Almost 10 years ago, state researchers conducted a study looking at how many people in Washington state became homeless after leaving inpatient treatment for a mental health issue or substance use disorder.
The results were shocking. Nearly half the people discharged from a drug or alcohol treatment facility in 2010 were homeless or didn’t have stable housing within a year. For the people discharged from state psychiatric hospitals, it was 30%.
In the midst of an ever-growing homelessness crisis a decade later, there’s little to suggest that those gaps have much improved. But now, state officials are embarking on a project to better connect people leaving treatment with the limited housing options that await them outside.
In a discussion Wednesday with Gov. Jay Inslee, officials from several state agencies shared concerns about the complexity of the housing system and the few resources available to those who need them the most.
Stable housing can be the difference between maintaining good mental health and recovery from substance use disorders or falling back into crisis for many people. People who are homeless tend to have a harder time staying connected to treatment or support systems.
Sarah Taylor, a case manager at residential behavioral health facility Elahan Place, said that the housing that does exist for people leaving treatment often has barriers that limit who can get placed inside, including obstacles for smokers, people with pets and people with low incomes.
“Discharge resources are limited,” she said.
A discharge planning toolkit, she said, would help cut down on the time it takes to find the housing for her clients.
To demonstrate the need for such a toolkit, the Department of Corrections also shared data in the meeting showing that the percentage of people released from its facilities into homelessness has steadily increased since 2013.
Steve Dalton, a housing specialist with the Department of Corrections, said it was often difficult to find housing vendors that accept people reentering society from prison in smaller counties, and few vacancies exist in larger counties. Zoning restrictions also limited housing options, Dalton said, particularly for people on the sex offender registry.
Finding housing for people with behavioral health issues added another layer of difficulty, Dalton added. Filling out paperwork alone could be a challenge, and sometimes, people placed in housing had their tenancies terminated because of behavioral issues on-site.
“They’ve been accepted, but then they lose their place,” Dalton said.
A discharge planning toolkit, according to officials from the Washington State Health Care Authority, would be a way to both present a list of resources to people leaving behavioral health care facilities and train housing and homeless service providers on how to receive them.
“Ultimately it really is about helping people and guiding people and giving them choice, power and control over where they want to live, and providing them information and resources on how to do that,” said Melodie Pazolt, the Health Care Authority’s recovery-support-services section manager.
One piece of the toolkit would look like a decision tree, Pazolt said, with various questions — like where a person might want to live, whether they had previously experienced chronic homelessness — that could point to appropriate housing.
But the limited housing options for people exiting behavioral health facilities vary in quality. The state Legislature attempted to clamp down on recovery housing providers with questionable practices in 2019 through a law that required behavioral health facilities licensed by the state to only make referrals to certified recovery housing, starting in 2023.
Earlier this year, a Seattle Times investigation into one private company taking referrals from shelters, the Department of Corrections and behavioral health care agencies showed that many people who ended up inside the homes managed by the company had to move after conflicts with the landlord or ended up homeless again.
The Health Care Authority plans to roll out a paper version of the toolkit in June and launch a pilot with five behavioral health facilities.