Mental Health System
return to Policy & Advocacy Plan
January 12, 2012
OBJECTIVE
Mental Health System: Prevent further erosion of Washington State’s mental health system and provide adequate mental health services in state psychiatric hospitals and communities.
BACKGROUND
Washington State’s mental health system is inadequate. The underfunded system was cut by almost $26 million in the 2011-2013 Washington State biennial budget. The Governor’s current budget proposals would cause further deterioration of the system through cuts to Western State Hospital and Regional Support Networks (RSNs) that care for patients. The Governor is proposing the following budget cuts:
- Close state psychiatric hospital wards. Community hospitals already face significant challenges in transferring patients with long-term mental health needs to Eastern and Western State Hospitals. The Governor is proposing further ward closures that will cause additional logjams in the system. When the state reduces wards at Eastern and Western State, scarce mental health beds in the community are occupied by patients with long-term treatment needs. Patients who seek treatment in emergency departments often wait hours or days to find a bed. This “boarding” of mental health patients in emergency departments and on acute care units is a significant problem across the state. Specifically, the Governor proposes closing two civil psychiatric hospital wards at Western State Hospital. This closure assumes patients will be treated in the community, but these long term beds will no longer exist in the state for acutely ill patients. While the Governor claims this closure will result in an investment in community funding of $4.1 million, hospitals oppose the reduction in bed capacity. The wards need to be kept open until more appropriate long-term settings can be funded and developed.
For state savings of $7.6 million, the Governor proposes closing the dementia and traumatic brain injury units at Western State Hospital and placing these patients in the community. It is crucial for community placement dollars to remain with the community. Closing the wards without adequate placement funding will result in patients accessing care through hospital emergency rooms, and hospitals will become a revolving door for these acutely ill patients.
- Reduce funding for community mental health services. The Governor proposes cutting RSN Medicaid and non-Medicaid rates for mental health services and reducing Spokane County’s hospital diversion resources. The cuts total $15.2 million in state funds and $9.8 million in federal funds. The previous decreases in bed capacity at Eastern and Western State Hospitals assumed Medicaid patients would be treated in the community. Further cuts at the community level will jeopardize the RSNs’ ability to provide essential services for patients. These services include crisis intervention and triage, jail and hospital diversion programs, and residential programs. Due to funding cuts, some RSNs have reduced the designated mental health professional staff who evaluate patients in crisis at community hospitals. This results in more patients “boarding” in emergency rooms awaiting evaluation and placement.
WSHA POSITION
Washington State should maintain the two civil wards at Western State Hospital. The beds are badly needed and community hospitals cannot absorb the need for care. If the legislature decides to close the dementia and traumatic brain injury wards, placement dollars must remain with the community. The state should also maintain Medicaid and non-Medicaid funding to RSNs for services to patients with a serious mental illness to ensure community treatment is available.
