For what it’s worth

Mental health? Addiction?

What do we need in Thurston County?

Posted

Anyone who walks around downtown is aware of the walking wounded that inhabit many doorways.   I was walking to the Washington Center around 7:15 p.m. and passed by a woman sleeping on the sidewalk who started hurling epithets at me, one of two people sleeping on that block. Sleeping on the sidewalk between 7 a.m. and midnight is illegal per the Olympia municipal code; we need an effective and comprehensive system to allow a compassionate way of addressing this problem, helping people while enforcing the law. 

Mental health and addictions have often been cited as a primary cause of homelessness and many of the social problems we face. That generates several questions:

  • Are we lacking in mental health services?
  • Are we lacking addiction and detox resources?
  • If we have resources, what prevents people from taking advantage of them?
  • If people are refusing to use the help offered to them what is our civic responsibility to them?

If we determine that the greatest unmet need is for these services what do the cities do? The local efforts addressing homelessness have been substantial. They have already demonstrated an unwillingness to ignore the problems, that it is not an acceptable course. 

I’ve discovered that although there are some resources available, they are not sufficient and there are significant impediments to getting people into treatment. I spoke with Joe Avalos at Olympic Health and Recovery Services (OHRS), which is a licensed Behavioral Health Agency that provides direct services to clients wherever needed including crisis intervention over the phone and in the homeless camps and jails. This agency provides the Designated Crisis Responders (DCR) who have the legal authority to get people into treatment even if they don’t want to go, also known as involuntary treatment.

1)  COVID-19

A major challenge Mr. Avalos sees, and maybe the most obvious, is COVID-19.   That is creating all kinds of hardships for service providers, especially removing resources that would normally be available. The result is that some facilities have closed or drastically scaled back their services. While there are often beds available for some conditions, detox facilities are lacking as are beds for people with co-occurring illnesses, chronic illness, and dementia. So people who fall into those categories either have no place to go or wind up at Providence St. Peter Hospital, which is both expensive and taking beds that they need for other patients.   

Meanwhile, demand is going up. OHRS saw a 32% increase in crisis calls last year.

2) Worker shortage

Compounding the problem is the lack of and difficulty of getting enough skilled workers in the treatment industry, another direct result of Covid. Meanwhile, the need has increased. This problem affects any number of industries, and the mental health/addiction treatment industry is no different. 

3) Police no longer transport

The last problem is with transporting people. This is a significant bottleneck for getting people help and into the treatment system. The inability to get people into the mental health system is particularly damaging, but once we get people into the system, there is often a path available to them to continue getting the help they need. The DCRs can involuntarily commit people who are either a danger to themselves or others, which is often what is needed in those cases where people will not voluntarily get the help they need. Mr. Avalos tells me that there is almost always a bed for someone somewhere; that is not to say that we don’t have a shortage of beds, but that shortage is not always the limiting factor for getting people into treatment. I called South Sound Behavioral Hospital (SSBH) in Lacey. They have over 100 beds for mental health, adolescents and detox, and found that the detox wing is often full while they normally have some beds available for mental health. They receive referrals from the other detox providers in the area because the others are full.   

The DCRs are called to intervene by SSDH and other providers such as the Crisis Response Team for the most difficult situations. The problem they now have is that the police used to provide the transportation for the DCRs when they needed it, but the police have stopped transporting as their position is that HB1310 prevents them from assisting. When this law was passed, many police departments, including Olympia’s, chose to use this law as a reason not to respond to “community care” calls. City manager Jay Burney subsequently issued a statement telling us yes, the police would still respond.  

Additionally, there is a recent opinion by the State AG that says:

“Officers may not use physical force when dealing with the mentally ill, runaways, dependencies, assisting fire and medics, or in any community caretaking function UNLESS such force meets one of the permissible uses outlined in 1310.”

I’m thinking this may also be what’s preventing them from enforcing Olympia’s non-sleeping language in the municipal code. 

What should the local governments do next? The city is working with the legislature this session to revise the language in HB1310 to clarify its intent and hopefully eliminate this roadblock, but regardless of what comes out of this session this problem has to be solved. Our public safety system has to be complete and has to respond as needed in all cases.  

Having sufficient mental health and addiction resources would allow the cities to have a comprehensive system to move people out of homelessness and other untenable situations. In addition, they would be able to set limits on what is acceptable behavior, helping those people who need help and can’t take care of themselves and setting limits on those that can but choose not to.

The cities don’t want to be in the mental health or drug rehab business, nor should they.   They have enough to do providing the current services from parks to public safety, public works to the arts.   It looks like the County’s new Home Fund may be available to do just that: leverage funds from the state, provide capital funds for facilities, support agencies that are providing these services, and set policy for how their staff, including the police, work with the groups directly providing services to fill in the unmet needs. That is a welcome step in the right direction.   Support of mental health and addiction services, completing the needed comprehensive system, should be a high priority for what to do next. 

Pat Cole  -  pcbiglife@gmail.com - is a former member of Olympia's city council. As a private citizen, he seeks to set a positive tone and lead informed discussions about local civic issues.

EDITOR'S NOTE:  The opinions expressed above are those of Pat Cole and not necessarily of The JOLT or its staff or board of directors.

Further, if you'd like to express your opinions, please write them up and send them to us, especially if you are focused on Lacey or Tumwater. If you've got questions about what would be acceptable, please call Danny Stusser on 360-357-1000 x1

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