and it will require action on several fronts from lawmakers. Approving expenditures to increase the number of beds for the mentally ill will not solve all the issues facing the state, and several bills are under consideration to address different facets of the issue.

Foremost is “Joel’s Law,” which passed out of the House by unanimous vote; a companion Senate bill is in committee. Named for Joel Reuter, a 28-year-old Seattle man who was killed by police during a psychotic episode in 2013, the law would add an appeal option to the convoluted involuntary commitment process, allowing families to protest the decision of counselors who do not recommend such commitment. In trying to balance the individual rights of those who suffer from mental illness with the need for them to get help, many states over the years have constructed impenetrable labyrinths that make it difficult for families to get assistance for loved ones. “Joel’s Law” was passed by the House last year but died in the Senate. With representatives again approving the measure, senators should join them this session in making a small but meaningful change to the state’s mental health system.

Lawmakers also should give due consideration to a bill that would allow for supervised outpatient treatment, which would provide judges an additional option in dealing with mentally ill patients. And they should support a bill that would improve training for police officers when encountering those suffering from a psychotic episode. The financial reality of such proposals is illuminated by this fact: The additional training has a cost estimate of $800,000 a year, but a single wrongful death lawsuit resulting from inadequately trained officers can be even more costly to the state.

Each of those proposals should be approved by the Legislature as the state shores up a mental health system that long has suffered from neglect. But the most important issue is that of increasing the number of psychiatric beds. When the alternative to receiving appropriate care is for an ill person to be strapped to a hospital bed for several weeks or be sent out onto the streets, then changes in the system are required.

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