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.
Mike Staszak is a therapist at Community Psychiatric Clinic in Seattle, as well as a member of SEIU 1199NW.