Psychiatric boarding. Emergency-room parking. Single-bed certification.
Those phrases — all related to mental health treatment — were new to most of us two years ago when News Tribune investigative reporter Sean Robinson started looking into them.
The phrases have since become part of the vocabulary of family members, caregivers, county officials, legislators and the judicial system as they work to end this destructive practice and otherwise improve care for the mentally ill. A number of individuals and agencies are trying to find solutions, but it’s clear The News Tribune’s reporting helped bring the matter to the fore.
The TNT headed into 2013 with a plan to have Robinson focus his investigative spotlight on the state’s mental health treatment system. The system was broken, ravaged by years of budget cuts. In the preceding months, our paper was littered with horrific stories exemplifying the problem:
• A young mentally ill woman shot three people in a Key Peninsula grocery store, killing one. She thought she was hunting pedophiles. Her mother had tried, but failed, to get her help.
• A Tacoma man with more than 300 contacts with the state mental health system, who said again and again that he would kill his parents, inexplicably was released from Western State Hospital. He murdered his father with a hatchet.
• A psychotic homeless woman stabbed her mother to death in the family’s home in Buckley to stop what she called a “spiritual rape.”
Why weren’t people with mental illness getting the help they needed?
In his quest for answers, Robinson stumbled into the problem of psychiatric boarding, also known as ER parking or single-bed certification.
Patients come into hospital emergency rooms with mental illnesses the hospitals are not equipped to treat. Western State doesn’t have room for them, and neither do county facilities. The patients sit in the hospitals, their mental illnesses untreated.
Sometimes they wait for days, sometimes for weeks or months. Often they deteriorate further. Sometimes they hurt themselves or hospital staff or fellow patients.
Robinson sat in the little-known involuntary commitment court at Western State and watched the ER parking process unfold. On Feb. 27, 2013, for instance, 11 patients from local hospitals were wheeled into court on gurneys seeking mental health treatment. Most were denied, loaded back into ambulances and returned to the hospitals.
Robinson was the only reporter there. We had to get a court order that allowed him in. He took pictures of the ambulances. We ran them on the front page.
Pierce County Superior Court Commissioner Craig Adams, who ran the commitment court, ruled the next month that ER parking violated state and federal law. His was the first shot in a two-year battle to eliminate the practice.
Robinson followed up with an in-depth narrative on ER parking told through the eyes of real people trying desperately to get care.
The matter began to draw some attention.
Months later, The Seattle Times followed with its own version of the Robinson story focused on patients in King County. And in his opening of the 2014 session of the Legislature, House Speaker Frank Chopp said: “This year, we must focus our attention on helping those with mental illness and those with disabilities. It is a disgrace to park people in hospital hallways. It is a disgrace to let the homeless mentally ill die in the streets. This has got to end.”
Over the past two years, Robinson wrote 32 stories related to problems with mental health services, including ER parking. Other TNT reporters pitched in, as well, and the editorial board maintained a drumbeat in support of improvements.
A few months ago came the first headline indicating change:
• “High court strikes down practice of psychiatric boarding”
And in December alone came these headlines:
• “New hospital would serve mental health; groups including MultiCare/Franciscan seek approvals to build”
• “Inslee budget seeks capital gains tax; tax would go to support schools, mental-health treatment, worker salaries”
• “Cities to hire mental health professionals to aid police; Tacoma, Lakewood poised to have their officers get help with mentally ill subjects”
• “Long jail waits for mentally ill illegal, must stop, judge rules”
• “Mentally ill no longer forced to wait in hospital hallways; Supreme Court requires state to find money for short-term psychiatric care”
• “County’s ‘mental health court’ ready for test”
Many of these stories offer promises of better care that may or may not be fulfilled.
But before we can begin to fix a problem, the public and those in power need to know it exists. A newspaper’s role is to shine a light into dark corners with the goal — ultimately — of trying to make this a better place to live. For everyone.
We plan to stay on this story.