Get documents about "Public Hearing Transcripts Adult Consumers
Document Sample
1
1 WASHINGTON STATE DEPARTMENT OF SOCIAL AND HEALTH SERVICES
2
3
4
5
6
7
8
9
10
11
12
13 SUBCOMMITTEE MEETING ON ADULT CONSUMES AND FAMILIES
14 MARCH 8, 2006
15 - - -
16
17
18 BE IT REMEMBERED THAT, pursuant to the Washington Rules of
19 Civil Procedure, the meeting was taken before Valerie
20 Allard, a Certified Court Reporter, #3040, on March 8,
21 2006, commencing at the hour of 3:00 p.m., the proceedings
22 being reported at Yakima Valley Community College,1015
23 South 16th Avenue, Martin Luther King Room, Yakima,
24 Washington.
25
2
1 APPEARANCES
2 JILL SAN JULE, CONSUMER CO-CHAIR
3 12833 16th Place NW
4 Everett, WA 98204
5 BILL HARDY, COUNTY/RSN REPRESENTATIVE
6 131 basin Street SW
7 Ephrata, WA 98823-1855
8 DIANA JADEN-CATORI, CONSUMER MEMBER
9 311 Champion Street
10 Steiliacom, WA 98388
11 DIANE SCHUMACHER, CONSUMER MEMBER
12 1310 West 6th Ave. #4
13 Spokane, WA 9904
14 BJ COOPER, CONSUMER MEMBER
15 BILL WATERS, OPEN NON-CONSUMER MEMBER
16 2610 North 8th Street
17 Tacoma, WA 98406
18
19
20
21
22
23
24
25
3
1 SPEAKERS
2 Sue Burdett
3 Marina Covey
4 Beth Danheart
5 Christine Gill
6 Gary Hodges
7 Freida Morford
8 Barb Noakes
9 Becky O'Grady
10 Vicki Rich
11 Michael Schwa
12 Frank Swanson
13
14
15
16
17
18
19
20
21
22
23
24
25
4
1 (Whereupon the public testimony began at 4 p.m.)
2 MS. JILL SAN JULE: Okay. I guess we'll get going here. I
3 want to welcome you all to this public hearing. My name is
4 Jill San Jule, and I'm one of the consumer liaisons. I was
5 recently hired to work on Washington States Transformation
6 Grant. Please excuse my note cards, but to be perfectly
7 honest, 13 years of psychiatric meds has kind of shot my
8 memory. so I rely a little bit on notecase.
9 I want to welcome you guys all today to this
10 exciting opportunity to testify about mental health
11 services in this area. And before I introduce you guys to
12 the Adults Consumer Subcommittee members and before I give
13 you a quick overview of the Mental Health Transformation
14 Grant, let me go over just a couple of housekeeping items.
15 The bathrooms are going to be out the door here
16 and to the right, all the way down here. And then we have
17 services available to those of you, if any of you are deaf
18 or hard of hearing. Is there anyone who needs those
19 services today?
20 Okay, so why don't we do some introductions.
21 Diana, do you want to start?
22 DIANA JADEN-CATORI: Yes. My name is Diana Jaden
23 Catori. I'm a consumer and advocate, 14 years. I also
24 have a seat on the Mental Health Planning and Advisory
25 Council for two years, as well as the legislative
5
1 subcommittee.
2 I welcome you all and look forward to hearing
3 your testimony.
4 DIANE ESCHENBACHER: Just so you know, this
5 public testimony is being complied as part of the
6 Transformation Grant. It will be complied in a report and
7 used to process, in hopes that we can go further and make
8 changes to the state-wide Washington State mental health
9 system. In doing that, we have the services here of a
10 stenographer. So it would helpful in you're giving your
11 testimony--it's hard for her to take and keep notes if
12 there's a lot of cross talk. So try to keep that down to a
13 minimum so it makes it easier for her.
14 Also, you're welcome to put your names in. We'd
15 love to have your names in. But if you are uncomfortable
16 and still want to give information but not have you name
17 in, you can have it redacted from the testimony or just not
18 give it at all and ur testimony will certainly be gladly
19 accepted.
20 My name is Diane Eschenbacher. I'm a consumer
21 advocate and also a registered nurse. I live in Spokane
22 RSN. I have served on the Consumer Roundtable for the
23 State of Washington, Ethnic Minorities Subcommittee,
24 Consumer Ad Hoc Committee, and I also now serve on the
25 Mental Health Planning and Advisory Council for the State
6
1 of Washington.
2 BJ COOPER: I don't know if everybody knows the
3 term "consumer". I know when I first started doing this
4 kind of thing and volunteering, I didn't know what it
5 meant. Consumer, any for people who don't know, it's a
6 person who has or is currently getting help from mental
7 health care services. And you're a consumer, even if it
8 was in the past. So, I am a consumer. And I actually was
9 the founder and facilitator of a consumer-run program. We
10 called it the Club House, but it wasn't an official--they
11 have an official type of club house. Ours was not under
12 the official category of club house, but that's what we
13 called it. It was really a drop in center and we had
14 educational opportunities.
15 I've been doing volunteer work at the State level
16 and locally for, going on 11 years now. So I was glad I
17 had the opportunity to be on this subcommittee where we
18 hear from consumers and families around the State about
19 what they would like to see changed about the mental health
20 care system and why it isn't working for them or hasn't
21 worked for a member of their family or someone they know.
22 So that's really a kind of important thing. And then if
23 you have any good ideas about what you know has worked for
24 somebody or an idea that you think should be tried out, we
25 can get that down too.
7
1 So, we really want all the input we can get for
2 the people that make the money decisions. So the more
3 ideas we have and the more--I'd just like if it's 10
4 people, it has a bit more impact than one, kind of thing.
5 So any ideas, we really want to hear them.
6 BILL WATERS: Hello. My name is Bill Waters, and
7 I'd like to join my other committee members in welcoming
8 you. We are very thankful that you're all here. We want
9 to hear the feedback you have about how to improve the
10 mental health system.
11 I'm the president of the Washington State Club
12 House Coalition. I serve on the NAMI State-wide board.
13 And I'm the executive director of Rose House when I'm not
14 doing this.
15 BILL HARDY: Hi. My name is Bill Hardy, and I'm
16 the administrator for the North Central Washington Regional
17 Support Network, which is Grant, Adams, and Okenogan
18 Counties. For those of you who don't know, the Regional
19 Support Network has been around since the early '90's. The
20 State contracts with the Regional Support Networks and then
21 we subcontract with community mental health providers to
22 provide direct services.
23 So, I'm glad to see you all here.
24 JILL SAN JULE: Thanks, guys. Well, I have the
25 privilege of being the co-chair of this subcommittee for
8
1 the past couple of months, and I can honestly say that I am
2 throughly impressed with the knowledge and the skills that
3 each of these guys have brought to the subcommittee,
4 particularly the fact that all of us up here are
5 volunteers. And we're volunteering our time to ensure that
6 your input and our input, you know, is heard.
7 I'm going to take a minute to talk about the
8 grant itself, and then we'll begin the public testimony.
9 So back in October of last year, Washington State was one
10 of seven states to receive this federal grant from SAMHSA
11 to the substance abuse mental health administration and so,
12 like I said, it's a five-year federal grant. And I want to
13 point out specifically that the grant is not to provide
14 direct services. It is technically called a Mental Health
15 Transformation Grant, meaning we're going to take the next
16 five years to compile--well, not the next five years
17 completely, but the next year to gather information in
18 numerous different ways and eventually this is all going to
19 be complied into a report that goes to the Governor.
20 How is this going to happen? Well, basically all
21 of our information-gathering activities, the public
22 hearings being one of them, is going to get channeled to a
23 State-wide work group. And the State-wide work group is
24 going to develop ways in which the State mental health
25 system can be transformed, like I said. I think it's
9
1 important to note that at every step of this process,
2 consumers, family members, advocates, providers are all the
3 table, having what we will hope to be as an equal voice.
4 And these public hearings, like I mentioned, represent one
5 piece of this information-gathering process. We are--this
6 Sub-Committee which represents adult consumers and
7 families, we are one of seven subcommittees. The seven
8 Sub-Committees being Adult Consumers, Children/Youth,
9 Co-Occurring Mental Health/Dual Diagnoses, Criminal
10 Justice, Homelessness, Older Adult Consumers and Families,
11 and Youth Transitioning into Adulthood.
