Mental health answers sought

In the 34 years since she was diagnosed with bipolar disorder, Terri Marklein has watched friends struggle against government bureaucracies and social stigmas.

Now 60, Marklein has sat on a bevy of boards and countless committees to improve the public mental health system.

“If you’ve been in the system as long as I have, you’ve seen everything tried,” Marklein said. “I just want the people who come after me to have better care than I’ve had.”

Still, Marklein thought a new state program to transform Washington’s troubled mental health care system had started with an interesting concept: Listen to the patients.

At a “listening session” at the Evergreen Club in east Spokane, more than 75 patients, advocates and mental health professionals listed what works and what doesn’t in Washington’s mental health programs.

In the corner, a court reporter furiously typed notes – part of reams of transcripted comments that will be pored over by analysts in Olympia later this year.

“People in this room can teach me some things,” said David Brenna, a senior policy analyst with the state’s five-year transformation project.

The federal government has given the state of Washington more than $13.6 million to transform its mental health system from a lumbering bureaucracy into a sleek, responsive and consumer-friendly model.

In the parlance of state officials, the grant will be used to “build the infrastructure for an ongoing process of planning, action, learning and innovation in mental health.”

But first, the meetings.

The state will host 24 subcomittee meetings, and each committee will produce 15 to 30 priorities. State analysts plan to consult testimony from 22 listening sessions across 14 regional support networks in Washington state, as well as data from telephone surveys, face-to-face interviews and online feedback.

This all adds up to … well, that remains to be seen.

“If we want to get anything done, we’ll need to narrow the scope,” said Ken Stark, director of the mental health transformation grant for Gov. Chris Gregoire’s office. “I struggle with all this process, but it has to be done in order to get information from the community.”

On Wednesday, the community was quite forthcoming. Providers complained about the maze of government regulations and their lack of flexibility. Patients spoke of their personal struggles with mental illness – from lack of insurance to inadequate housing.

“I’m very concerned about people with mental health difficulties who are in jail when they should have other arrangements to better suit them and society,” said Tom Chandler, a 45-year-old man with bipolar disorder.

Steve Winward, a 54-year-old Spokane man with a personality disorder, said he feels trapped. Unable to work because of his illness, he and his wife survive on less than $2,000 a month. That’s too much to qualify for Medicaid, the state-federal program for low-income people. But health insurance remains far too pricey.

Winward said he owes between $15,000 and $20,000 in health bills. Yet each month, he must find the money for the medications that help keep him stable.

“My wife takes her tips and any little money she makes on the side,” he said. “Other times, it goes on the credit cards.”

The stress has taken its toll on Winward, a former mechanic. As the bills mounted, his wife hid his guns and razor blades.

“I don’t know where they are at,” he said, unrolling his sleeves to reveal scars on his forearms, “and I don’t want to know.”