Shortsighted savings on mental health care

Whatever else the 2009 Legislature does, it must change the way this state deals with the mentally ill.

Not just because people with severe psychiatric problems need it. Taxpayers and the public at large are also poorly served – and placed at risk – by failures to connect sick people to the help they need.

A string of violent crimes, most recently a rampage that left six dead in Skagit County, has underscored the problem in the most appalling way.

In the case of 28-year-old Isaac Zamora, who’s been accused of the Skagit killings, family members desperately sought to get him into care as his behavior grew more bizarre and violent.

One characteristic of severe mental illness is that it often leaves patients resisting the very treatment they need. Nor, in this state, can they be required to accept therapy except in the most dire cases. Washington law – as extreme as any in the country – bars mandatory treatment unless disturbed people pose an imminent threat to themselves or others.

The killing of a woman in Seattle last year by another violent, mentally ill man led King County Prosecutor Dan Satterberg to convene a task force to study the problem. It is reportedly about to propose several legislative measures, including:

 • Broader power to enforce outpatient treatment.

 • Giving police easier access to suspects’ mental health histories.

 • Letting the people who make involuntary commitment decisions take into account a patient’s record of violence – not just the imminent threat in the here-and-now.

Good ideas. Another good idea would be to completely rethink how the state spends its money dealing with the people with psychiatric disturbances.

A recent analysis by the Seattle Post-Intelligencer estimated that Washington sinks a staggering $1.8 billion a year into mental illness. Unfortunately, only about $530 million of that goes to anything related to treatment.

More than twice that sum is spent doing other things with the mentally ill – such as arresting, jailing or prosecuting disturbed people who might never have run afoul of the law if they’d received proper care. Or holding them in emergency rooms at great expense to the public.

This staggering waste of money results from a false economy. The state government has long refused to cover the real up-front costs of psychiatric treatment. According to the P-I analysis, Washington ranks last in the country for providing community-based psychiatric beds – even as it continues to eliminate beds at Western State Hospital.

It makes no kind of sense to skimp on care for severely disturbed individuals until some of them explode. Dealing with mental illness on the cheap has proven very expensive in this state.