Lanya Neeley stood on the sidewalk, upset, in crisis and surrounded by disarray.

She’d knocked down bikes, tossed Safeway grocery carts into the street and ripped plants from their pots, smashing them on a Capitol Hill sidewalk.

A car was following her, she told police.

It wasn’t the first time she’d made that kind of claim, an officer noted in the police report of the January 2018 incident.  

She “is transient and has numerous contacts for Mental health incidents,” the same officer wrote in 2016, after Neeley allegedly struck a man in the head with a chain when he stumbled upon her sleeping behind his garage.

Now, like all the times before, the officer turned to the one option readily available to him.

He arrested her.

If you live in or visit Seattle, you’ve probably seen someone like Neeley experiencing the debilitating effects of mental illness or substance abuse in public spaces. Instead of getting treatment, Neeley is one of more than a thousand people — most of them homeless — who cycle in and out of King County’s jails multiple times a year and leave no healthier.


Local authorities have struggled to help people like Neeley, for her sake and for others in the community, whose compassion is tested daily as they try to reconcile the suffering of individuals with the street crime and drug use they see across the city. Neeley was arrested at least 16 times since the beginning of 2015 for misdemeanor offenses.

Even she didn’t realize she’d been arrested so many times. “Meth has really destroyed my life,” she said. “It’s crazy to think everything’s OK even when it’s not.”

But after her arrest in January last year, authorities gave her another option: She was enrolled in a King County program called Vital, for people booked into jail at least four times in one year in two of the past three years, often for property crime or drug offenses, and who are struggling with serious mental illness and chemical dependency.

She would be connected to a team of people from different systems — prosecutors, housing and mental health specialists, nurses and case managers — who could help stabilize and keep her out of jail, stopping the cycle for her and also addressing public safety. Her own personal safety net.

The county’s preliminary results look promising: more than 78% of Vital clients were booked into jail less often once enrolled in the program for at least six months. On average, Vital participants went to jail about a third less often per year compared to the three years before their enrollment. A typical client had at least two fewer bookings into a King County Jail compared to the three years before entering the program.

The program is endorsed by King County Prosecuting Attorney Dan Satterberg and Seattle City Attorney Pete Holmes, who say it’s a reasonable alternative to a criminal justice system that was never designed to for people with serious mental illness.

“We need to develop something that hasn’t been developed before,” Satterberg said. “Because right now it looks like our only options are incarceration or nothing.”

However, while the program is lauded, many say Vital is far too small — only 60 people enrolled, at a cost of $1 million this year — to address the need. More than 3,200 adults were estimated to be homeless because of serious mental illness during the 2018 King County homeless point-in-time count.


The Vital program is the right concept, “but the scale is a joke,” said Scott Lindsay, a former City Hall criminal-justice adviser who recently authored a report that profiled 100 so-called prolific offenders in Seattle, all of whom were homeless and repeatedly arrested.

There is also some debate about how to define success. Vital case managers use a “harm reduction” model, which doesn’t require sobriety, and allows clients to define their own goals for success. They talk about the slow-going nature of stabilizing clients who’ve spent years on the streets; clients are not kicked out of the program if they return to jail.

The public has made clear it wants strategies — on a large scale — to ease the homelessness crisis. Doing so will also have serious implications for people like Neeley, who for years heard voices all the time, a condition exacerbated by drug use and her time on the streets.

“It’s like trying to stop a freight train. It takes over a mile to stop,” she said, describing the effects of methamphetamines on her mind. “If you don’t have anything and it’s the only hustle and the only way to survive that you know, it’s going to take a lot of convincing to tell them that a job is enough, that you won’t have to hustle on the side, you don’t have to go home and take a hit, that you’re going to be OK today.


“It’s really difficult to get through to people when they start hearing things.”

A revolving door

Washington state has long struggled to deal with the needs of its mentally ill people who land in jail. In a landmark class action lawsuit known as Trueblood, a federal judge ruled in 2015 the state had “warehoused” mentally ill inmates without appropriate treatment. The judge imposed fines that rose to $83 million before a settlement in December, pending action by the state Legislature.

Vital grew out of an initiative launched in 2015 called Familiar Faces, bringing together law enforcement, public health, social services and the judiciary to address people who are frequently arrested and utilizing a variety of other crisis services.

An analysis found the typical way of dealing with these offenders is extremely costlyKing County estimated it spent about $35 million serving the 1,242 people that made up the Familiar Faces population in 2014 — more than $28,000 per person.

The program was also a recognition that homelessness, the criminal justice system and mental illness can work together like a snare trap, one exacerbating the other. Homeless people were booked into the county’s jails more than 16,100 times in 2017 — an estimated 45% of total annual bookings, according to a 2017 King County Jail Health Services report.

An analysis identified more than 1,200 people who were booked into the jails at least four times in both 2013 and 2014 and were also struggling with mental illness and chemical dependency. Nearly 60% were homeless; the study authors thought that was likely an undercount.


Often, the bookings weren’t even because of a new crime. The most common offense, in 41% of the bookings, was noncompliance, meaning someone failed to make a court date, for example. Two of Neeley’s arrests last year were for noncompliance.

Homeless inmates were also more than twice as likely to spend time in the jail’s psychiatric and infirmary wards as those with housing, according to the Jail Health Services report. The jail’s definition of homelessness is broad, and includes people transferred from other jails, for example.

Yet King County employs only six jail-release planners, who help inmates set up medical or drug treatment before they leave custody. In 2017, they served about 1,300 people, roughly 8% of the homeless people who cycled through jail that year.

One potential result — as Lindsay’s chronic offenders report asserted — is that many inmates are released at times when no homeless services are available or without any guidance.

