A recent report from King County’s Behavioral Health and Recovery Division reveals persistent challenges in accessing mental health care, with 1,173 instances of people in mental or behavioral health crises being turned away from treatment facilities in the Seattle region last year. Contrary to what might be expected, the primary reasons for these denials are not a lack of available beds but rather a range of other factors, including the severity of the condition, a history of aggression or restraints, and the presence of cognitive or developmental disabilities such as autism.
The report underscores how individuals facing the most complex and challenging conditions often encounter difficulties in accessing appropriate care, as many facilities and staff may not be adequately equipped or willing to handle such cases. On average, facilities declined individuals 25% of the time, a rate similar to that of the previous year.
Families of adult children struggling to find suitable facilities for their loved ones in crisis often face the prospect of their relatives entering the criminal-legal system rather than receiving the necessary care. The goal is to prioritize getting individuals into care rather than incarceration.
The report examined the acceptance rates at nine local facilities, including residential treatment facilities, free-standing psychiatric hospitals, and traditional hospitals providing crisis care. To secure a bed at one of these facilities, individuals must go through an extensive process, starting with an evaluation by a designated crisis responder. If they meet specific criteria for involuntary treatment due to being a danger to themselves or others, or if they are too ill to care for themselves, they may be detained for up to five days, with potential extensions.
For those not accepted into a facility, they typically remain in a hospital emergency department or medical unit under temporary single-bed certification. Critics argue that this practice falls short of providing adequate treatment, as staff in such departments may lack the necessary training or expertise to care for patients with severe mental illnesses or substance use disorders. If individuals in crisis do not secure a placement in a timely manner, they may ultimately be released without receiving treatment.
While the data does not specify whether individuals declined at one facility found placement at another, it is evident that many individuals struggle to secure appropriate care. On average, 443 people per month in King County were held under a single-bed certificate last year, according to data from the Washington Health Care Authority, highlighting the ongoing challenges in accessing mental health services. Different facilities vary in their acceptance rates, with Harborview being more accepting of patients with complex backgrounds, while Cascade and MultiCare declined individuals 44% and 40% of the time, respectively.
