Cheer new Tacoma psych hospital, then get to work staffing it

Puget Sound power brokers have decided a great way to solve outsized problems and squelch outside competition is to forge alliances between traditional adversaries.

Consider the Northwest Seaport Alliance. The Ports of Tacoma and Seattle signed a truce last year and are now pooling their resources to stay afloat in the deepwater shipping game. They’re challenging all comers, from the Panama Canal to the Port of Prince Rupert.

Another new group that’s wielding influence is the Alliance for South Sound Health. It unites two fiercely competitive nonprofits, MultiCare and CHI Franciscan health care systems, to plug a gaping hole for acute mental-health treatment in Tacoma – a formidable task that neither could accomplish alone.

The health alliance, cheered on by a who’s who of Pierce County civic leaders, secured the state’s blessing this month to build a 120-bed, $41 million psychiatric hospital on the campus of Allenmore Hospital in Central Tacoma. Their application beat out a competing proposal from a California for-profit company.

Alliance members have reason to celebrate. The community is overdue for good news on the mental-health front at a time when Western State Hospital is in crisis mode, hundreds of citizens with untreated psychoses have been warehoused in jail cells and emergency rooms, and the county has a mere 2.8 treatment beds available for every 100,000 residents – about one-tenth the national average.

After the champagne corks stop popping, the real work begins.

One of the most critical steps will be staffing the hospital adequately. The state Department of Health must review and approve a list of key staff before the hospital’s projected 2018 opening.

The alliance expects to have about 250 employees when all the wards are open. It should start planning immediately for a first-rate team of directors, psychiatrists, nurses, social workers and therapists.

Just how vital is it to recruit and retain high-quality mental-health professionals? Much of what’s wrong at Western State Hospital – forced overtime, poor training, unsafe conditions, low morale – revolves around a chronically muddled staffing picture.

In September, the 800-acre Lakewood campus had more than 300 open jobs, including 10 psychiatrists and more than 50 registered nurses. And this was after six months of active recruiting filled hundreds of other positions.

Understaffing also contributed to the downfall of Puget Sound Hospital, the last inpatient psychiatric hospital in Tacoma. The facility on Pacific Avenue went through various incarnations and rolling closures before locking its doors permanently in 2010. An emergency shutdown in 2006 was precipitated by what a state licensing official called “a very serious shortage of staff, leading to all kinds of other problems.”

The U.S. simply doesn’t produce enough mental-health professionals, especially since the Affordable Care Act mandated equal coverage for mental-health conditions. The No. 3 most in-demand medical specialists in 2015 were psychiatrists, according to Merritt Hawkins, a national recruiter of doctors and advanced practitioners.

The alliance knows what it’s up against. It is already bolstering its mental-health foundation through internships and fellowships with the University of Washington School of Medicine. It plans to hire specialists into inpatient and outpatient settings around the region, then move them to the new Tacoma hospital when the time is right.

State officials can help by expanding access to psychiatric residency programs and medical school rotations. They can offer better scholarships, debt-forgiveness incentives and other sweeteners for students committed to working in these high-stress careers. And they can make sure the new Washington State University School of Medicine has a strong psychiatry component.

In short, building and sustaining a reputable psychiatric hospital in Tacoma will require help from legislators, universities and others. Nobody benefits, least of all people coping with mental illness, from a zero-sum cycle in which Puget Sound mental-health institutions have to poach staff from each other.

The local health alliance needs all the allies it can find because psychiatric facilities are notoriously difficult to operate, and because Pierce County is a notoriously difficult place to operate them.

This story was originally published January 23, 2016 at 3:39 AM with the headline "Cheer new Tacoma psych hospital, then get to work staffing it."