12 So by the end of this month, each of our
13 Committees will have held three different ones of these
14 public hearings across the State. And at that point, the
15 University of Washington, their research team is going to
16 take all of the transcripts and compile them and kind of
17 spit them back out to all of our Committees finding the
18 common themes. And at that point, we're going to look at
19 that information and kind of decide if, hopefully, the same
20 conclusions that we come to will be the same things that
21 the University of Washington comes to. And then on April
22 7, all the Sub-Committees will get together, and we
23 will--the goal of that day will be coming up with key
24 recommendations. Those recommendations will go into the
25 final Mental Health Plan and that is going to be presented
10
1 to the Governor later on this year for implementation in
2 the next few years. So is that real clear? Well, if you
3 want any further information on the actual grant
4 activities, there are handouts in the back. Hopefully, you
5 saw them when you came in.
6 Okay. So if there's no questions about the grant
7 itself, we'll get to the public testimony time. Just a
8 couple notes about that. We're going to be going until 7
9 o'clock tonight. At some of the meetings, there have been
10 up to 80, 90 people, so we've had to limit the time that
11 people have had to speak. This looks like a little smaller
12 group, so unless we have a whole bunch of other people
13 come, we really won't be limiting your time.
14 What we do ask is that you kind of frame your
15 testimony using these four questions. We would love to
16 hear your feedback on this; however, if you're not
17 comfortable speaking up today, we also have the four
18 questions in written format that you can either mail,
19 there's an address on them; or you can turn them in to one
20 of us, and we'll get them to the grant staff team. I think
21 that's about it.
22 So the way that we're going to do this is when
23 you came in there should have been a sign-in sheet asking
24 if you wanted to give public comment. And we'll first go
25 down this list. Of course, if you didn't sign that, you're
11
1 more than welcome to let us know that you would like to
2 give public testimony.
3 DIANE ESCHENBACHER: Did anyone have any
4 questions about the first part in the process, the
5 application grant process before we get into what people
6 have to say?
7 JILL SAN JULE: Do one of you guys want to--
8 DIANE ESCHENBACHER: Oh, sure.
9 JILL SAN JULE: --look on that list. There
10 should be yeses on the ones that--
11 DIANE ESCHENBACHER: Oh, I see. I didn't
12 realize. Gary, did you want to go first? You're on the--
13 GARY HODGES: I don't want to go first.
14 DIANE ESCHENBACHER: You want to slide in there.
15 Okay. Sue Burdette?
16 SUE BURDETTE: I said, maybe. Is that okay?
17 DIANE ESCHENBACHER: Okay.
18 SUE BURDETTE: I might.
19 DIANE ESCHENBACHER: Becky?
20 BECKY O'GRADY: I'll go first. Do I have to
21 stand somewhere or may I sit here?
22 JILL SAN JULE: You may sit, stay where you are.
23 DIANE ESCHENBACHER: Just as long as you keep in
24 mind that she has to be able to hear you.
25 BECKY O'GRADY: Can you hear me?
12
1 COURT REPORTER: I can hear you. Can I get your
2 first and last name?
3 BECKY O'GRADY: My name is Becky O'Grady. My
4 friends and I sat down at lunch today and first, there was
5 one thing that we wanted to talk about. By the time we
6 were done, they made me write out list of things we
7 discussed today. And since you said there wasn't a time
8 limit, and since I am willing to go first.
9 BJ COOPER: Now, we only have three hours.
10 There's a certain amount of executive--
11 BECKY O'GRADY: I will be brief. What is working
12 well in regards to mental health services in Washington
13 State. These are the things that I know are working for
14 me. I am a former board member of NAMI Yakima. I am a
15 consumer. I have bipolar disorder. I'm a former special
16 education teacher, so I come at this in several different
17 directions.
18 The things that are working well personally for
19 me right now is what I'm going to address. I have access
20 to my psychiatrist when I need to. He is an outstanding
21 doctor, and he provides me with what I need when I need to
22 get it. He calls me back personally. He knows me well
23 enough that if I need something, he knows who I am. I can
24 call and talk to him and say, this is Becky. He knows who
25 I am. That's very important to me. We have that
13
1 therapeutic relationship so that when I'm sick, when I need
2 to be hospitalized, whatever it is, I know I can trust him.
3 That works well for me.
4 Until January 1st, my medication system worked
5 quite well for me. I could get all the medications I need;
6 they were covered; and I didn't have to pay for them. I
7 did not have any concerns about getting my medications.
8 That used to work very well for me.
9 BJ COOPER: Does that mean you can't get your
10 meds now?
11 BECKY O'GRADY: It means I've had quite a bit of
12 difficulty getting my meds lately, but that's question
13 number two.
14 BJ COOPER: Oh.
15 BECKY O'GRADY: Okay. I'll do the medication
16 thing. Since January 1st, since the changes in Medicare
17 Part B, I have had a lot of problems with getting
18 medications. And I think I can speak for a lot of
19 consumers who have had quite a lot of problems with getting
20 medications. I've had medications that were not on the
21 formulary. I've had medications that were not covered or
22 told I would have to take the generic when the specific
23 name-brand medication worked better. I've been told that
24 at times, consumers are going to have to wait until we get
25 very ill on one medication before they'll consider changing
14
1 us to another medication. While that has not happened to
2 me yet, it scares the hell out of me. The idea of having
3 to get sick before anyone will help you, it's a farce that
4 we should be treated that way. I don't think any other
5 group of people has to wait until they have their third
6 heart attack before someone says, Oh, I think we'll treat
7 you now.
8 I know that I've been very anxious. Anxiety is
9 one of the symptoms of my disorder. I've been very
10 anxious, having to find out, having to make phone calls to
11 the doctor, having to make phone calls to the pharmacy,
12 saying what do I do now because this medicine isn't
13 covered.
14 Also, I used to have my medication covered. Now,
15 I have to pay co-pays. I have 12 different medications at
16 $3.00 apiece, that's $36. It doesn't sound like a whole
17 lot, for me it's a week's worth of groceries. It's not a
18 decision I like to have to make, so I cut back on how much
19 I eat. That is one of the things that is not working right
20 now.
21 These are other things--I'm sorry. I going to
22 have to skip around on the questions right now. My friends
23 tell me that they have gone to counselors--and I have seen
24 this happen too--where one of their identities, whether
25 it's being a person of disability, or being a gay or
15
1 lesbian person, whatever it is, their racial ethnicity has
2 gotten in the way of the therapeutic process to the point
3 where they have quit seeing the therapist. A friend of
4 mine who is a lesbian went to see a counselor about
5 depression and anxiety issues. The counselor was so
6 focused on her sexuality that she would not address the
7 depression issues. In fact, up to the point where she
8 said, well, maybe you're depressed because you're a
9 lesbian.
10 I've seen other examples, where a man went to see
11 a therapist for anxiety and depression. The therapist was
12 an intern who was planning to become a counselor within a
13 particular religion. Instead of counseling that person
14 regarding his mental health issues, he encouraged the
15 person to pray and become more involved in religious
16 activities. Again, that's highly inappropriate.
17 There are significant cultural and ethnic
18 differences. I've talked to people who are being counseled
19 by a therapist who is speaking English as a second
20 language, which is fine except that the counselor did not
21 have the fluency enough in the English language to
22 communicate to build up a therapeutic relationship. This
23 person spoke English quite well but not to a trust level
24 with his client. Parity, of course, is something we're all
25 fighting for.
16
1 Again, I'll come back to the issue of physical
2 illnesses. Diabetes is covered. No one here questions
3 that it's a physical disability or a physical illness and
4 it's covered. The idea that still our illnesses are
5 sometimes second best or--is not acceptable. My illness is
6 as much a physical--physiological thing as diabetes is.
7 The stigma should not be their ethic. The parity issues of
8 whether mental illnesses are covered, we shouldn't have to
9 be faced with that. The idea that persons with Alzheimer's
10 disease, which is clearly a brain-based disorder, can get
11 coverage and we can't. That's a serious problem.
12 Let's see. Our local crisis line sometimes has
13 provided me with significant help in a crisis. Sometimes
14 has hung up. Sometimes has promised to call back and
15 didn't. Sometimes it's handed me off to as many as five
16 different people before I got the help I needed. I have a
17 friend who called Open Line two weeks ago with a promise to
18 call him back. As of four days later, they still hadn't.
19 And he needed to be hospitalized, and they never called him
20 back. I once had someone, when I called the Crisis Line
21 say, "It's not like I can talk to you all night, you know".
22 BILL WATERS: Becky, is the Crisis Line, the one
23 you tried, is that in Yakima. Is that set up for this
24 area?
