By Girmay Zahilay
King County Councilmember
On March 25, 1966, at the convention of the Medical Committee for Human Rights in Chicago, Dr. Martin Luther King, Jr. said, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”
Based on these words, it’s not hard to imagine that Dr. King would be shocked by the lack of care for people in behavioral health crisis in King County. It’s not hard to imagine that Dr. King would find it inhumane that so many in our region are left to suffer in the streets from their psychiatric conditions and addictions. It’s not hard to imagine that in the County named after him, Dr. King would expect us to do right by our sick neighbors.
Contrary to the values of our namesake, Martin Luther King County is in the midst of a health care crisis. An unprecedented number of people are experiencing mental illnesses and substance use disorders with nowhere to go for relief. In even further divergence from Dr. King’s sense of justice, Black communities are bearing a disproportionate share of this crisis. Black people in King County are more likely to suffer from behavioral health issues, substance use disorders, fatal overdoses, and homelessness. Furthermore, rates of self harm amongst Black adults, teens, and children have sharply increased in the past two decades.
These problems persist, in part, because there are devastatingly few places for people to go for treatment. Hospitals are beyond capacity, emergency rooms are full, shelters are overflowing, jails are at their breaking points, and the places that actually specialize in behavioral health services are woefully inadequate. There is only one 46-bed crisis care facility for our entire county of 2.3 million people, and in order for one of our neighbors to access this facility, they need a referral from a first responder. Without a first responder referral, there are exactly zero options in King County for someone seeking urgent care for a behavioral health crisis.
To make matters worse, our region has lost one third of its long-term residential treatment beds in recent years. Indeed, the places where people would stay for long-term care have gone from 355 beds in 2018 to 244 beds today. As of July 2022, people were waiting an average of 44 days to access a mental health residential bed.
Just like the physical infrastructure described above, the workforce operating these facilities is also in a historic decline. Behavioral health agencies in 2021 saw at least double the job vacancies of 2019. Workers aren’t being paid enough, recruited enough, trained enough, or supported enough to do these extremely difficult jobs.
Addressing these issues and promoting the health of our loved ones and neighbors means giving people somewhere to go when they are in crisis. That’s why over the past year I have been working with a coalition of partners to propose the Crisis Care Centers initiative. This initiative would make a generational investment in our region’s behavioral health system: $1.25 billion dollars to build five crisis care centers around the region, preserve and increase residential treatment beds, and invest in a robust behavioral health workforce.
Crisis care centers would be a network of buildings across the county where anyone could walk in to access stabilizing, potentially life-saving support. This investment, along with more long-term residential beds and a healthy workforce, would give our sick neighbors better places to go than suffering in the streets, jails, or jam-packed emergency rooms.
If our legislation passes out of the King County Council and the Regional Policy Committee, it would then go to the ballot this April for voters to approve or reject. I hope voters will approve this Crisis Care Centers measure.
But we cannot stop there. We must also address the root causes of behavioral health issues in the Black community, including poverty and systemic racism. This means supporting initiatives that promote economic and social equity, such as affordable housing and living wages. It also means investing in culturally appropriate education and outreach efforts that provide critical information and debunk the stigma surrounding mental illness.
It is time for action. The behavioral health of Black people in King County is in crisis, and it’s up to all of us to build the vision of health equity described by Dr. King.
