Fixing the behavioral health crisis response systems
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December 2022
In this issue:
- Fixing the behavioral health crisis response system
- Hobson Place wins award
- Nicole Macri honored
Fixing the behavioral health crisis response system
Investments to restore and build the system we all need will get us through the current chaos and into a new era where everyone with psychiatric conditions can resume thriving and healthy lives.
DESC has led tours over the past several months of the Crisis Solutions Center (CSC), the only such facility in King County. Above, Director of Clinical Programs Maggie Hostnick gestures during a tour in September. Listening are King County Director of the Department of Community and Human Services (DCHS) Leo Flor, DESC Associate Director of Mobile Response Freyton Castillo and King County Executive Dow Constantine.
By DESC Executive Director Daniel Malone
You may have missed the article, "Seattle psychiatric nurse reckons with the city’s most vulnerable residents," on Nov. 25, featuring a psychiatric nurse working at DESC trying to help some of the most vulnerable people in our community.
It’s two stories in one, showing an intense level of suffering being experienced by people living with serious psychiatric conditions and the heavy toll that can take on the people attempting to relieve that suffering. And it’s vividly told, showing minute-by-minute examples of what inadequate support from the behavioral health crisis response system can look like.
Service providers have sounded the alarm
More than a year ago I joined with numerous colleagues across the behavioral health treatment continuum to sound the alarm to government leaders about the state of the crisis response system and scarcity of appropriate community supports, using phrases like “people in crisis” and “workforce challenges” and “the under-resourced behavioral health system.” The stories chronicled in this article are the raw versions of what those phrases mean.
People living with psychiatric conditions are not inherently dangerous, but in all walks of life danger rises with desperation. If you can’t get the help you need for the symptoms you are experiencing and the pain you are suffering, you can deteriorate in ways that might include diminished ability to regulate your emotions. When that leads to risks of harm to yourself or other people, you need more intense help, and you need it now, not sometime after waiting weeks for an evaluation as described in the article. Same-day evaluation with immediate placement into treatment used to be the norm in responding to these severe situations, but now DESC and other community providers are often left without that essential backup support.
So with a picture this bleak, what’s the way out?
Last year we and others proposed essentially the three-legged stool of a greatly enhanced crisis response system including the creation of places for people in crisis to receive immediate support, major support for the behavioral health workforce, and investment in the basic infrastructure everyone needs to have a healthy life, none more important than safe and affordable housing. We applaud King County’s recent announcement of plans to ask voters to approve a proposal to build many more crisis centers and to provide appropriate compensation and training to the behavioral health workforce. The state and federal governments should also provide resources to bolster this system. While enhancements to our crisis system’s capacity are urgently needed, solely building up the crisis response system is not sufficient to fully address the needs of people experiencing crises and frontline workers who are caring for them.
“More than a year ago I joined with numerous colleagues across the behavioral health treatment continuum to sound the alarm to government leaders about the state of the crisis response system and scarcity of appropriate community supports, using phrases like 'people in crisis' and 'workforce challenges' and 'the under-resourced behavioral health system.' The stories chronicled in this article are the raw versions of what those phrases mean.”-Daniel Malone
A whole lot of crisis can and will be prevented when we fully attend to the support systems and housing everyone needs. Evidence-based practices implemented at DESC and elsewhere, such as Housing First permanent supportive housing, Assertive Community Treatment, specialized outreach and crisis response programs, and routine behavioral healthcare services delivered in community-based settings for people with long histories of trauma, have been under immense strain during the pandemic. Normal supports have been weakened, and timely interventions not as available.
The Legislature has an opportunity to invest for now & the future
The Washington state Legislature will be convening in January and has an opportunity to invest in behavioral health and affordable housing resources and the essential workforce that prevents people from experiencing a crisis and supports their recovery after a crisis.
There are reasons to be hopeful, at least in the long run. For one, there is an incredible behavioral health workforce, albeit a fractured and hurting one, to build on. At often great personal sacrifice, people continue to show up every day to carry out the proposition that people with psychiatric conditions deserve direct, personal care and can thrive when they get it. Likewise, people with these conditions want that help and care, and make use of it best when it’s consistently available and they aren’t fighting for survival.
System investments can lead us into a new era of behavioral health
The pandemic exacerbated all of this for sure. As that recedes there should be some level of natural improvement. Investments to restore and build the system we all need will get us through the current chaos and into a new era where everyone with psychiatric conditions can resume thriving and healthy lives.
Hobson Place wins excellence award
Hobson Place/The Clinic at Hobson Place wins Affordable Housing Development of the Year award! Congratulations to everyone who was involved in designing, developing and building this project.
This award recognizes a project that exemplifies design, construction, and development excellence while creating lasting social, economic and environmental impacts. Projects addressed “the serious affordable housing crisis in our region and 100% of the residential units within the projects in this category must be income qualified.” You can read more about it here.
National Homelessness Law Center honors Legislator Nicole Macri
The National Homelessness Law Center presented Nicole Macri, 43rd Legislative district representative, with the 2022 State Legislator Award at a ceremony for their Human Right to Housing Awards in Washington, D.C., on Nov. 16. Nicole is DESC's Deputy Director for Strategy.
“I am truly humbled and honored by this recognition,” Macri said. “I share this award with the many people who have worked with me over the years on crafting strategic policies to prevent homelessness and increase housing stability for families across Washington.”
Nicole talks about the need for enhanced crisis services in the photo above.
DESC in the news
Seattle psychiatric nurse reckons with the city’s most vulnerable residents. Seattle Times, originally Washington Post. (This story focuses on suicide, self-harm and other topics related to psychiatric distress.)
Here’s what Seattle-area homeless organizations need this holiday season. Seattle Times. Includes DESC.
- UNIQLO to open its first store in downtown Seattle. The Registry/Pacific Northwest Real Estate. In the lead-up to the grand opening on Nov. 3, UNIQLO donated 1,000 units of cold weather clothing to DESC, and UNIQLO Pine Street team members volunteered at DESC.
Inslee previews homelessness and affordable housing efforts for the 2023 legislative session. Governor’s media release. DESC Deputy Director for Strategy (and state Legislator) Nicole Macri spoke at this press conference, which you can watch here.
Housing Solutions: Build Subsidized Housing Only For The Neediest. Forbes. “One model I have cited often is a project built almost two decades ago in Seattle by the Downtown Emergency Service Center (DESC), a project called 1811.”
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