25 BECKY O'GRADY: Yes.
17
1 BILL WATERS: Thank you.
2 BJ COOPER: Crisis Line, not an One Line?
3 BECKY O'GRADY: It's called Open Line here.
4 BJ COOPER: Now, see, so that sounds more like--
5 BECKY O'GRADY: It is the local suicide, hot
6 line, crisis line.
7 BILL WATERS: The Crisis Line.
8 BECKY O'GRADY: Yes. It doesn't matter if you're
9 having a bad day, or you're acutely suicidal, that's the
10 line number you're supposed to call.
11 BJ COOPER: Okay. Thanks.
12 BECKY O'GRADY: I have had times when they were
13 very, very helpful and got me through crisis situations.
14 So it's been a wide range, and I'm not sure what the
15 problem is, but I do know it could be improved.
16 Okay. Stigma is a huge thing that needs to be
17 combated. I think it's well beyond the scope of what we're
18 doing today, but I think it is probably the biggest fight
19 that we still have before us, is not being second best
20 because we're mentally ill. And this is a particular thing
21 that has been a problem for the last several years. The
22 local mental health agency--there's probably several
23 representatives here, but that's okay--has funded a support
24 group for people with bipolar disorder for several years
25 and then it quits. While later, years later, it decided,
18
1 hey, maybe it would be a good idea to fund a support group
2 for people with mental illness--or with bipolar disorders.
3 And we start going to it again. More than one person in
4 the group said, you know, this isn't going to last. It
5 didn't last last time, and it won't last this time.
6 Something--it won't happen. The funding will be cut again.
7 And seven months later, they took away our funding for our
8 bipolar support group again. I was outraged. I told them
9 then that more people will become ill, more people will be
10 hospitalized because they cut this funding. They claim
11 that they could not fund a therapeutic group for people
12 with bipolar disorder. They would, however, fund a support
13 group which is once a month; whereas, a therapeutic group
14 is once a week. We need the more frequent support.
15 I truly believe that saving pennies by cutting
16 back on how many support groups you have is going to cost
17 an enormous amount of money by the number of us who have
18 been rehospitalized again since the group stopped. It's
19 increased our medications. It's made us sicker. Cutting
20 small amounts of money is not the answer to improving
21 mental health care.
22 BILL WATERS: Becky, can I clarify?
23 BECKY O'GRADY: Please do.
24 BILL WATERS: So they discontinued the funding
25 saying that that was a group they could provide support
19
1 once a month, but they couldn't provide--
2 BECKY O'GRADY: --therapeutic
3 BILL WATERS: -therapeutic support.
4 BECKY O'GRADY: Therapeutic support which would
5 be more than once a month. For some reason, they defined
6 support groups can only happen once a month. Any more than
7 that would be therapeutic, and they're not going to provide
8 therapeutic services.
9 BILL WATERS: Why is that?
10 BECKY O'GRADY: Funding.
11 BILL WATERS: Funding.
12 BECKY O'GRADY: The person from mental health who
13 was providing this support told us that the funding was the
14 problem. And like I said, I know more than one person who
15 had been rehospitalized because we don't have that support
16 any more.
17 Oh, one more thing I forgot to say. My
18 psychiatrist has moved to a different clinic in this town.
19 I used to have a nurse that when I called, I said I need
20 this, I need that. She took care of it, or like I said,
21 the doctor would call me back directly. He's at a new
22 clinic. As of tomorrow, I will be out of my anxiety drugs.
23 When I called this nurse, she said, "Well, you have an
24 appointment in two weeks. You can wait until then". Do
25 you think my anxiety--my anxiety has skyrocketed, let me
20
1 tell you. The nurse providing services needs to meet the
2 needs and she needs to not do anything that's going to
3 increase my illness or my anxiety.
4 There, I started off.
5 BILL WATERS: Thank you very much. That was a
6 good start.
7 BJ COOPER: Some of those things you recited, I
8 have some responses, things I know are going on on some of
9 the issues you brought up. So before you go, when we have
10 a break or something, I'll bring them to your attention.
11 BILL WATERS: Before you--do you have any
12 suggestions then in three and four here that you think
13 would be, that you would like us to capture?
14 BECKY O'GRADY: Absolutely. I told you if you
15 asked me a question, I'll answer it.
16 BILL WATERS: That would be good.
17 BECKY O'GRADY: A transformed system would be
18 more client based. I know for quite a while, I know people
19 were talking about consumer-based systems. I would like to
20 see it happen. It would ask us what we need. And when we
21 tell people, they would actually do it. We have informed
22 comprehensive mental health repeatedly that we need a
23 bipolar support group on a more frequent basis. They, like
24 I said, have cut our funding more than once. That is the
25 kind of thing that happens. They need to listen to us.
21
1 It's nice that you're listening here, but I heard you say
2 five years down the road. Something needs to be done much
3 more quickly.
4 A transformed system has hot lines, crisis lines,
5 whatever you want to call them, that have trained people on
6 the line when you call them. They don't have volunteers
7 that say, oh, I don't know. I'll have someone get back to
8 you. I talked to the people or I called the Crisis Line
9 number this morning, and they said people are currently
10 unavailable, please hold.
11 A transformed system would not look like big
12 institutional buildings. They would have smaller centers
13 where we feel safer, more comfortable. Going to a mental
14 health center that's huge and impersonal doesn't help. It
15 would have a crisis center that is separate from the detox
16 center. Currently, if you're having a mental health crisis
17 and need to be in a bed but there's not one available in
18 the hospital, you go to the same crisis unit as the detox
19 center, which means those of us having mental health
20 breakdown are in a bed next to somebody who is going
21 through withdrawals. That is completely unacceptable.
22 Detox is not a mental health crisis and why we're put in
23 the same place, I don't understand.
24 Other outcomes. I've heard a lot of people say
25 that nurses were not available to them or that they
22
1 couldn't get to doctors and that. Like I said, my doctor
2 works quite well with but there are others that don't. A
3 transformed system would also be connected to the other
4 local mental health agencies. NAMI, for example, the local
5 Clubhouse, agencies would work better together. I've
6 talked to two or three people, and I know there's lots more
7 out there who have dual diagnoses who get treated for one
8 or the other, but not both. I've also talked to people who
9 have a mental health issue, who have been told they have to
10 go to drug treatment because they were self-medicating and
11 the system cannot tell the difference between somebody who
12 was having a crisis and smoked a joint, if you will, and
13 somebody who's chemically dependent. And they all get
14 processed through the same chemical dependency program
15 whether it's occasional use or a dependency problem.
16 A transformed system would have therapists
17 available to meet the needs of individuals. The therapists
18 need to be comfortable with, as I said, with the gay
19 community or with various ethnic communities, various
20 religious communities. I know of people who are pagans who
21 will not go to therapy because they don't have someone who
22 will judge them because of their religion.
23 A group would be responsive to individual people,
24 as opposed to those of us who are consumers. It would also
25 stop calling us by different names. We have been patients,
23
1 clients, consumers. What else are we? If you could call
2 us individuals, that would be really nice, people.
3 Outcomes would indicate something better. If we
4 lived in our own homes, if we were hospitalized less
5 frequently or hospitalized safely when we needed it. If,
6 when I called the Hot Line and told them I was suicidal, I
7 didn't have multiple police officers show up at my door. I
8 don't think that's an appropriate response. I think
9 suicide by cop needs to stop. And I think the crisis--what
10 is it called? The CIC Program needs to be put in place in
11 every city and county in this State so that police officers
12 are trained to deal with people with mental illness.
13 There's a person in Yakima who died last year. He was
14 having a crisis. The police came. His wife said that he's
15 having a mental illness breakdown. These are the things
16 that have worked with him in the past. And they did not do
17 those things. And the poor man, they tried to take him
18 down, but they could not. The poor man ran frightened into
19 a nearby lake and drowned because the police officers did
20 not listen to what his wife was saying, that there was a
21 way to treat him that had worked for him in the past. They
22 didn't listen. The man is dead. Every police officer in
23 this State should have the proper training to deal with us
24 when we're sick.
25 BJ COOPER: Maybe the lady with her daughter
24
1 there could maybe speak for a little bit. She needs to be
2 leaving.
3 VICKI RICH: I'm Vicki Rich. I'm a consumer and
4 I also have children who have small--. Addressing the CIT,
5 I'm the consumer advocate for jail diversion for mentally
6 ill offenders and we are putting in place, in fact, in the
7 next month some CIT training on rotating shifts for the
8 officers that addresses the concerns that I have in Yakima
9 County. So, just to let you know that issue is being
10 addressed right now as we speak this month.
