Finding a therapist, getting substance use treatment or having someone to lean on in a moment of crisis: None of it is easy. Unfortunately, many people get stuck in the web of the mental health care system before finding what they need.
A new state-funded agency is looking to smooth that path to recovery.
The new Office of Behavioral Health Advocacy is staffed by people with lived experience, and charged with educating and consulting people who need care, as well as holding public and private providers accountable. For Michelle Tinkler, who heads OBHA, this mission is deeply personal.
Tinkler had depression as a child and eventually began self medicating with illegal drugs. It’s now been more than two decades since she began recovery from addiction to methamphetamine. Several years after her recovery began, she spotted a job opening at a crisis stabilization unit. “I felt it was a sign for me to go there,” she said. “I was able to actually see the magic that happens, how [an] individual comes in and then when they leave, so that just set a passion for me.”
She eventually went back to school and earned a business degree so she could take on more administrative responsibilities. Later, she joined Peer Washington, a nonprofit that now runs OBHA.
As OBHA ramps up its services, The Seattle Times spoke with Tinkler about how this new agency can help people navigate the behavioral health system. You can reach the office by calling 800-366-3103, emailing firstname.lastname@example.org or by filling out a form on its website at www.obhadvocacy.org.
- What is the Office of Behavioral Health Advocacy?
OBHA is an independent agency funded by the state. The federal government mandates that states fund mental health advocacy services, and OBHA creates a central hub for this work, Tinkler said.
Until recently, several separate, regional mental health advocates were spread across Washington. Because of funding and logistical reasons, these advocates struggled to coordinate resources for people who might be located in one part of the state, but need services in another.
That changed in 2021, when lawmakers signed off on legislation that created OBHA, which officially began operations in October. Now, for example, if a person in crisis is detained in King County but resides in Snohomish County, one agency is responsible for making sure they get services where they live.
“When there was talk about getting [services] centralized, and the bill passed, I was so excited because that is really needed,” Tinkler said.
The agency has an annual budget of about $2.5 million.
- How is Peer Washington involved?
Although Washington is required to fund advocacy — otherwise known as “ombudsman”— services, the state can’t be charged with holding itself accountable since ombuds are intended to be impartial. That’s where Peer Washington comes in.
The nonprofit has a history of providing peer support for people with behavioral health concerns, as well as those with HIV/AIDS. When policymakers announced the creation of OBHA, Peer Washington bid on a proposal to run it, and won. OBHA is now housed within the nonprofit, and because it operates independently from the state, has the ability to make both public and private entities accountable for care.
- Why do people reach out to the OBHA?
One of the main reasons people call for help is because they’re struggling to cut through red tape and get mental health care, Tinkler said.
But a majority of people call because they’re getting treated involuntarily and they don’t know why. Treatment facilities are required to post OBHA’s contact information, and people often reach out because they’re being held against their will and want an advocate who can help them. Some might also call 211 — which connects them to health and social services — and get rerouted to OBHA.
“They don’t understand why they’re there [getting treatment]. Or they feel that they were put there wrongly,” she said. “They would call us and express what their concerns are and we will get a behavioral advocate to call them and try and go out there to the facility and meet with them or we just discuss it over the phone.”
Many callers are family members of people in crisis, such as parents of adult children. Unfortunately, Tinkler said, behavioral health advocates aren’t able to dig into the details of what adult family members need without their permission. Once they give consent, OBHA can start connecting the family to services.
- What is a “behavioral health advocate”?
Advocates are peers who have lived experience with mental illness, substance use, or both. They’ve already learned how to navigate the behavioral health system on behalf of themselves or a loved one, and they’re trained to help people in crisis find care, Tinkler said. “We step in, and we try to be that common voice so that their voice is heard.”
Even though she’s now in an administrative role, Tinkler still serves as an advocate. When she started going through recovery, she said, she never found the kind of support that’s available today.
“I just want to make sure that people are taken care of,” she said. “From my personal experience, when I didn’t know where to turn, I just felt hopeless.”
- What happens when someone goes to OBHA for help?
Staff members start by collecting lots of information — the caller’s name, where they’re located, the kinds of care or services they’re seeking, or what they’re concerned about. Said Tinkler: “That’s when they’ll find out if they just need information and resources, or if it’s actually where we need to dig deeper.”
They can help people navigate the complexities of the behavioral health system free of charge. No concern is too big or small for OBHA, Tinkler said, and it doesn’t matter whether callers have public, private or no insurance.
“By the time people reach us, they’re already in a crisis … We’re not going to say sorry, wrong number. We are going to make our best effort to try and get a hold of what they’re requesting,” Tinkler added.
What about when someone is dissatisfied with their care or has been denied coverage by their insurance company?
OBHA is intended to be a neutral party, but staff can serve as advocates for those who want to pursue more formal action against a provider, insurer or government agency responsible for care.
OBHA doesn’t have the power to enforce laws or regulations. But if someone is struggling to feel heard by their mental health provider or insurer and wants to file a complaint, a behavioral health advocate can walk them through the complaint process; people can submit complaints to either the state’s Department of Health, or the Office of the Insurance Commissioner, depending on their concerns. When insurance denies care, advocates can help write an appeal letter, or seek information about the denial from the insurer.
- How can people learn more?
“We do have monthly forums for each region, so individuals can actually log into that forum and have a chat with the community and with one of our advocates about what’s going on in their community,” Tinkler said, noting that people can sign on anonymously if they’d like. “It’s just a safe place for them to go to be able to talk about their concerns.”