Proposed intentions at Western State Hospital are welcome, but true change is what’s needed for mentally ill people on waitlists whose treatment is delayed.
Flanked by lawmakers and mental-health officials, Gov. Jay Inslee stood on the steps of Western State Hospital earlier this month and announced what he called a “major transformation” to get the ailing psychiatric facility on track.
Yet, despite the fanfare, not much is new about Inslee’s plan to move civilly committed patients out of the Lakewood hospital and into community treatment facilities. It is an approach top lawmakers have largely agreed on for the past two years as a way to free up desperately needed mental-health beds at Western State and that Inslee himself has proposed in a prior budget plan.
What is new is Inslee finally setting a 2023 deadline for the transition to take place — a long overdue step.
What would be truly revolutionary, however, is actually getting the job done.
The real test is whether Inslee ensures that his Department of Social and Health Services, which runs Western State Hospital, follows through and makes his vision a reality in the next five years. Too many times in recent history, the agency has failed to implement changes the Legislature has paid for, including opening new wards on schedule and installing a system of electronic medical records that could help the hospital better manage patient care.
The problems are not just about money, but also management — and that falls on Inslee, who is in his sixth year as governor.
Lawmakers have spent the past several years trying to rebuild Western State after recession-era budget cuts. Despite pouring in hundreds of millions of dollars and adding 760 staff members since Inslee took office in 2013, by several measures the 857-bed hospital’s problems are worse than ever.
Right now, Western State has a waitlist of 233 mentally-ill people who are languishing in jails as they await mental-health treatment or a psychiatric evaluation. That is the longest waitlist the hospital has ever had for these type of patients, said DSHS Secretary Cheryl Strange.
These are people in crisis who are either deemed mentally incompetent to stand trial or who are awaiting a psychiatric evaluation to determine whether they fall into that category. While they wait in jail, they are not receiving the treatment they need, potentially causing their conditions to worsen and making them difficult to treat once they actually are admitted. The state is already paying about $3 million per month in court fines over the ongoing violation of these patients’ rights.
Meanwhile, people referred to Western State for civil commitments — generally, noncriminal patients who are deemed a danger to themselves or others — are similarly facing unacceptably long waits. About 100 civil patients who need stabilizing treatment are on a waitlist to enter the hospital now for potentially lifesaving interventions.
They cannot get in because others cannot get out — for lack of a place to go.
More than 200 civil patients at Western already have completed their treatment and are ready for release. Yet the state doesn’t have enough facilities in the community that can take these types of patients, many of whom have traumatic brain injuries or dementia, creating a backup in the entire system.
Federal surveyors from the Centers for Medicare and Medicaid Services are back at Western this month, determining whether the state has fixed 57 problems the agency identified last year. The hospital risks losing about $60 million in annual federal funding if it hasn’t shaped up.
Inslee’s promise of a 2023 deadline for fixing Western cannot just be a show to try to appease the inspectors.
The Legislature, Inslee and DSHS must make solving the crisis in our mental-health system their top priority now, in the 2019 legislative session and beyond.
Too many people in our communities are suffering with mental illness for this new deadline to be another promise that goes unfulfilled.