11 BILL WATERS: Would you agree with her that it
12 should be across the State?
13 VICKI RICH: Oh, yes. I'm in contact with NAMI.
14 I'm on their email lists. On this list, out of like your
15 seven, all your seven areas, I'm one of each of those being
16 that I'm a co-occurring, dual diagnosed.
17 BILL WATERS: Worked on the sub-committees?
18 VICKI RICH: I did all of them. Basically, I was
19 just going to read over my notes on it. On No. 1, within
20 Washington State for mental health services private or
21 public what's working well. I have found for myself, there
22 are several supportive agencies that cater to my
23 multifaceted lifestyle. I've received numerous ones.
24 Family Preservation Services, Parent/Child Advocate
25 Program. I've been through Drug Court that they supervised
25
1 me. When I got my felonies, facilitated my recovery.
2 MICA, fully diagnosed in the program. EPIC, my child have
3 all been involved with them and have received services. My
4 little one here has anxiety adjustment. And I have an ADHD
5 high-risk onset of bipolar 15-year-old daughter. I've
6 received Catholic Family VIP which is Valley Intervention
7 Program for my daughter. I didn't want to have to medicate
8 her. So I've received a lot of these services. But I had
9 to seek out many on my own and force them into action to
10 meet my and my kids' needs. My kids have been a part also
11 of the Youth at Risk Program which is very time consuming
12 and. So that's No. 1. Those services are working really
13 well. It took many of those services to stabilize me.
14 I've been in the system since I was seven years
15 old. My father was an alcoholic and he killed my mother,
16 you know, a blackout drunk and us children, the five of us,
17 were put in the system. And due to all that trauma and
18 stuff, we weren't quite the most well put together
19 children.
20 Within Washington State, for all the mental
21 health services public or private, what is not working and
22 creates barriers or fails to provide quality service and
23 support. Many of these services are not well recognized
24 and can be integrated to facilitate a more well-balanced
25 and enhanced success rate of recovery. Open Line,
26
1 definitely it needs more significant consistency and
2 training. I had to make calls, and I agree with the lady
3 over here, my 15 year old, she's having a fit. She's
4 arguing with me. She's throwing things. The cops comes.
5 I call the Open Line. They're like you need to bring her
6 here. So how do you get a non-compliant mentally ill child
7 that is having, you know, she's having one of her little
8 days, or moments. How do you get them in the vehicle? So
9 when you try to get them in the vehicle, the police are
10 called because she's freaking out. So I don't understand
11 how that--how am I supposed to do that? So I think that
12 could be more consistent, more catered to the family's
13 needs.
14 In the criminal justice, providers need more
15 education on special needs and co-occurring mentally ill.
16 Like for Drug Court, they weren't wanting to let me in
17 because I have a mental illness, and one of my medications
18 is an amphetamine, it's for my AHD. When the weigh you all
19 the time, they don't want anything that's going to mess
20 with it. In my first year and a half of recovery, I had to
21 struggle to have that focus and control without medication
22 so that I can take care of my four kids.
23 What would a transformed metal health system
24 looked to me? A more informed provider network to meet
25 each person's specific needs combined sites of care, that's
27
1 where I find it's lacking. I would like to see more
2 combined client based and more consumer driven with
3 employed positions and funding the facility for more
4 consumer involvement.
5 I just finished training on peer support
6 counseling. It's an excellent program. I know from all my
7 12-step stuff, I learn more from others that have been
8 there and can relate. With the Mental Pride Program, I
9 looked at them and said if you walked in dressed like that
10 and tried to address my needs, I would be like uh-huh,
11 right. And that's coming from when I was really ill. I
12 don't consider myself ill or labeled anymore. When I
13 hadn't developed the perceptions and the skills that I have
14 now, three-and-a-half years later. When I first started
15 out, I remember I had to seek all those services. In order
16 to be in Drug Court, I had to find somewhere to get
17 childcare paid for because Work First wouldn't pay for it
18 because I wasn't in the work-approved activity. So how do
19 you go to all these functions without childcare for you
20 children so you can get well enough?
21 I'm a student now, a full-time student and
22 part-time employed. I have four children. It's taken me
23 three-and-a-half years to get to this point. I often hear,
24 not everyone is like you, not everyone is as ambitious and
25 driven as you; but I believe everybody has that potential.
28
1 They just need a booklet that says, okay, if childcare is a
2 barrier, Family Preservation can take care of that.
3 I didn't have the living skills. My Family
4 Preservation worker came to my house. While I did laundry
5 and did my dishes, she would sit there talk to me about
6 things that triggered my mental illness. One of them was
7 inadequacy as a mother. I never thought I was good enough.
8 She taught me how to budget. Often times, people with
9 co-occurring come from a background where they weren't
10 given a real stable outline living skills. We're talking
11 shopping. We're talking budgets. We're talking, how do
12 you do your laundry and organize it, and how do I get my
13 kids on time in the morning. I was given that, therefore,
14 how do I transmit that into my children. So it's kind of a
15 generation thing, at least that's what I see.
16 So I would like to see transformed would be more
17 the sites combined so that a person doesn't have to run
18 around and go how do I get this taken care of, how do I get
19 that, how do I get me electric bill, you know. There's the
20 basic Salvation Army, the Mission. There's a few numbers
21 in the phone book. Other than that, there's so many other
22 program. You know, the Parent/Child Advocate Program is
23 really good for recovering addicts. Out of my four kids, I
24 have one that is a sobriety baby, and she has the structure
25 and the life that I wish I could have done for all my
29
1 children, but at least I did that with one of them.
2 So my story for me, is that there are programs
3 out there, if they could just combine them to meet our
4 needs because not everyone is well informed to seek out
5 those things. I often get a lot of people going, well, how
6 come you got that service? How did you do it? It really
7 was, it was hard. I had to make a lot of calls and seek
8 things out. I had to do a lot of humbling things to get my
9 Family Preservation for childcare. I had to go and turn
10 myself in and do a self report for having abused my first
11 two when I had been drinking. I had to go in there any
12 say, okay, if this is how I have to do it to get the help I
13 need, I'll sit here and bare my sole. And that's okay.
14 That was part of my story to get to where I'm at today.
15 I think the agencies can do it. There's programs
16 out there. They just need to combine them and let them
17 know. I mean I had an attorney that said, Vicki, you know
18 three DWI's in five months, you people don't do those
19 things anymore unless there's something going on. And he
20 had no idea where to send me. He didn't want to see me
21 locked up. He knew I had issues going on, but he had no
22 idea where to go. So I would like to see some type of
23 catalog put together or something for these services.
24 MICHAEL SCHWAB: My name is Michael Schwab, and I
25 am a Superior Court Judge here in Yakima. I just happened
30
1 to be able to come today because some cases I was working
2 on finished up. I don't know whether I can come back on
3 Monday, which is a subcommittee that I'm interested in.
4 We see a wide variety of people coming into the
5 system, all different kinds of cases, not just criminal
6 cases, but all who have mental health issues. And as this
7 lady just said, the court system doesn't understand a lot
8 of these matters and really needs to learn. So that would
9 be an important improvement would be somehow providing
10 awareness, not just for judges, but for lawyers, court
11 staff, about mental health issues. We have a large number
12 of people who are locked up, juveniles and adults, with
13 serious mental health issues and the don't belong there.
14 We would love to have the opportunity to release them if we
15 could, but we're being told constantly that there are no
16 places for people with some of the issues. I'm talking
17 about the need in the juvenile system to have specialized
18 group homes. Many of those children cannot be returned to
19 their families because either the families are unable to
20 take care of them properly or unwilling to do so or there
21 aren't any families. Many of the children we see are
22 homeless.
23 In the adult setting, likewise there are a lot of
24 people who are homeless or don't have families who can care
25 for them, but they come into the system for some behavior
31
1 issue out in the community. As I say, we would really like
2 the opportunity to release these people to some kind of
3 better environment where they can be worked with and
4 assisted, but we don't have that. So I would see it as an
5 improvement to have more of those opportunities.
6 Domestic relation situations, we have lots of
7 families where domestic violence is an important issue.
8 Families are being torn apart. And you pile on top of that
9 a serious methamphetamine problem that we're having now,
10 it's not just Yakima, it's everywhere. So we have these
11 cases where parents are fighting about children, children
12 are being raised by grandparents, great grandparents, aunts
13 and uncles. And the parents want to be able to reunite
14 with their children, but it's not safe because of mental
15 health issues.
