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Spokane, Washington  Est. May 19, 1883

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Opinion >  Editorial

Editorial: Shortage of mental health care providers is concerning

Efforts to treat depression and other mental illnesses have grown, but the availability of caregivers is not keeping pace.

It’s a good news/bad news story that frustrates the medical community, policy makers and government institutions.

The good news is the increased recognition that early intervention pays off. The Mental Health Parity Act and the Affordable Care Act have combined to bring about more preventive services and early treatment to behavioral health.

The ACA and expanded Medicaid have made mental health services more accessible.

Recently, the United States Preventive Services Task Force issued a series of recommendations that call for primary care physicians to screen adults and teens for depression.

Severe depression is the leading cause of disability in the United States and other developed nations, with 7 percent of adults suffering from a major episode last year. Left untreated, the result is often suicide: 90 percent of incidents are related to mental illness.

Depression costs the country $210 billion a year in treatment and lost productivity. Untreated mental illnesses lead to substance abuse, lawlessness and homelessness.

Jails and prisons are filled with people who would have benefited from early intervention. As a result, criminal justice budgets are strained.

The state of Washington has struggled mightily to provide timely care, and last April it was placed under the supervision of a federal court. Large cuts to mental health budgets preceded the decline in care.

U.S. District Court Judge Marsha Pechman ordered the state to conduct competency evaluations for criminal defendants within seven days. The court found they had been “warehoused” at emergency rooms for long periods of time as they awaited evaluations at state hospitals. She ruled that this “psychiatric boarding” violated the defendants’ constitutional rights.

The Legislature has since set aside more money to address the shortcomings. And last week, Judge Pechman granted the state a reprieve on speeding up competency exams for criminal defendants.

The original deadline was Jan. 2. Now the state has a phased-in schedule to comply with the seven-day rule by May 27. By March 1, the state hospitals must complete competency evaluations within 14 days. By April 1, it’s 10 days.

We have no beef with the court’s order; the pressure was obviously needed. But compliance won’t be easy. The hospitals, particularly Eastern State Hospital, have struggled to fill positions.

The Spokane Veterans Administration Medical Center has also experienced a shortage of psychiatric care staff, which has led to longer wait times for patients.

The increased demand for mental health care services is a healthy development, but the insufficient supply of caregivers is holding back progress.

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