Inslee details budget investments to guide transformation of state’s behavioral health system, begin UW partnership

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Gov. Jay Inslee today formally announced a detailed plan for transforming Washington’s behavioral health system based on treatment in community-based facilities. His plan includes a first-of-its-kind partnership with University of Washington Medical School to establish an innovative new teaching hospital.

Speaking to providers, legislators and family members at a mental health treatment center in South King County on Tuesday, Inslee provided details for transforming Washington’s behavioral health system. The $675 million plan is part of the 2019–21 biennial budget he will unveil on Thursday.

“Today, we’re bringing hope,” Inslee said at Navos Mental Health and Wellness Center in Burien. “We have an obligation to help our friends and family who depend on these services for their quality of life and recovery.”

Inslee said ‘we are doing what we said we were going to do’ by getting rid of an outdated model of mental health care.

Gov. Jay Inslee visits Navos Mental Health and Wellness Center in Burien, July 2016 (Office of the Governor photo)

As demand for behavioral health services increases, state officials have grappled with a shortage in the number of beds available in the state’s two large mental health hospitals, as well as a shortage in community placement options for patients ready to be discharged. The result has been a chronic waitlist of patients waiting for treatment. Inslee’s plan turns the state hospitals into Forensic Centers of Excellence for forensic patients, and moves civil commitment patients into the community by supporting and building additional beds at a combination of smaller state-run and private facilities.

These new facilities will provide expanded treatment options to better serve the unique needs of individual patients. He used the Navos facility and programs as an example of the type of facility needed in Washington state.

Inslee’s plan also includes a new, first-in-the-nation partnership with UW to create a program dedicated to innovative and integrated behavioral health care. A teaching hospital will serve patients and provide support for the nation’s first comprehensive training program for integrated behavioral health, which will help address our shortage of behavioral health professionals. The hospital would provide patients with basic clinical care, complete with features such as an inpatient facility and tele-psychiatry care.

The governor’s proposal focuses on five crucial needs. First, Inslee funds a significant expansion of community-based behavioral health treatment facilities statewide.

Second, the state will expand how and where patients receive care. This means certain hospital beds can remain available for patients who truly need them.

Third, the state can offer these individuals housing resources for getting back on their feet. Housing assistance is a key part to helping people stay stable so they can focus on recovery.

Fourth, the state can address the national shortage of behavioral health workers by investing in a larger network of care. Today there are 300 licensed psychiatrists in Washington state, 45 of whom are at Western State Hospital alone. As of November 2018, there were 17 vacant psychiatrist positions at the hospital. These include scholarships, residences, and new educational opportunities — which is where the UW partnership comes in. Experts from various schools within UW will develop a new academic curriculum for psychiatrists, psychologists, social workers, nurses and medical assistants, nurse practitioners, and registered nurses.

And fifth, the state will continue investing in state hospitals and continue with behavioral health integration efforts for patients.

The plan includes elements included in the approved settlement agreement in the Trueblood, et. al. v. DSHS lawsuit issues, the case challenging the unconstitutional delays in competency evaluation and restoration services. The case includes five key areas of investments with a goal of keeping individuals with mental illness out of the criminal justice system: competency evaluations; competency restoration; crisis diversion and supports; education and training; and workforce development. The agreement also requires the DSHS to open 80 new forensic beds at Eastern State Hospital and Western State Hospital.

Tuesday’s plan continues the work that Inslee and the state legislature put into motion over the last two years. This includes integrating behavioral health with primary care, moving stable patients into community-based facilities in a timely manner, and shoring up the behavioral health workforce. The plan also connects to the state’s opioid response.

“This is challenging work, and I’m continually impressed by the men and women in our hospitals who are so deeply committed to making sure these patients get the care they deserve,” Inslee said. “Their jobs are more difficult because our hospitals and the kind of care they allow for are more than a century old. It’s time we make modernize our system so our nurses, doctors and staff can deliver 21st century care.”

The state will continue investing in the quality of care for patients and safety for employees at Western State Hospital while building up the new community facilities across the state.

“Let’s bring hope,” Inslee said. “Let’s turn that corner.”

Inslee’s behavioral health press conference can be found at tvw.org

For those who need help, you can seek treatment from the Recovery Helpline. You can also call one of the crisis hotlines available in Washington. Your information is confidential.