16 But we're not being able, nobody is presenting us
17 any options for services, or we're being told that there
18 aren't any services, or people can't afford to get the
19 services. We want to be able to direct people in a way
20 that they can get services and then come back to court and
21 be able to have appropriate relationships, but we're not
22 competent in the courts to be able to diagnose those things
23 and know all the resources that are available.
24 So I guess I can come back to what I said in the
25 beginning. The courts need to be educated and aware and
32
1 better able to help people who come into the system with
2 mental health issues. Thank you.
3 BJ COOPER: When you say in terms--when they come
4 into the system with a behavioral problem are there certain
5 types of behavior problems that would still be criminal
6 versus needing only mental health care?
7 I know, I'm not being very clear. If it's a
8 sexual offender, would a person, a sex offender be treated
9 the same as a person who has committed domestic violence,
10 or you know, a person maybe that is speeding that is
11 bipolar and not taking medication? So things like that.
12 Or you would need to be educated about that?
13 MICHAEL SCHWAB: First we have to have somebody
14 who is a professional tell us what kind of condition the
15 person has. Otherwise, we dealing with the police saying
16 this man stole something, this man hit somebody, this man
17 abused somebody. You know, something like that which is
18 just the bare bones of what we get.
19 BJ COOPER: So it's the act of what they did that
20 brings them and not what got them there?
21 MICHAEL SCHWAB: Typically what will happen is:
22 A person will be locked up. They'll come before the Court.
23 We may start to observe some signs that something is wrong.
24 But what usually happens is the lawyer who is appointed
25 will bring to the Court's attention, they can't talk to the
33
1 individual, or the individual is disoriented, or the
2 individual is--there's some indication that there's a
3 mental health issue that needs to be addressed. So it will
4 be brought to our attention that way.
5 JILL SAN JULE: So you guys have no like
6 rebooking diversion program? No one coming in and making
7 an assessment on individuals?
8 MICHAEL SCHWAB: Unless there are some real overt
9 signs that something is wrong, mental health professionals
10 do come in. But, even then, the system has to continue the
11 accountability. We just can't turn somebody loose. We
12 have to figure out what's going on, what sorts of behavior,
13 what sort of history there is, and what sort of potential
14 there is for the future. Whether the individual is safe to
15 be at large.
16 As I say, we would love to be able to release a
17 lot of people in that condition if there was some mechanism
18 that could take them in and monitor things and report to us
19 if there are any problems. Being in the jail is really,
20 it's a negative.
21 JILL SAN JULE: Do you know, are these
22 individuals who are not hooked up with any types of
23 services. They're not--
24 MICHAEL SCHWAB: Lots of times they are.
25 JILL SAN JULE: They are.
34
1 MICHAEL SCHWAB: But either they've stopped
2 medicating, or they have some kind of overwhelming other
3 things in their lives. Often times they're families are
4 taking care of them and the families fall apart so that
5 system breaks down. It's just the widest variety of
6 combinations. But whatever it is, you know that the judges
7 and the lawyers, we're not trained, just like this lady was
8 saying over here. This lady was giving you some really
9 good information. As I was listening to her, it just
10 reminded me of numerous cases that I've had.
11 What's working well? I don't mean to diminish
12 the wide variety of very good services that are out there,
13 service providers and different programs. There are many,
14 and they do a great job. But the ability of the courts to
15 partner with those services and to understand how we can
16 match people up correctly, there's still a gap there that
17 should be bridged.
18 JILL SAN JULE: There's access, actually.
19 MICHAEL SCHWAB: Access is a very big question.
20 But there are some wonderful providers, all kinds of
21 providers, although I have to say, and I have some
22 colleagues here from the juvenile division. When I worked
23 in the juvenile court, I was always looking for a place to
24 send a youngster, a specialized group home. Sometimes I'd
25 be told, well, we have a place like that in Idaho or in
35
1 Oregon. And we have a contract with Oregon and so we can
2 send them. Why don't we have one in Washington? What's
3 wrong with Washington that we don't have a place? We have
4 to send a kid to Idaho. That made no sense to me.
5 Thank you.
6 B.J. COOPER: Thank you.
7 BARB NOAKES: Well, what is working well in the
8 mental health services in Washington State for me is that I
9 come from Wenatchee and so there are so few psychiatrists.
10 Because before I was in Seattle, so you come over to
11 Wenatchee, and I don't know how many psychiatrists they
12 have, probably two. So I see a nurse practitioner. For
13 counseling, I go to the Wenatchee Behavioral Health and
14 that has worked really well.
15 What has worked the best for me in Wenachee that
16 I have been participating in is, we have a clubhouse and
17 it's called the Promise Club. I go in there. First it
18 was, I was invited down to the Promise Club. I was
19 contemplating committing suicide. I mean I had--my husband
20 was a state engineer. I had the Cadillac of mental health
21 care. I had been up in Chelan for three weeks at their
22 trauma unit for battered women. I come out and there's no
23 connection because when you try to make a follow-up
24 appointment, the doctors say, well you need to follow up.
25 Well, my insurance didn't cover the Chelan doctors because
36
1 it was out of the area. So then you try to get plugged
2 into Weather, and they say, well, we'll have an appointment
3 for you in 45 days. So you go through that.
4 I came to the Promise Club, and I started
5 participating in there. First, I felt pretty safe with
6 helping Marina do research and everything about the
7 clubhouses and everything. But I was still, because I had
8 been a teacher and also a teacher with Headstart, but I
9 just felt because of my marriage of 38 years had ended. I
10 had grown children who were telling me, whatever you say,
11 it doesn't make sense. So I just totally stopped talking
12 pretty much. So research fit me pretty well and
13 everything. Then a surprising thing happened. When I
14 started everyday going into the Promise Club, and it's
15 voluntary and stuff, I started feeling better about myself.
16 It was like deciding, well, some of these things maybe
17 people that have observed me, and maybe this husband that I
18 have that I dumped, you know. He really didn't know what
19 he was talking about. So I have, through the Promise Club,
20 have had less use, I mean I still go to the nurse
21 practitioner, and usually they were going to schedule me
22 once every six months, and I go as needed to the mental
23 health counselor. From being at the Promise Club, or the
24 Clubhouse, it has made me so that feel so good and
25 everything that I want to get up in the morning. I have a
37
1 computer at home. When I want to go to the Clubhouse to do
2 my research because, I do public speaking and everything
3 with another group, but it's just the atmosphere in there.
4 Because everybody is there for you to succeed, and you feel
5 so good. And you make friends, I mean real friends. Like,
6 I was involved in a church in town, in Wenachee. I had
7 done daily vacation bible school in the summer, and I had
8 gotten a tutor position out of that. One of the people I
9 was supposed to mentor, I was supposed to mentor two adult
10 women as teachers. And one of the woman said, well, you
11 know, people that have mental illness, she had two members
12 in her family, she said, you know, they're just not trying
13 hard enough. And they're not spiritual enough. And she
14 said, you know, it doesn't say anything in the Bible. This
15 is like a month ago. And she says, I don't see anything in
16 the Bible about schizophrenia or depression or any of
17 these. People are just possessed. I said, do you know who
18 you're talking to? I said I have a mental health illness.
19 I have post-traumatic stress syndrome, you know, from the
20 way I was brought up. And then being in the juvenile
21 justice for protection and everything and being in the
22 system. And I said you are just a bigot, and it's not
23 right the way you're saying. I left the church. I told
24 them flat out, I said if a woman like that is going to
25 teach young people, I am not going to be a part of your
38
1 church.
2 So, I think in this State of Washington, I think
3 throughout the United States, that we have a mental health
4 system first of all that is in our communities, but it's
5 marginal. It's not working real well. And you either have
6 to be really poor, you have to be on Medicaid, or you have
7 to be really rich to be able to afford the services.
8 So I'm going to go right into what's not working
9 because there's a lot that's not working. In the 1950's,
10 the State of Washington got this idea, I think down in
11 Olympia, and everything. I don't think anybody knew
12 anything about mental health down there, but they got this
13 idea that they wanted to de-institutionalize people and
14 send them back to the community. Well that sounds good,
15 but you know, they just didn't have any plan to do that.
