Washington State revolving door mental health care, funding crisis continues

The phrase "revolving door" patient has been used quite often to describe the mental health care in Washington state. I have personally witnessed dozens of clients in the mental health system return again and again to the same hospitals, the same out patient care facilities, to the point, that after 4 years I know clients in the system by name, and they know me. They also know my daughter, who is also a revolving door client.

The state has limited funding for care for mental health patients, limited resources for out patient care, and I have personally had clients cry on my shoulder when they were discharged to the streets or a homeless shelter. I have witnessed much in this system as a mother who stands alongside her daughter, who is a vulnerable client.

To receive a phone call after 9pm at night in October, and being told my daughter was missing for 3 hours and having the state ran care facility staff tell me they were ordered "by the boss" not to call the police---was unacceptable, and that facility placed my daughter in grave danger.

To have a parent call 911 and report her vulnerable daughter missing from 45 minutes away in another city, to have a parent drive and look for her daughter until nearly 1am, terrified she would be found dead or never at all, or victimized, is not acceptable.

My daughter was one of the "lucky" clients who was discharged to a state ran care facility to reside, which of course is questionable now, about what safety and care really means in this system.

This has got to stop.
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The article below is dated 2005, and I dare say that is when my daughter entered the adult system (December 31, 2005 age 18) and the nightmare of care and revolving door began. Things have not changed.

Western State Hospital Discharging Patients to “Unsafe Places”--Injunction sought to force State to halt “unprofessional” practice-2005

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My daughter was dumped to the curb in June 2007 by a medical hospital when she was admitted for dehydration; because the doctor said she "is a psych patient, she cannot sleep here". She has been treated inhumanely in ER seclusion rooms, often laying in her own urine and left alone for hours on end while waiting for MHP's to come assess her for ITA admit to a locked psych ward.

If I wasn't there, what would happen to her? Look where my advocacy got her today. She ended up at Western State Hospital, and is now waiting for housing again.

It all comes down to funding/money and lack of facilities to discharge to, and if I took her home, she loses all services. You do not get housing unless discharged from a hospital, and if you go home with parents, you get a case manager appointment. She's on Medicaid, by age 22 is in a system that lacks dignity, and funding for residential living situations, the one place that they all end up at if they have no where to go is Western.

It is a revolving door, where agencies do not collectively work together, where people pass the buck and push people around, in the process. I have stories that can make a person sob.

The outside air time is the least of my worries, it is a right, oh yes it is---but she also has a right to reside in a safe place in the least restrictive way, and once she is out of Western, she will be in the care of another facility that could jeopardize her safety again. The track record in this state isn't so great, and many doctors I've asked over the last 4 years have never been to residential facilities, some have no idea what happens to the patients once they discharge from a hospital.

This is the harsh and cold reality, that doctors hands are tied, stuck in a system where they are themselves confined to offer only so much to a patient, because of lack of money.

The residential places are so few and far between, that people are being discharged to homeless shelters. It happens from Harborview Hospital, I've witnessed it happen in 2007 to 2 women at NAVOS hospital, and Western's history speaks for itself when my daughter was discharged to me, while still severely psychotic in March 2006, due to sexual assault threat. The letter I have from DSHS states, that it was not too much to ask for her safety there, and they sent her home. Without services, with a case manager appointment 6 weeks later, she never made it to that appointment, because she ended up back in the hospital.

The revolving door then hosted patients I had met before, again and again. I've also witnessed more young people her age in the hospitals the last several months, and there are a few I know from when she was a teen at Fairfax, the private facility where many foster kids were waiting discharge to RTC's.
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Seattle PI news article, showing a mother and son on a walk at Western Hospital in 2008. The story has an ironic resemblance to my daughters showing the same age and same hospital pattern, from the teen hospital to Western.

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My daughter is not the only person in this mental health system, there are hundreds of people, if not thousands that need the Governor to know cutting the budget for mental health care is not acceptable. Removing and closing long term care facilities is not acceptable, and most important:

Placing people like my daughter, who are deemed the most vulnerable in society in danger by not having appropriate facilities to discharge to is not acceptable and in my opinion a crime against humanity.