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There’s too much bad news these days about the failure
of the mental health care system and the seeming inability
of policymakers to address the problems. So, here’s
some good news.
In the 2007 legislative session, Washington State leaders
took a significant step toward fixing what’s wrong
with mental health services in the state. And they did
it not just in reaction to a horrific tragedy, but as
a result of hard work and persistent lobbying by hundreds
of people who work within the mental health care system.
For the past three years, I’ve worked as a therapist
in community mental health care in Seattle. It’s
always hard work but it has big rewards when people get
better. When I get to witness a person creating a life
worth living and finding a sense of hope restored, it
is quite rewarding.
Unfortunately, working in community mental health is very
frustrating. There is never enough time for the clients,
there’s an excess of regulations that complicate
the process and there are very long wait times for appointments
and the proper treatments. Plus, there are increasing
amounts of paperwork which result in a system where the
client’s needs start to look like they become the
least important priority.
I get frustrated when I am not able to give a client the
treatment they need because my caseload is so large or
we don’t have the resources to provide the type
of treatment they need. It’s also discouraging to
the clients and they are not surprised when the mental
health care system breaks down again. It’s no wonder
so many mental health clients leave treatment and end
up in our emergency rooms, state hospitals or jails.
Countless studies have shown what’s obvious to me
and my co-workers: In mental health treatment, the key
to a client’s recovery is a stable and trusting
relationship with their therapist.
But our historically and chronically under-funded community
mental health system does not allow for client-therapist
relationships to be formed because of the constant turnover.
High workloads and increasing paperwork demands make it
impossible to spend enough time with our clients. This
translates to frontline staff turnover averages of 33
percent a year and at some agencies it’s over 50
percent. Mental health professionals with bachelor’s
and master’s degrees make less than $30,000 a year
in community mental health, which is $15,000 or more below
what we can make in comparable jobs or in private practice.
My colleagues and I work in the community because we share
a passion for serving the most vulnerable people. Unfortunately,
when our passion runs into the economic realities of paying
off student loans, starting a family or buying a house
we end up making the difficult decision to leave community
mental health.
In the past year, rather than feeling hopeless, my colleagues
and I decided to do something about the situation. Along
with other community mental health workers who belong
to Service Employees International Union District 1199NW,
we formed the Campaign for Quality Mental Health Care.
With other mental health advocates, we reached out to
legislators, telling them about our heavy caseloads, low
pay and benefits. Hundreds of community mental health
workers wrote letters, made calls, sent emails and personally
lobbied our elected officials.
We told legislators about clients who left treatment because
the system broke down again and again. And we told them
our stories of success — clients who got better,
found hope and began leading productive lives again in
our community. We urged our legislators to fund workforce
stabilization in order to improve services and build safer
communities. Our employers weighed in to support increased
funding.
As we told our stories to legislators, Democrats and Republicans
began telling us about how mental illness had touched
their lives — a friend, a neighbor, a loved one,
or even themselves.
When the Legislature’s final budget was unveiled,
we were excited to see $24.5 million in new funds dedicated
toward stabilizing the community mental health workforce
by improving wages and benefits.
I’ve learned two things from this experience. First,
that ordinary citizens can work together and get state
leaders to fix problems in our community.
Second, we got quite a bit accomplished and there
is still a lot of work to be done. Working together,
union members, employers, consumers and other mental
health advocates can effectively push for improved funding
and services, so that people like me will never have
to say “No” to a client. |