16 They started closing down Medical Lake or Eastern State.
17 Now they have like 217 beds or something, and 110 go for
18 the population of from 20 to the age of 49. And then
19 there's so many beds for psychiatric. And then there are
20 the forensic, you know, for the mentally insane which
21 they're trying to figure out and everything. And then in
22 the communities, I worked at General Hospital as a
23 financial person in Everett. We had a beautiful
24 state-of-the-art physic unit in Everett. And they spent
25 millions on it and whatnot. And because the reimbursement
39
1 rate was so low for DSHS and everything, that they closed
2 the unit and they made it into a storage unit. The same
3 thing happened in Wenachee. So what happens is, I wrote an
4 article for General Hospital, because we were going to be
5 having--we wanted to have an open heart surgery, and DSHS
6 goes, oh, no, you can't do that because we have those
7 services in Seattle. Well, the article that I wrote for
8 the paper, I said, why should people from Snohomish County
9 have to go to King County to get services? So why in the
10 world would mental health close down your community
11 hospitals, send people across the state, usually your poor,
12 people do work, their family members work. There's not
13 support system. So you send them, if there's a bed at
14 Medical Lake because I doubt that, and everything. So
15 you're sending them away from their community, sending them
16 away from their providers, sending them away from their
17 families; it does not work.
18 So what is happening in our state and across the
19 United States is that we have closed down the big mental
20 health hospitals because we didn't want people to be
21 treated badly. And then we closed down the community
22 hospitals. So what has happened is that the criminal
23 justice system has taken on the burden of being a mental
24 health provider. But in Wenachee, because I just spoke to
25 criminal justice there on Friday, and we met, and they want
40
1 us to come back and speak to the juvenile justice part and
2 also to the jailers. Because 70 percent of the people that
3 are incarcerated in Wenachee or in the United States are
4 incarcerated for non-violent offenses. And a lot of them,
5 16 percent, have mental health issues. Either they're not
6 on their meds or there isn't enough treatment provided.
7 And then the incarceration rate for women is even higher
8 with women that have mental illness.
9 And in the wintertime, it makes perfect sense.
10 Like today, we came over in a snow storm. So if I was
11 poor, and I couldn't get my meds, and I can't get into a
12 psychiatrist, well, why not just break the law and get
13 arrested. But even when you get arrested, and aren't
14 currently connected with a mental health person in Wenachee
15 or any other town in this State, they can't give you
16 medications because they don't know what disease or
17 disorder you have. Okay, so let's say that I was having a
18 post-traumatic panic attack, full-blown disorder. So they
19 arrest me. I go in, and I don't have my medications with
20 me. I can't remember my doctor's name or whatever. So
21 they start talking to me and I become defiant or something.
22 I start talking back to them. So in Wenachee, what happens
23 to you is that put you in solitary confinement, right off.
24 And then if I get really lippy, or you know I spit at one
25 of the jailers or something, they put you in this specially
41
1 designed chair and keep you locked in place for four hours.
2 So people go through all of this trauma. Talk about
3 inhumane treatment. That is inhumane treatment. You can't
4 go to the bathroom. You are not released and some stuff
5 like this. A lot of the jail people, because I talk with
6 the probation officers, and they said one of the big things
7 they're concerned about in Wenachee is a lot of the jailers
8 that work for the system are there and they don't really
9 understand, you know, a lot of the mental health issues.
10 They need more education, which is true. And also, these
11 jailers need to be held accountable because we don't lock
12 people up in a chair, or we don't put them in solitary
13 confinement. That's only going to make the condition worse
14 and everything like that.
15 So a transformed system would--first of all, it
16 would have a plan. In this whole state, that the justice
17 system is connected right with the mental health system.
18 And then, people lose their benefits when they go into the
19 criminal justice. Like if they're longer than 30 days,
20 they lose their medical coupons or if they're on social
21 security, they lose that part and stuff. So people--they
22 need somebody like me at the jail that can say, okay, Mark,
23 you're going to be getting out on a certain day. We have
24 this set up for you. We are going to streamline you right
25 into mental health services. We have a psych doctor coming
42
1 into the jail, giving you medication you're already on and
2 everything. Then to have a person there that's
3 knowledgable on how to connect with DSHS, and how to
4 connect with Medicare so that they have some support. And
5 then they need housing so that they're not just out of the
6 building, going around the block, and this happens,
7 breaking the law so that they can get back into a safe
8 place. It's costing a lot of money, and it's not working.
9 And then when you get into the criminal justice system--
10 BILL WATERS: Can I ask you a question about what
11 you said just a minute ago?
12 BARB NOAKES: Sure:
13 BILL WATERS: So when you said a person like you
14 would be available to somebody just being released, you
15 mean a person who has had a mental illness or setback?
16 BARB NOAKES: It would be a lot more helpful than
17 what we have right now, which is nothing.
18 BILL WATERS: So there would be some peer
19 support--
20 BARB NOAKES: Well, peer support or somebody that
21 is good with handling the system because the people that
22 are in the system aren't good at it. So somebody that--
23 BILL WATERS: The professionals in the system
24 don't seem good at facilitating--
25 BARB NOAKES: No, I mean they're not connected.
43
1 It's like you've got mental health over here; you've got
2 the criminal just over here and somehow they don't have a
3 bridge. You know, it's broken or it's up for the train to
4 come though. I don't know. It just isn't working.
5 So to have a transformed system, what it would
6 look like. First of all, on the State level there would be
7 a plan. You just can't say, well, we're going to revamp
8 the mental health system. And you need us consumers that
9 really advocate for it. We know what works. We're
10 educated in diseases because we have the diseases. There
11 needs to be a lot of education in the community. I'm tired
12 of people have this red-necked-biased-attitude that people
13 who are mentally ill should be locked up and the keys
14 thrown away and all of this and stuff like that.
15 Because a lot of us, I graduated from college in
16 the top 10 percent in the United States. So we're not all
17 dysfunctional and stuff. But there's so much stigma in
18 trying to get a job in Wenachee. You know, we go out and
19 give these wonderful presentations. Nobody wants to hire
20 you because you're mentally ill.
21 The other part that wasn't working, if you're
22 incarcerated in the criminal justice, you have another
23 stigma of a criminal record so that goes against you for
24 housing, that goes against you because you can't get
25 federal grants for education. So that needs to be changed.
44
1 So the transformed system, it has to come with
2 education. There has to be an incentive in the community
3 for employers to hire people who are mentally ill. There
4 should also be housing. Do you know what number I am on
5 Section 8? I am number 3,324. When I left the hospital, I
6 was homeless because my husband, who works for the State,
7 took all the money out of the bank, savings, checking,
8 everything. So I had to go and live in the domestic
9 violence shelter and go myself to the Salvation Army and
10 different places to try to get funding, you know, to get an
11 apartment and everything like that. It was really hard
12 because I had no food, I had no clothes, I had no shelter.
13 I had nothing.
14 So it makes it really difficult, and it isn't
15 fair that we have to be traumatized more and everything
16 because your system isn't working. We can't wait five
17 years. It makes it really hard right now with the new
18 Medicare B Plan. I spent a whole week researching all of
19 the 49 plans and pulling down all the screens and finding
20 out everything before I signed up for one. Then I went to
21 Costco, and I got charged double. I called the place that
22 I'm getting my prescriptions from, and they said they made
23 a mistake. But see, they didn't give them the correct
24 information at Costco. So I had to follow up. I'm always
25 following up.
45
1 I've been going through a divorce for two years,
2 and I knew more about everything than my attorney that I
3 paid $12,000. He didn't want to listen to me because I
4 have a mental illness. So I was writing Judge Bridges, in
5 Wenachee, letters saying we need to do this, we need to do
6 that. And finally, that what they did. And I finally got
7 my divorce. But it's like, you want to be
8 traumatized. I went into the juvenile system when I was 10
9 years old for protective custody in Wenachee. I was locked
10 up there for two weeks with the rest of the kids, the girls
11 that were a lot older than I was, and they were in there
12 for prostitution, for stealing, everything and anything.
13 And I was right in there with them and at night, I was
14 locked up in my own cell. My biggest fear was that my dad
15 would come up the back stairs and kill me. No one talked
16 to me. I didn't see any mental health professional. My
17 brother had murdered by grandmother that day. Blood was up
18 the wall. My dad was getting ready to go to the parade.
19 He got arrested when they got back. And then I was taken
20 out to Waterville and made a ward of the Court. Was there
21 any counselors or caseworkers? No. They just sent me off
22 to a foster home.
23 DIANA JADEN-CATORI: So would you say that part
24 of transforming the mental health system even as a family
25 member, for you would be identifying needs immediately as
46
1 far as trauma and those types of things?
2 BARB NOAKES: Yeah. I don't understand where you
3 guys are coming from because as a Headstart teacher, I was
4 required--
5 BJ COOPER: I just wanted to interject something.
6 I think you came in a little later after we did our
7 introductions.
