Mental health services a critical investment

Published on Wed, Apr 23, 2014 by Bill Elfo and Anne Deacon

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Whatcom County is experiencing a disturbing trend shared with the rest of our nation. Our jails and prisons are becoming de facto mental health institutions for our country. 

The number of seriously mentally ill people held on criminal charges in the Whatcom County Jail has increased significantly over the past decade. The county jail operates at nearly twice its designed capacity and very little space exists for special housing and treatment of these offenders. 

The problem has been exasperated by federal and state reductions in funding for community-based mental health treatment. Some symptoms of untreated mental illness ultimately lead to crime and incarceration. Jail operations are also significantly impacted by reductions in services at Western State Hospital, where offenders receive competency evaluations. The long wait for these evaluations results in offenders remaining in county jail, often without the necessary treatment for restoring mental health and stability.  

Many crimes and prosecutions could be prevented if community-based mental health services were available. But funding of these programs has also experienced significant reductions. Many mentally ill offenders who find themselves in jail are uninsured and do not have the resources to pay treatment costs. Under federal law, offenders insured through Medicaid and Medicare lose medical benefits once they are booked into jail. Treatment costs become the responsibility of local taxpayers. Once released from jail, they risk falling through the cracks of a disjointed system and may not re-enroll in these public benefit programs. Without appropriate treatment and medication, disabling symptoms may generate the same behaviors that send them back to jail as a direct result of their untreated disorders. 

As Whatcom County continues to plan for a replacement jail facility with adequate space to safely hold, monitor and treat those with more serious forms of mental illness, a more effective treatment strategy could not be delayed. To help stem the revolving jail door and enhance public safety, the sheriff’s office partnered with the Whatcom County Health Department to expand the Jail Behavioral Health Program. The goal of the program is to stabilize behavioral health symptoms for jail inmates and ensure connection to community services upon their release.

A contract funded through the behavioral health sales tax provides professionals from a local non-profit psychiatric clinic to diagnose and treat acute symptoms of the most serious forms of mental illness. The process includes screening, triage, assessment, treatment planning, medications, counseling, coordination of civil commitment evaluations, connection to community-based treatment and assistance with healthcare enrollment or re-enrollment.

The program was initiated in February 2013. During the next 11 months, 7,601 people were booked into jail. Of those, 3,867 were referred for behavioral health services. Of those referred for treatment, 86 percent received services within 24 hours of booking. Staff is continuing to evaluate the program and will track improvements in behavioral health within the jail as well as the offenders who were treated in the jail and subsequently received timely community-based treatment. 

Due in part to the expansion of mental health services within the jail and efforts made for a continuum of treatment in the community, the sheriff’s office recently received re-accreditation from the acclaimed National Commission on Correctional Health Care (NCCHC). The Whatcom County Sheriff’s Office is only one of two correctional agencies in the state to hold accreditation. The accreditation ensures that industry standards are being met and helps shield the county from potential risks and liabilities. NCCHC noted the exceptional collaboration between our behavioral health and correctional staff in its recent accreditation visit. 

Behavioral health revenues also fund a number of other successful programs that are designed to enhance public safety and treat offenders. Whatcom County District Court provides intensive out-of-custody pre-trial supervision and treatment for many with mental health and substance abuse issues. The Superior Court operates an adult and juvenile drug court diversion program. A joint city of Bellingham municipal court and Whatcom County District Court mental health court is being planned as a means to divert offenders from the criminal justice system to effective mental health treatment and supervision. 

Revenues also support mental health services in all seven school districts. An ounce of prevention is worth a pound of cure. Intervening early to support our youth challenged with behavioral health concerns can prevent an unnecessary default to the criminal justice system later in life. It is a critical investment in the future health of our youth and ultimately our community. Mental health treatment works and we must ensure it is available to all who need it.


Anne Deacon is the Human Services Manager for the Whatcom County Health Department.

Bill Elfo is the Whatcom County Sheriff  and Chair Whatcom County Behavioral Health Revenue Advisory Committee.