That didn’t happen with Neeley. Like the majority of Vital clients, she was enrolled in the program while still in jail.

So on the day Neeley was released, her new Vital case manager, Jordan Ramsdell, was there waiting to meet her.


Getting better outcomes 

Neeley, 35, figures she first lost the idea of what a home was at the age of 6, when Child Protective Services removed her from her mother’s care. Neeley said she spent the next 12 years in foster care — she counts 42 homes in all.

“It just felt like everything was a punishment all the time. There was no rewards in my life,” she said.

She went to Seattle’s Roosevelt High School but eventually got her GED certificate. She felt like an outcast, belonging nowhere, and so started to hang out with other people like her, “smoking weed, drinking, going to (youth homeless) shelter.” By her mid-20s, she was sleeping on the streets.

She first recalls hearing voices when she was 29, a few years after she started using alcohol and meth.

Neeley’s psychosis was very apparent in her initial meetings with the Vital team last year.

“She wasn’t hostile, she was just so disorganized,” recalled Nissa Freed, an advanced registered nurse practitioner who works with Vital. The program primarily operates out of the Belltown office of the homeless outreach program REACH. 


Even after being enrolled in Vital, Neeley was still living on the streets, carrying only a backpack and a blanket. She split her time between Capitol Hill and the University District, sleeping in doorways or wherever she could find a spot. Ramsdell would meet her at intersections for their outreach sessions.

But she still heard the voices.

One day in June, witnesses reported Neeley tipping over trash and recycling bins on Capitol Hill.

When officers arrived, Neeley pushed up her sweatshirt sleeves and balled her hands into fists as she walked toward them, looking ready to fight, a police report said.

Then in August, officers responding to a nuisance call spotted Neeley walking down another street in Capitol Hill. They found her crawling under a porch. ” ‘Do you hear that?'” Neeley asked them, according to the police report. “‘It is quiet. No one is yelling at me.'”

As the officers arrested her, Neeley asked them to call her Vital case manager to tell her what happened.

This signaled progress to her case managers, but it’s not unusual for those connections to take a while to form, particularly for someone who’s experienced years of homelessness, mental illness and trauma, said Michelle Conley, the Vital program manager. That’s why there is no time limit on someone’s involvement in Vital.


It’s also why the connection with prosecutors is critical.

Although King County operates drug and mental health courts, they may not work for Vital clients, said Grace Ritter, a King County deputy prosecuting attorney who also works with Vital. Mental health court isn’t designed for people with substance abuse issues. Drug court is time-intensive and requires strict compliance. 

“If the person standing in front of the judge is in a behavioral health crisis suffering drug withdrawals, hearing voices in their head, suffering the trauma associated with living on the streets, that experience in court is meaningless for them,” said Satterberg.

The King County Prosecutor’s Office and the Seattle City Attorney’s Office create an individualized plan for each Vital client, said Heather Aman, an assistant city attorney who is a liaison to Vital.

Aman gets email notifications any time a Vital client shows up in a Seattle police incident report. She tracks clients’ jail bookings, and notifies other Vital team members if a client is arrested. This kind of information helps prosecutors see if a client is working to improve, which could result in some charges being dismissed or downgraded.

“If prosecutors had this type of information on every defendant,” Aman said, “we’d have better outcomes for individuals and better outcomes for the community.”

A possibility for change 

But prosecutors don’t get that information on most defendants. There isn’t the funding nor enough available programs.


About 600 people enrolled in the Law Enforcement Assisted Diversion (LEAD) program, a larger, sister initiative to Vital, but it generally focuses on people with less-severe mental health issues. Another county diversion program, called the Legal Intervention and Network of Care, has a capacity of about 50 people at any one time.

“Everyone is sort of trying to beg, borrow and steal from each other almost in order to provide these services,” Aman said.

One critical gap is housing, which is not guaranteed with Vital. Plymouth Housing makes 20 permanent supportive housing units — which embed social services in housing projects — available to Vital clients, only enough for about a third of the program participants at any one time.

Supportive housing is in high demand across the community. An evaluation of Vital, scheduled to be released later this year, will include a look at whether the program needs more housing, said Leo Flor, King County’s human services director. The question of whether Vital will be expanded hasn’t been answered, pending the outcome of that evaluation.

But he and other policymakers and criminal justice experts agree one program isn’t enough. Making a difference will require money and political support. “The question is,” said King County’s Public Defender Association director Lisa Daugaard, “where is the momentum to apply that approach at scale going to come from?”

Mayor Jenny Durkan also recently convened a working group, including Holmes’ and Satterberg’s offices, to look at the issue of repeat offenders in the region.


Quieting the voices

After another arrest in September, Neeley was released and went to the REACH offices. By then, she’d spent 49 days of 2018 in jail.

She met with Freed, the Vital advanced registered nurse. Neeley said she was finally ready for medical treatment. Freed administered Neeley’s first dose of a long-lasting antipsychotic medication called Invega Sustenna, which requires a monthly injection that she continues to receive.

She hasn’t been back to jail since.

She is in a relationship now and stays at her girlfriend’s apartment, though she still utilizes day services at Seattle’s Navigation Center, a homeless shelter where she briefly lived. Neeley is learning how to do everyday things she couldn’t do when homeless, like laundry and taking regular showers. She meets regularly with the Vital occupational therapist.

She still hears voices, but they are quieter now.

In February, Neeley was back in court again, where a judge agreed to give her no additional jail time on two outstanding cases. Because Neeley is in Vital, regularly checking in with case managers, she doesn’t have to be on probation.

Conley, the Vital program manager, and Aman, the deputy city attorney, were in court to support her.

The woman standing before them looked very different from the person described in so many police reports.

“She looked fabulous,” Aman said.