Another Mental Health Program Cut Funding Changes Force County To Focus On Emergency Services

Another program intended to keep people who are mentally ill out of hospitals and jails will be cut next month.

Spokane Mental Health’s Intensive Outpatient Program is the third program with a rehabilitative focus to be eliminated as part of controversial reforms of the public mental health system in Spokane County.

Closures of the Evergreen Club and RALLE program previously drew criticism from patients who relied on them to stay healthy.

County officials say limited funding required them to prioritize emergency services above those for rehabilitation. Other new programs will offer help, they say.

The overhauled public mental health system begins Thursday for thousands of county residents too poor to pay for their own treatment.

Mental health officials, therapists and advocates for the mentally ill say cutting rehabilitative programs could end up costing the community.

“With that loss, there’s a much bigger hole to be filled than can be filled with individual therapy,” said David Panken, chief executive of Spokane Mental Health. “This is an issue about quality of life, not just treatment.”

Announcing the July 31 closure of the Intensive Outpatient Program, he said, “There’s been no other program for severe, persistent mental illness that’s met with that success and gotten people back to work.”

The Intensive Outpatient Program served people with severe, chronic problems in a group setting.

The Evergreen Club was a daytreatment center where the mentally ill socialized, saw therapists and hunted for jobs. Sacred Heart Medical Center’s RALLE Program served people with disorders such as depression and anorexia in a group setting.

Tom Richardson, president of the Washington chapter of the National Alliance for the Mentally Ill, said closure of programs like the Evergreen Club is indicative of a statewide trend toward treating patients only when they reach crisis.

“Our system is moving to, `Let’s wait until they move way off the deep end and then bring them back,”’ Richardson said.

Doing so is more expensive than focusing on prevention, and causes permanent harm to patients, he said.

“Every time you suffer psychosis, there’s further brain damage that is irreparable,” he said.

“It’s like a bouncing ball. Each time you drop to the bottom of psychosis, you can be brought back with medication and help. But you don’t come back up quite as high as before. Your long-term recovery is more difficult.”

Kasey Kramer, head of the county’s Community Services and Community Development departments, said limited funding required tough choices.

County staff prioritized services for the mentally ill in emergency situations first, he said.

They also paid for doctors and nurses, and case managers to visit the mentally ill at home, at schools and public health clinics, and in jail.

There wasn’t enough left for rehabilitative programs, he said.

“Cost is a factor in the decision-making of how to allocate the taxpayer dollars,” he said.

County staff members are unsure “whether or not the investment is paying off, whether the rehabilitative aspects are paying off.”

Discussions about opening a new, smaller version of the Evergreen Club begin next week, he said.

As some mourned the loss of programs, Spokane Mental Health staff fretted for their jobs.

The nonprofit agency, which for 30 years has been the umbrella for all publicly funded mental health services in Spokane County, is losing a quarter of its work force - 90 jobs - because of the reforms.

Dozens of other nonprofit agencies will receive much of the money previously funneled to Spokane Mental Health.

Agency staff members were told on Tuesday the details of the cuts. The agency’s top administration shrank from seven positions to six. No salaries will be cut, Panken said.

Among the hardest hit was the department serving children and adolescents, which will lose 20 of its 71 staffers.

As elsewhere at the agency, staff in Heidi Whitney’s department will reapply for their jobs on Friday. Co-workers are now competitors.

“It feels really sad” for the agency, said Whitney, a single mother of two teenage boys. “Every day we’re walking further into chaos that doesn’t always make sense.”

Staff have known jobs would be cut since last fall. But few guessed the extent of the layoffs.

Caprice Morrison, a therapist who is six months pregnant, said finding other work would be difficult if she loses out in the job lottery. She worries about losing medical benefits while pregnant, and says she may have to move in with her parents.

“For me, it’s been difficult to have to have the motivation to go to work,” she said. “When I get there, there’s a lot of anxiety, depression and stress rolled into one.”

As they await their fate, staff members were busy on Tuesday closing as many cases as possible, and offering parents of mentally ill children a list of agencies where they can get help.

The most critically ill will remain with agency staff.

Sending fragile children - who can reach crisis by a simple change of a school teacher - to a new therapist unnerves Whitney and Morrison.

“What’s saddest is the foster kids, who’ve had so much change already,” Whitney said. “They say, `You’re going to go away, too?’ “I think it’s going to be real chaotic for Spokane for a while,” she said.