Psychiatric hospital planned amid soaring demand for care

The state has been sanctioned multiple times for violating the constitutional rights of patients, who sometimes languish in jail instead of receiving treatment.

Many times, the callers are relatives of someone having serious psychiatric symptoms: hallucinations, psychosis or suicidal thoughts and behaviors.

Frontier Behavioral Health, which provides mental health services to Medicaid patients in the Spokane area, has seen an 80 percent increase in new patients since 2012, mostly as a result of Medicaid expansion, CEO Jeff Thomas said.

Years of anemic state funding have also created a backlog of people needing serious mental health care, said Ron Escarda, CEO of Fairfax.

Washington's Department of Social and Health Services, which operates state mental hospitals, was sued in 2014 over "psychiatric boarding," where patients with severe mental illnesses sat in emergency rooms because there weren't enough beds available in psychiatric facilities.

A federal judge ruled in 2014 the department was violating the constitutional rights of jail inmates with suspected mental illnesses by leaving people stuck in jail, sometimes for months.

The emergency room has seven designated psychiatric beds, but other beds are often full of psychiatric patients as well, emergency department director Alex Richards said.

Mental health providers say the new psychiatric hospital should relieve pressure on the region's overburdened mental health system.

[...] concerns remain about whether the state will provide enough funding to cover Medicaid patients seeking care and whether the hospital will increase competition for a scarce supply of psychiatrists.

Escarda said patients could be referred to the new hospital from community providers, like Frontier, or through visits to the emergency room, in addition to seeking care on their own.

In many states, federal Medicaid money can't be used to pay for inpatient behavioral health care in facilities over a certain number of beds.

Christine Barada, director of the county's Community Services, Housing and Community Development Department, said she's concerned the state may sign a contract with the new hospital, which would obligate the county organization to pay for beds at a negotiated rate, whether or not they're given any funding to do so.

Gov. Jay Inslee's budget proposal included expanded mental health funding, which Barada said would likely include giving county behavioral health organizations more funding to cover services like this.

Administrators at Frontier Behavioral Health and Eastern State Hospital, the other largest providers of mental health care in Spokane County, say the new beds will be good for the community, but worry about losing staff to a private entity that can afford to pay more.

Demand is soaring as baby boomers retire and need more health care, and nursing schools only have capacity for about one-third of qualified people who apply.