The Seattle Times’ recent news article on the “re-imagining” of our state’s mental health system only confirms that the supposed “re-imagining” fails to address systemic problems that have a direct relationship to the homeless population in our state’s urban areas. [“How big changes at WA’s Western State Hospital fit into Gov. Inslee’s plan to ‘re-imagine’ mental health,” March 26, News]

The state’s mental health system is in free fall. 

A quick history lesson: In 1979, when I started in the Legislature and chaired committees addressing our mental health system, the Washington State Department of Social and Health Services (DSHS) operated thousands of beds for mentally ill people at Western, Northern and Eastern state hospitals, when our state’s population was half of what it is today. Those hospitals were accredited by the Joint Commission on the Accreditation of Hospitals as meeting national care standards. In the years thereafter, the state reduced those hospital populations on the mistaken belief that beds would be added in Washington’s communities for that severely mentally-ill population. Those beds never materialized. We now have dramatically fewer beds for that population statewide. Guess where that population formerly served in our state mental health system landed?

We should be embarrassed at losing Joint Commission’s accreditation for Western State Hospital, our principal state mental facility. Adding a new 350-forensic bed facility at Western to replace some of the aging buildings is a drop in the bucket. And the number of treatment beds at Western State will be reduced, again on the promise that beds will magically spring up in Washington’s communities. Where precisely are the necessary beds for mentally ill people in our local communities going to be located? Who’s going to build and operate them? This claim is just another pie-in-the-sky promise. 

How does the dysfunction in the mental health system tie into homelessness? The problem of homelessness is all too often not a housing problem, but a mental health/substance abuse/housing problem. Homelessness will not be solved if the mental health problems of those who are homeless are not addressed. 

If people do not voluntarily seek mental health services, governments need to use the Involuntary Treatment Act to provide needed mental health services to gravely disabled homeless people. We do no service to mentally ill homeless people by allowing them to reside in “encampments” or along freeway right-of-ways without basic sanitation or public health services. 

The state’s “reimagination” of its constitutionally required mental health responsibilities needs to be a real commitment and not a 350-bed fig leaf. It is essential that citizens demand more of our state government than a “re-imagined” mental health system that does little to really treat severely mentally ill people. 

Cities and counties are similarly unrealistic if they fail to factor mental health treatment into the calculus for addressing homelessness. No more “reimagination” or wishful thinking about these problems — we need real solutions, real treatment of the severely mentally ill.