Hundreds of millions of dollars have been invested in behavioral health in our state, and an alphabet soup of task forces and other entities have studied the issue. Yet, “With all that investment and all that work, we still see that the system does not work for everyone.” That’s Amber Leaders, a senior policy advisor to Governor Jay Inslee and co-chair of the Joint Legislative Executive Committee on Behavioral Health, or JLEC.
JLEC’s charge, according to Leaders, is not to set the state on a new path, but rather assess what’s been done, the challenges that remain, and craft a long-term strategic vision for Washington’s behavioral health system.
One element of that vision will be to continue to transition the state from what Leaders calls “deep end” care – in which behavioral health care was centered in large state institutions, the criminal justice system and hospital emergency rooms – to preventive, community based care. While state institutions will always be needed, “The important piece is, figuring out how do we narrow the pipeline coming in to that level of state care, so that people can receive care in the community when that is better suited to them. And how then do we make sure that the pathways out of state care are there and available so that people don’t just sort of stall in our state hospitals.”
What’s going right? “There is work going on, I know sometimes it doesn’t always feel like it.” Leaders points to Washington’s “really ambitious approach to 988” the crisis response hotline; the opening of UW’s new behavioral health teaching hospital; more community beds coming online; increases in Medicaid reimbursement rates; “street medicine” and behavioral health specialists partnering with police; and the state coming into compliance with it’s obligations under the “Trueblood” lawsuit.
Among the challenges that remain, she says, are continuing to expand community based resources; expanding and training the behavioral health workforce – including more opioid treatment providers and crisis responders, providers who can prescribe, and providers willing to provide medication assisted care; finding the right balance between involuntary commitment and individual rights; and more.