King County leaders announce $1.25 billion plan to address behavioral health crisis

At a news conference this morning, King County Executive Dow Constantine and a coalition of local elected officials and service providers proposed a new property tax to generate $1.25 billion to pay for care infrastructure needed to address the behavioral health crisis. health in the region.

According to prepared remarks, the plan focuses on four major areas of investment: building five new crisis care centers across the county, preserving and restoring King County’s limited treatment beds, recruiting more people to work in behavioral health care and standing up of mobile or field-based emergency crisis responders to provide care while the county builds the five permanent facilities.

Constantine will need the King County Council to approve the plan and send the levy to voters for a referendum in April, but with a majority of Council members who appeared at a news conference this morning supporting the measure, the prospect of conflict over the proposals tax seem weak. The real test for Constantine’s coalition will be whether spending increases can have an impact quickly enough, given the extraordinary toll the pandemic has taken on the behavioral health system.

It’s hard to overstate how overtaxed the county’s current behavioral health system is at this point in the pandemic. Michelle McDaniel, CEO of Crisis Connections, said their crisis lines have seen a sustained 25-39% increase in calls since the start of 2020, and that callers on average report more severe stress than pre-covid.

The region also lacks urgent care facilities where someone in crisis can walk in to get help without a referral from first responders or law enforcement, and we only have one 46-bed behavioral health crisis facility operating in the entire county.

Without adequate care facilities available, many people in crisis wind up in emergency rooms, jail, and living on the streets simply because they have nowhere else to go.

Even those with case managers supporting their search for services can be left out in the cold, as many providers report being at capacity by the middle of the month each month. The county says that as of July, people were waiting an average of 44 days for a bed in a psychiatric facility. The county recently purchased a residential facility to maintain its 64 beds, but a population of more than 2 million people will need much more capacity than that to truly meet the currently unmet needs.

People who do the work of treating people in crisis don’t fare much better. Caregivers’ wages are so low that many of them qualify for the same social assistance programs they help their clients with, even though their jobs often require a bachelor’s or master’s degree. By allocating some of the new funding to support the wages these workers receive, county leaders hope to attract more people to the district and bolster a dwindling workforce.

King County Sheriff Patty Cole-Tyndall also emphasized that these investments are part of a holistic approach to improving public safety in the region. She pointed out that by having more trained health professionals to respond to people in crisis, her deputies can focus on dealing with higher-priority threats to public safety.

All county leaders acknowledged that these investments will take time to show results because the care centers will take time to build and because it will take time to educate and train workers. In the short term, Constantine hopes to address the immediate crisis by complementing state and federal government investments in expanding mobile crisis teams. These teams employ a trained mental health professional to respond to emergency calls when people are experiencing a behavioral health crisis, who can de-escalate the situation and provide immediate emergency care.

Assuming the King County Council approves the plan and voters sign off on the levy in a planned special referendum in April — which is a big assumption given the current economic climate, persistent concerns about “tax fatigue,” etc. – Constantine’s coalition believes these comprehensive investments will create a system that can finally provide the behavioral health care people need, when they need it.

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