Community-Based Treatment

Governor Inslee’s Five-Year Plan and Vision to Transform Washington’s Behavioral Health Systems

“We are trying to provide 21st century medical care using a 19th century model of care. Large institutions were popular in 1918, but in 2018, we know smaller hospitals closer to home are far more effective for patients. Through a combination of mostly state-run options, we will be able to serve nearly all our civil patients in smaller facilities that are much closer to home and much more able to sustain the kind of supports that ensure patients get the right care at the right time. Gov. Jay Inslee (Policy Brief. December 2018)

Supporting the Governor’s Vision

Two years ago, Governor Inslee laid out his vision to provide services in local communities for people with acute mental illness. Serving people in their home communities is essential to this plan. To do this, this transformation requires development of a continuum of services that can prevent or divert people from being committed to the state hospitals and can support people in their recovery after treatment in a hospital is complete. The interest by Governor Inslee and the Legislature is spurred by Washington’s rank of 47th in the nation in capacity for appropriate mental health services. Compared to the rest of the country, Washington has a high prevalence of mental illness and low access to care. Within two years, the state will need almost 370 more civil beds than our current capacity. The state is at the beginning of a major reform of the entire mental health service delivery model. Other state agencies and the University of Washington also have been funded and charged with the responsibility to increase the number of psychiatric services in our communities, as well as support services such as housing.

DSHS' Commitment to Community-Based Treatment

The Legislature supported Governor Inslee's concept and, in the 2019 Session, enacted a budget and provided direction to the Department of Social and Health Services to begin development of three small community-based/ behavioral health residential treatment facilities. These facilities would provide a range of services to people as they move through the treatment regimen: evaluation and treatment, 90-day to 180-day intensive treatment, and a step-down program to ready people for their return to home and work. The department is required to submit to the Legislature a preliminary predesign of these facilities by December 31, 2019. The department is at the early stages of this development process. We have several geographic areas that we are researching to determine suitability based on access to a qualified staff pool; existence of other community services and supports; availability of land and utilities and; suitability for neighboring homes, businesses, and industries.