8 We are volunteers involved in the Mental Health
9 Transformation Grant. We're volunteers from around the
10 State, other people are administrators, different things,
11 but the biggest percent of us are consumers of mental
12 health care services. So, we're a part of this process.
13 We are your peers and as well as the people who would treat
14 you, or medicate you, or whatever. I just wanted you to
15 know that we are volunteers. We don't work for DSHS, but I
16 was going to say "you people," we're also peers, and I'm
17 not sure if you understand that.
18 BARB NOAKES: Headstart is a federal program for
19 low income. And as a teacher for Headstart, I was required
20 within the first 30 days to test and refer children out if
21 they needed mental health services, if they needed speech
22 therapy, whatever they needed. I don't know--there doesn't
23 seem to be any accountably, like with the justice or mental
24 health, there's just so little of it to access that there
25 needs to be more. There needs to be like an inpatient
47
1 facility in these small towns like Wenachee, which we can
2 support. They had it. They closed it because there wasn't
3 enough reimbursement. When people go to jail--
4 JILL SAN JULE: We're going to ask you to wrap
5 things up here. We want to get everyone a chance here.
6 BJ COOPER: And you can put a lot of this in
7 writing too.
8 BARB NOAKES: It's like when people go to jail
9 they need to be assessed first off. You need to have
10 professionals doing that. And so that the people are not
11 traumatized more, that they get the medication they need.
12 Why should they have to wait until they're discharged from
13 jail? And they need to be set up with mental health
14 counselors and have services in place so that they don't
15 reoffend and to help these people that need the most help.
16 (Whereupon a recess taken.)
17 DIANE ESCHENBACHER: Okay. We have some people
18 here whose time is limited. We'll start with Frank
19 Swanson.
20 FRANK SWANSON: Hello, my name is Frank Swanson.
21 I'm the father of an adult son who suffers from mental
22 illness and who resides in Tacoma at the present time. But
23 I also wear a lot of other hats. My wife Betty and I, who
24 is right up there, have been advocates for many, many years
25 in several states, in the State of Oregon and the State of
48
1 Washington. I have served as an officer in NAMI
2 Washington, I have served as director of the Family Program
3 in this state, I have taught family to family courses to
4 many, to some of the folks in the room here. I have served
5 on several mental health boards, advisory boards, and I am
6 presently serving as an advocate on the Quality Management
7 Oversight Committee for Great Columbia Behavioral Health.
8 I wanted to simply come and testify to you as a friend of
9 consumers and as a friend of family members of consumers
10 today, not as anyone of those other people, although I
11 still am a member of NAMI and I serve in a different
12 capacity.
13 What is working well with regard to mental health
14 services in Washington State? I'll talk about a couple of
15 things. There are many things. Financing is not working
16 Well for mental health in Washington State. The National
17 Association of Mental Health Directors Research
18 Organization has some very interesting statistics on the
19 relative nature of the financing of mental health in the
20 United States. In Washington, in a per capita basis, more
21 than--for the 2001 figures that they have developed is 18th
22 in rank out of 56. Well, that sounds pretty good, doesn't
23 it? Except for some of the other figures. Washington is
24 high in the cost of its hospitalization. It is low in the
25 amount of state-only funds. In fact, it's 49th of 50 in
49
1 state-only funds, other than matching funds for Medicaid,
2 that is spends on mental health. So if the State wants
3 better programs, it better pony up in state-only funds.
4 And that relates to much of what is said by many of folks
5 here already testifying about the stigma of mental health
6 in this state.
7 What then does not work well with regard to
8 mental health services? I'll just mention a few things.
9 Care for people who are approaching or in crisis does not
10 work well. Why? Well, it isn't funded because that takes
11 state-only funds. You've heard the stories of the people
12 in the room. My son, after a seven-year stent of recovery,
13 had a crisis. He missed work at his mental health center
14 for two weeks. Finally to get him involuntarily committed
15 because he was so psychotic at the time, that when they
16 finally got to him, he had to be involuntarily committed,
17 he couldn't take care of himself. Okay. So here he was, a
18 person in the system close to professionals, let him go for
19 two weeks. What's not working? We don't have
20 accountability. You have to be accountable for individual
21 people. This cannot say if you are supervising this
22 program, if you're going to have it work, oh, that's not my
23 program, that's not my jurisdiction. It's not in the
24 system and we fund, pay for it. That's not working and
25 it's costing us bundles. It's part of the reason why we
50
1 have this high cost of hospitalization, not the only one,
2 but it's part of it.
3 What would a transformed system look like? Well,
4 a transformed system would look like one that is consumer
5 controlled. It's one that would bring consumers who begin
6 to show symptoms into counsel people that are having
7 degrading health, and help them find the appropriate
8 service. It means consumers being involved in various
9 kinds of telephone systems so that they are educated so
10 that they know what's it like and that they counsel people
11 to get to the right resources and they know where they are.
12 But in many cases, there is no resources. Many cases there
13 is no resources for it because we haven't spent enough for
14 it. We know that. Finding the right location for the
15 person is critical, as it was in my son's case. He came
16 out of the community hospital there in Tacoma which is now,
17 by the way, not in business anymore. He came out of that
18 after two weeks in there and went to a crisis respite
19 center. Oh, but they were too busy there to keep him very
20 long, probably long enough. So where did he end up? In a
21 group home. Is that the right place for his recovery? No.
22 Why? Because there's everybody under the sun in the group
23 home, people with mental illness, people without mental
24 illness, there's no care, there's no consumer support going
25 on there to any great degree. He gets the basics, but will
51
1 that engender recovery? No. I think recovery, and some of
2 my consumer friends tell me this, I am not a
3 consumer--actually, I'm a consumer because I have
4 generalized anxiety disorder, I think largely because I'm a
5 parent of a consumer. So I take my pills too. But I do
6 believe my son would progress better as my wife has been
7 talking, with more supports, more consumer supports, more
8 help along that way. In fact, he probably would not have
9 had the crisis had he had those supports beforehand, and he
10 will not have them again if he had it afterward.
11 So finding a way to organize consumer supports is
12 critical to any solution. A transformed system would look
13 towards clubhouses and other types of organizations,
14 consumer-run organizations, to make that work.
15 Now, what outcomes would indicate that the
16 changes were creating results? I'll go into that for a
17 minute. There are a number of widely accepted,
18 professionally accepted outcomes for recovery. In many
19 states, not Washington State, because Washington was one of
20 the last to even consider it, making recovery an objective.
21 They just did that. By the way, I serve on the Mental
22 Health Advisory Board for DSHS that recommended that
23 several years ago, but it took them over two years to put
24 that into the objective for the mental health division. So
25 again, I second the motion that many have made here. You
52
1 don't have five years. You do not have five years to make
2 this work. One of the outcomes that you must look for is
3 hands-on management at the mental health division level.
4 You've got to have hands-on. These people have got to know
5 what's happening. They don't need another commission,
6 another support group, another work group. They need a
7 director that knows what in heaven's name they're doing.
8 BJ cooper: Recovery, since this is the big
9 question, when you're a consumer, you know what recovery
10 means. What does recovery mean?
11 FRANK SWANSON: I'll take the definition of the
12 law.
13 BJ COOPER: Which is?
14 FRANK SWANSON: The definition of Washington
15 State law?
16 BJ COOPER: Uh-hmm.
17 FRANK SWANSON: Well, I can't quote it to you,
18 I'm sorry to say. But it's the notion that recovery is a
19 state of the consumer in which the consumer directs their
20 life. After they have recognized they have the illness,
21 that's step one, after they've sought care, after they've
22 moved outward so that they realize that contact with other
23 human beings is very necessary for their healthful
24 continuance, and then after they've realized that, they
25 have to be interdependent. They have to relate to other
53
1 people. Those are the four steps, four phases of recovery
2 that are used in the State of Ohio, which incidentally is
3 one of the leaders. It has a very excellent system in my
4 opinion.
5 BJ COOPER: So that's what you go with?
6 FRANK SWANSON: Yes.
7 BJ COOPER: That makes sense to you?
8 FRANK SWANSON: Yes.
9 JILL SAN JULE: I want to clarify one thing
10 because I've heard several people reference the five years
11 that I spoke about. The grant is for five years. This
12 plan is technically going to the Governor in June and it's
13 supposed to become implemented over these next five years.
14 FRANK SWANSON: I understand that. I think
15 that's a good thing to discuss because I think people want
16 it now.
