Smith leads effort to fix mental health system

Rep. Norma Smith employed her good-natured tenacity, in-depth knowledge of state government and bipartisan spirit to help lead an effort lawmakers hope will transform the state’s mental and behavioral health system.

The four-month effort by Smith, a Republican from Clinton, and Rep. Strom Peterson, an Edmonds Democrat, was historic. The two-year capital budget includes $308.1 million in spending for a new behavioral health teaching hospital at the University of Washington, housing grants, more treatment facilities across the state — including one in Oak Harbor — and additional psychiatric beds.

That’s 15 times the investment made in the 2013-15 budget, for example.

“It’s an amazing, amazing story of everyone coming together,” she said. “We were all in this together.”

Smith said she and Peterson were assigned by leaders of the capital budget committee to do a “deep dive” and come up with a plan to plug the many holes in the state’s mental health and behavioral health response.

“What Rep. Peterson and I found was sadly stunning,” she said.

“Clearly there was no vision keeper.”

Several departments in the state are involved in different aspects of mental and behavioral health, but there was little communication and no overarching plan. Smith said one of her first steps was figuring out what projects were already in the works and mapping out when they come online in order to define deficiencies and avoid redundancy.

In addition, Smith and Peterson worked with lawmakers writing the operating budget to ensure that funds will be available to run the new facilities, a step which hadn’t been done in the past.

As an Island County commissioner, Jill Johnson has worked to understand and improve the mental and behavioral health system and has been a strong supporter of a crisis stabilization and detox center planned for Oak Harbor.

Smith was able to get $1 million for the project in the new capital budget, which comes after the original $4 million allocation last year.

Johnson said the realization of how much Smith accomplished with the capital budget brought her to tears because it represents “a monumental step toward ensuring access to treatment and care for those who struggle with mental health.”

“She inspires me to fight the good fight every day,” Johnson said. “She leads with her heart and backs it up with intellect and a deep understanding of the issues.”

The problems with the state’s mental and behavioral health care system are well documented. A lack of beds for competency evaluations and restoration led to a federal lawsuit and jails filled with people who shouldn’t be there.

The federal government de-certified Western State Hospital, the state’s largest psychiatric hospital, for not meeting standards.

Smith said she’s sat with many families and listened to people “falling apart” because they can’t get help for someone with a mental health or drug problem.

The lack of investment in the past, Smith conjectured, may have been a byproduct of the sophisticated lobbying efforts by other special interest groups over the years. In contrast, lobbyists and advocates for behavioral and mental health care couldn’t compete.

This year, the lawmakers became the advocates, she said.

The capital budget includes $120 million in Behavioral Health Capacity grants for community mental health facilities. Smith said the grants will be prioritized for rural areas, which have been largely underserved.

About $35 million was allocated to the Housing Trust fund for supportive housing for the chronically mental ill.

Nearly $34 million was included to plan and design a behavioral health teaching facility run by the University of Washington. Smith said she pushed to move the project along as soon as possible.

More than $64.4 million was allocated for patient safety and other necessary upgrades at Western and Eastern state hospitals.

A total of $55 million is in the budget to increase and improve capacity at Western State Hospital and new state-run community settings.

The importance of the unprecedented investment was evident during the emotional floor speeches given by Smith and others involved in the effort.

Smith focused on how so many people came together to make the issue the priority it should be.

Peterson said behavioral health needs continue to grow and investment lags behind.

“This capital budget not only invests in the immediate needs of increasing and improving treatment capacity and community-based services,” he said, “but also serves as a foundation for the future of our behavioral health system.”