How Washington Lawmakers Did — and Didn't — Boost Mental Health Care This Year


New laws around mental health issues were often placed on the back burner during this year's legislative session, as hot topics like policing and affordable housing demanded legislators' attention.

Ambitious bills that sought to improve workforce shortages in the behavioral health world and some aimed at providing more psychiatric beds didn't make it in this year's short and saturated session. Neither did a bill to legalize psilocybin, or psychedelic mushrooms, for mental health treatment.

Here are some of the bills that did — and didn't — pass in Olympia and what they mean for the future of mental health care in our state.

Use of force

One thing many lawmakers and advocates agreed on this year was the need to prioritize a patch to House Bill 1310. Passed last spring, it was part of a package of police reform bills responding to the 2020 protests for racial equity and defined when officers could use physical force.

The bill had unintended consequences, however, as law enforcement stopped responding to some calls from social workers and counselors who needed help transporting people in crisis to emergency rooms or psychiatric facilities.

This year's fix, HB 1735, clarifies that police officers can respond in these situations and must enforce the state's Involuntary Treatment Act, which goes into effect if a person is a threat to themselves or others, or gravely disabled and worsening. The bill was signed by Gov. Jay Inslee last week and is now in effect.

Workforce issues

Despite growing concerns over labor issues as health care workers leave the field, three bills that aimed at bringing more professionals into mental health did not make it.

Senate Bill 5638 would have allowed associate-level social workers, counselors, and therapists to work while their license applications are being processed. Another, HB 1863, would have allowed psychologists to prescribe psychotropic medicine. Typically only psychiatrists are allowed to do so, but advocates hoped the bill would have improved access to medication as wait times to see a psychiatrist can take weeks or even months.

Lastly, HB 1865 would have created a peer specialist credential for people with personal experience with substance use or mental illness. The peer movement has seen a growing wave of support and a version is used within the Medicaid system. Legislators wanted to roll it out for people with commercial insurance as well, but the bill died in the Senate.

One bill that passed is HB 1286, allowing Washington state to join 28 other states in the U.S. in the Psychology Interjurisdictional Compact. This allows licensed psychologists to temporarily practice telehealth counseling in another state for up to 30 days.

The state budget also currently includes a 7% increase to the amount community behavioral health agencies receive when they bill Medicaid, which the agencies say they need to continue providing services to people with low incomes.

Staff at the King County Behavioral Health and Recovery Division were also excited about $10 million in the supplemental budget to construct a new 16-bed crisis stabilization facility that would open in the coming years. Gov. Inslee is expected to sign off on the budget in the coming weeks.

Expansion of services

A few bills focused on expanding available services for people with mental illnesses.

HB 1773, a contentious bill, opens the door to court-mandated, assisted outpatient treatment. It passed and allows a designated crisis responder to petition to get a person medication or therapy before they get worse and require involuntary treatment in a more restrictive setting. While groups like Mothers of the Mentally Ill (MOMI) and the National Alliance on Mental Illness' Washington organization supported the bill, other organizations like Disability Rights Washington worry that it limits the agency of people with mental illness to make their own decisions. Critics also cite the high price tag saying the money could be better spent on voluntary, community care.

But Jerri Clark of MOMI stands by the need for more programs like this. "Assisted outpatient treatment, I believe, was the missing ingredient that might have saved my son's life," she said.

Clark's son Calvin died by suicide in 2019 after cycling through years of homelessness, incarceration, and hospitalization after a diagnosis of bipolar disorder.

Another bill that passed the legislature is SB 5736, which extends coverage for young people 21 and under who are on the Apple Health state plan so they can receive partial hospitalization and intensive outpatient services.

For Sen. Manka Dhingra, D-Redmond, who co-sponsored SB 5736 and the Senate's companion bill to HB 1773, these are vital moves. "It really is about making sure you're providing services earlier on than later," she said.

Children's mental health

Legislators also rallied around children and youth mental health this session, passing three additional bills that now await the governor's signature.

HB 1905 focuses on the moment when youth leave foster care and search for housing — where some young people fall into homelessness. The bill requires the Department of Children, Youth, and Families to coordinate a rapid response team that would support youth in the system who are under 25, with planning and funds if needed, to secure safe housing.

Schools will also see some changes thanks to HB 1664, which will increase the number of nurses, social workers, counselors and psychologists who work with students. Over three years, the minimum ratio of these staff members will rise to offer students more emotional and psychological support.

A separate bill, HB 1890, looks further into the future, instructing the Children and Youth Behavioral Health Work Group to develop a strategic plan for youth and their caregivers. They'll be analyzing what services are currently available in behavioral health, and crafting a plan for an improved future system.

"The way we've been kind of chugging along the last three, four years, we will start seeing that impact later this year, [and] next year," said Sen. Dhingra. "As [new mental health] facilities come online and these beds come online, I really do think that we are getting past that tipping point."