It was good to hear Gov. Jay Inslee, during the last presidential debate, speak about the importance of providing mental-health care.
Perhaps it’s time for Inslee to return to Washington and ensure that its troubled mental-health system gets fixed. Improvements are happening, under court orders, and only after the state’s cruelty of leaving too many vulnerable people with mental illness untreated in a system under federal scrutiny for years. So much work remains.
Inslee should also tell the full story when taking credit for Washington’s success on different fronts.
His brag about raising teacher salaries, for instance, could have mentioned years of work by legislators to address school-funding inequities. Their job was made harder by Inslee’s coziness with the powerful teacher’s union, which resisted moving toward state-funded schools and spending guardrails.
Politicians are politicians, but veracity will be important for voters in 2020. Americans are tired of fact-stretching and mistruths from the White House. The next president’s paramount duty should be restoring trust in the office.
That starts on the campaign trail, where the full account of candidates’ accomplishments and failures must be shared.
Washington is belatedly making progress with mental-health care. Its latest budget provides long awaited investments in community-based treatment and state facilities, and $154 million to develop the University of Washington’s new 150-bed behavioral-health teaching facility.
Building facilities takes time. Meanwhile the state has a severe shortage of capacity for treating mental illness and supporting those leaving treatment facilities and reentering the community.
Much of this progress is happening not because of enlightened governance but because Washington was forced by advocates, lawsuits and judges to address inhumane and unconstitutional treatment of vulnerable residents. Problems predate Inslee but continued, and in some cases worsened, since he was elected governor in 2013.
Inslee formed a mental-health task force in 2014 but progress on its suggestions was slow.
In 2015, the state’s primary mental-health facility, Western State, failed a federal inspection. Mismanagement, staffing issues and neglected facilities caused a litany of problems the Inslee administration couldn’t fix. Last year, in Inslee’s sixth year in the governor’s office, Western State lost certification and $53 million a year in federal funding.
Despite conditions, patients were waiting an average of 56.6 days to get into Western State in 2017. Getting out was even harder — that year behavioral-health patients ready for discharge waited an average of 3.7 months for community placement, while patients with developmental disabilities ready for discharge waited an average of 13.3 months.
This has been Washington’s equivalent of border-detention facilities — an overwhelmed bureaucracy detaining vulnerable people for too long in deplorable conditions. That includes people restrained in emergency rooms, “warehoused” for days. Some were left untreated, others were forcibly medicated, according to lawsuits that culminated in a 2014 state Supreme Court ruling declaring the practice unlawful.
Simultaneously, the state was sued in federal court for taking too long to assess the mental competency of criminal defendants. Thousands of mentally ill people a year were being left in jails for weeks or months, awaiting competency evaluations and treatment, often in solitary confinement. For some, this worsened their mental health. Some also ended up incarcerated longer than they would have been for the original crime.
A federal judge in 2015 ordered that defendants be evaluated within seven to 14 days. The state failed and was found in contempt twice, leading to an order, approved December 2018, that it seek funding for community-based treatment and more beds at Western and Eastern state hospitals.
Broadly, this crisis contributes to difficulties Seattle and other communities have with a subset of homeless residents, some of whom are mentally ill, repeatedly cycling through courts, jails and treatment programs with poor outcomes for themselves and the community.
It goes on. Inslee was named defendant in another lawsuit last year, alleging 70 mentally ill patients at the Walla Walla state prison were severely confined, even though they were supposed to be in minimum or minimal custody.
So it was surprising to hear Inslee’s boast during the latest debate. Asked about health-care reform, he said, “I’m also proud of this ... it is time to give people adequate mental-health care in this country.”
Indeed. One could say it’s past time, and finishing that difficult but critical job in Washington should be a top priority for its governor.
