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Opinion: Behavioral health professionals are key to addressing crisis

Kailey Fiedler-Gohlke and Kim Rettig – Contributing writers

Apr 10, 2021

View Article: Opinion: Behavioral health professionals are key to addressing crisis

In the wake of too many tragedies nationwide, Seattle and many other cities are re-examining how they respond to mental health emergencies. It’s clear that we must respond to these crises with trained caregivers and not law enforcement officers who have a different charge.

As a person living with serious mental illness and as the director of a mental health clubhouse working with people to successfully chart their lives after such a diagnosis, we know all too well what it can mean to have a mental health emergency.

Imagine what it is like to feel highly anxious, to be paranoid about situations that feel normal to others, even to hear voices, only to confront someone in a police uniform.

We have observed the often deadly outcomes of police encounters with individuals in mental health crises. At least one of every four people killed in an interaction with law enforcement has a serious mental health diagnosis, according to a 2015 report from the Treatment Advocacy Center. Black and Indigenous people and other communities of color continue to be disproportionately impacted by these instances, further exacerbating the racial inequities in our system.

When in crisis, people experiencing intense amounts of anxiety and stress act out of fear or misinterpret situations, inadvertently jeopardizing the safety of themselves, or those nearby. These situations can escalate into violence, and too often are the front door to misguided incarceration. For the best outcome, mental health crises should be treated for what they are: health emergencies, not crimes.

The status quo is not a paradigm that works for anyone. Police recognize that they are being asked to do jobs they were never intended to do: responding to people who have mental health needs or who are homeless. Many in the law enforcement community acknowledge that their training is not always best suited to addressing many of these situations. The solution is to develop health-focused models and personnel for responding to these situations — what we call care responders. Seattle Mayor Jenny Durkan and the Seattle City Council took a step in the right direction on this issue at the end of 2020 by expanding Seattle’s Health One program, which uses teams of two firefighters and one case manager to provide specialized outreach, transport and referrals to callers experiencing behavioral health crises, as well as non-emergency medical complaints and those with social service needs.

Gov. Jay Inslee and both chambers of the Legislature further demonstrated the state’s commitment to mental health care by proposing investments in mobile crisis response enhancements for the upcoming fiscal year that align with our care response principles. Legislative leaders are working with stakeholders to implement a coordinated “988” crisis hotline center and crisis services system that will save lives by improving access to behavioral health crisis services.

Seattle leaders should be applauded for expanding this promising, vital program. And Inslee and the Legislature deserve praise for prioritizing the care response model with critical funding in the budget. But with the stakes this high, we can’t can’t stop there. Health One is a promising approach that can, and should, be built upon in collaboration with city and county leaders across the state. The state Legislature has an opportunity to support and expand care responders programs in communities across our state.

Innovation and adequate resources at all levels of government are crucial to expanding this work successfully. Also necessary is working closely with peers — those with lived experience. We must listen to those who are most affected by our flawed emergency response system, hear their stories and engage them in finding solutions. Ideally, we can go beyond this, as some communities have done, by successfully engaging trained peers as part of care-response teams.

Working together, decision-makers, stakeholders and those most affected can build new, better response models that lead with care and focus on the best outcomes for all.

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