By Erica C. Barnett

On Thursday morning, King County Executive Dow Constantine announced his plan to introduce a plan to expand services for people experiencing behavioral health crisis as part of his 2023 budget proposal in September. The plan will attempt to address the worsening shortage of short- and long-term treatment for people with behavioral health conditions and substance use disorder. As of this year, Constantine said, the county has lost a third of its residential behavioral health care beds, “and it would have been more but for our intervention. And more facilities are potentially closing their doors in the months ahead.”

Currently, there is only one 16-bed crisis stabilization unit—the Downtown Emergency Service Center’s Crisis Solutions Center—in the entire county. A person in crisis who needs help right away can call 911 or the new 988 mental health crisis line, but people who need immediate, intensive intervention generally have nowhere to go but emergency rooms, which are ill-equipped to deal with behavioral health crises, or jail.

Gesturing toward the King County Correctional Facility across the street from the county building where the press conference was taking place, Constantine noted that of about 1,530 people in the county jail, more than 600, or two in five, are in some kind of treatment for behavioral health conditions. Many of those have been jailed for crimes that are often related to mental health conditions and poverty, such as theft, trespassing, and assault.

“We cannot accept having the county jail as the main place for people to get behavioral health care. And right now, the fact is that the jail across the street is the second largest behavioral health facility in the state of Washington. We can’t accept relying on law enforcement to solve what is ultimately the health care challenge,” Constantine said.

Constantine did not provide any details about the scope or cost of his plan, which the county is working on as part of a coalition with other elected officals—including state Rep. Nicole Macri (D-43), Seattle Mayor Bruce Harrell, and King County Councilmember Girmay Zahilay—and health care providers. However, he did indicate that in addition to new walk-in crisis centers, it will include better pay for behavioral health-care workers, such as Naomi Morris, a registered nurse who works for DESC.

“I’m glad we’re here to be talking about potentially expanding [the crisis] system,” Morris said, “but we can’t just expand it. We need to fix what is broken. And if I’m being honest with you, I am part of what’s broken, and every other behavioral health workerm because the system has put us in an impossible situation.” Morris said a coworker recently had to take unpaid leave to deal with the trauma caused by their job as a case manager and found themselves unable to meet their basic needs because “the amount of money they make [is] barely above what the clients we serve get.”

Earlier this year, the King County Regional Homelessness Authority asked the city to pay for salary increases for people who work for agencies like DESC; the KCRHA also funds its own in-house outreach team and pays them significantly more than nonprofit employees doing similar work.