17 JILL SAN JULE: Oh, I want it now.
18 FRANK SWANSON: No question of it, right?
19 JILL SAN JULE: And I can guarantee you that I
20 have an extremely loud voice. I'm not sure they know what
21 they've got yet in me for hiring me, but I want it
22 yesterday too. You can be assured that that is going to be
23 vocalized to them, probably every day.
24 FRANK SWANSON: That would be great. I hope you
25 don't have to wait like I did, to have that recovery issue
54
1 become a departmental objective for two years. I think
2 people then realized what recovery was in general. It's
3 now been codified, put into law, so we have a marching
4 order and I expect that people will have some irritation
5 about certain aspects of that. But if we could just use
6 that one, we could go a long distance.
7 JILL SAN JULE: And I do think there's hope. I
8 recently came back to Washington. I spent the last ten
9 years doing this exact same thing in Arizona.
10 We were about where you guys are now, ten years
11 ago. They way the system looks now, the number of
12 consumers employed within the State, the number of
13 consumer-run organizations, the number of family
14 organizations, it's incredible. I think, I know it's going
15 to happen her.
16 FRANK SWANSON: So the outcomes would mean that
17 you would have to measure employed consumers, right?
18 Otherwise employed or serving in voluntary positrons
19 because that's often the step up that was with our son.
20 Got a voluntary job, got a permanent job. So that
21 transition has to be measured.
22 BJ COOPER: I think--well,I guess I'm not
23 supposed to give you my opinion here. I was just going to
24 say though, is recovery for someone with a mental illness
25 that may never have been successful at anything their
55
1 entire existence, or could be, and I say that for myself
2 sometimes, it's like for me recovery is opening my door and
3 stepping out.
4 FRANK SWANSON: Yes.
5 BJ COOPER: And I think along with recovery,
6 there are many of us being sure that our voice is here
7 about that, that recovery is individual. It just doesn't
8 mean that you're employed.
9 FRANK SWANSON: I should assure you too, that
10 people at Greater Columbia Behavioral Health are thinking
11 of that right now. I serve on a committee that's working
12 on outcome measures for consumers.
13 One of the reasons I emphasize aggressive
14 hands-on measurement, because in every RSN, as you all
15 know, some measure, some don't, some don't use a good
16 instrument, some don't. There's no way to merge this
17 information. So the State have to have acted on it. It's
18 beginning to try to catch up. By the way, I served on
19 Performance Indicators Work Early for several years. I
20 know what those performance indicators are.
21 That's all I really have to say was those points.
22 Thank you.
23 BECKY O'GRADY: I have one thing, I just don't
24 want to forget it. If I may?
25 JILL SAN JULE: Yes.
56
1 BECKY O'GRADY: Something needs to be done so
2 that small town hospitals have the same information and
3 training, ability to treat people in crisis as other
4 people. When I was very sick last summer, I called 911 and
5 said that I need help. The police officers came to my
6 door, weren't quite sure what to do with me. Took me to
7 the ER of a very small town hospital. Went into ER. A
8 nurse came in to do triage and watched me. I was very
9 manic. I walked wildly around the hospital. He walked
10 with me. He said, I've never seen anybody like you. I
11 don't know what to do. In 20 years of nursing, I've never
12 seen anybody like this. I don't know what to do. After
13 quite a while with me running wild, he finally pumped a
14 whole lot of Ativan into me and sent me home, instead of
15 driving me 15 miles to the big city hospital here in Yakima
16 where they have a psych unit. It took me two days later
17 before I finally got admitted and I was much sicker. Small
18 town hospitals need to have the know-how and the ability to
19 access services. I shouldn't have had to wait that long.
20 And the nurse shouldn't have had to be treating somebody
21 who he didn't have any idea how to treat.
22 DIANE ESCHENBACHER: Next, Freida Morford.
23 FREIDA MORFORD: Well, as like this gentleman,
24 I'm first a mother of a consumer that's unmedicated,
25 somewhat diagnosed. Secondly, I'm a probation officer so I
57
1 work with a lot of consumer/clients that have mental issues
2 and varies across the board. I guess I'm here because I
3 wanted to hear about some of these things and I also have
4 some concerns.
5 I just going to go down the list. I agree with
6 the medical coverage for mental health needs to be the same
7 for mental health as the same for medical. My son is on my
8 insurance, but it's like it's just not enough. If he had
9 some other disease, he would be able to be covered. Also,
10 on that same note, when two years ago he was not on my
11 insurance because we were changing policies and he was
12 working and kind of on his own. When this incident first
13 occurred, I was trying to tell everybody, I will pay for
14 whatever it takes to help him. Nobody would help me.
15 Nobody. I work in the business. I know the people at
16 mental health, and nobody would help him. He's still
17 undiagnosed. He's still depressed. He threatens suicide.
18 Nobody will do anything. It's the most traumatic thing a
19 mother can go through.
20 BILL WATERS: Because he's not on Medicaid, is
21 that the issue?
22 FREIDA MORFORD: No. It's because won't accept
23 he has a problem. He denies the problem. So basically,
24 excuse me. The thing that I want changed more than
25 anything is the immediate services for a parent to give to
58
1 their child. Because James didn't tell me he was going to
2 kill me, because he didn't tell me that he wasn't going to
3 harm himself or others, and the he could take a shower by
4 himself, they wouldn't take him in. That should not be the
5 only criteria. If he were able to get in at that time when
6 he first came home and was psychotic, I think he would
7 recognize that there is a problem and get some sort of
8 assistance. He got none.
9 BILL WATERS: So you're trying to help him get
10 him assistance even though he is not recognizing he needs
11 help?
12 FREIDA MORFORD: Right. He needed to be
13 hospitalized. We don't know what the problem is. He did
14 go to a psychiatrist with me who sat there for 15 minutes,
15 20 minutes and the psychiatrist said he has bipolar. I
16 said, how do you know that. You've only seen him for 15
17 minutes. Well, because you've talked about it. Anyway, he
18 diagnosed him within 15 minutes as being bipolar. Great.
19 Now what do we do? And he says, James, what do you want to
20 do? And James says, I don't have a problem. You're the
21 problem. And he walks out of the office. And the doctor
22 says, I can't do anything. I said, he is psychotic. He's
23 been out there telling me--I'm not going to get into the
24 whole situation except that he was very psychotic. He
25 thought people were after him, the government was talking
59
1 to him, Hollywood, people were talking to him on the TV.
2 He could hear voices. There were all these other things
3 going on, and yet he would not be hospitalized. They would
4 not hospitalize him because I was stupid enough not to say,
5 he said he would hurt me. You know, that ridiculous. And
6 then if I did say that, there would not have been a mental
7 health professional come out to take him in, it would have
8 been the police. He would have been arrested. And as
9 Judge Schwab was saying earlier, we have so many people in
10 our system right now that have mental health issues that
11 are not being addressed. What they're being addressed
12 through is the criminal justice system. We can only do so
13 much, and we do not have the ability to give
14 psychiatric--or assessment. That's not our field of doing
15 that.
16 We are working really close with mental health.
17 I think we've come a long way from where we were. I've
18 been in this business 15 years, 16 years now, and we've
19 come a long way working with the mental health system and
20 the criminal justice system in trying to get some system to
21 work together on that. It's not perfect.
22 What would a transformed system be like? Exactly
23 what somebody said, I can't remember who it was. Somebody
24 said being assessed immediately. It's just a 10 question
25 questionnaire, you know, have you ever thought about
60
1 suicide? Have you ever had depression? You know, those
2 sorts of things. Has anybody ever said to you, you need
3 some mental health? Those are just simple questions that
4 could be asked in the jail setting. The wrap-around
5 services that we're talking about, rather than having the
6 police come out to help somebody that going though an
7 episode. We don't need the police. We need professionals
8 to come.
9 My son now lives in California. They have a
10 program in California right now that, if I were to call,
11 which I did, they didn't go out because the psychiatrist
12 actually called him because I--I'm working deals with my
13 son to get him to go. They're able to out to home, three
14 or four individuals would go there in plain clothes,
15 they're mental health professionals and they would talk to
16 him. If they felt there was a need, they would have him
17 institutionalized, or they would take him to the hospital,
18 or they would contact a doctor immediately. They do follow
19 up. They did do follow up with me the following day. This
20 is something I didn't get here when my son was going
21 through that in Yakima, in Washington State.
22 Like I say, I work in the system, so it was very
23 difficult for me to accept this. I told them--I thought
24 this was kind of ironic and funny--I did get my son to go
25 to Comprehensive Mental Health. As we're going down there,
61
1 he said, mom, I know that there's one good person and one
2 bad person. The good person is Jeff, that's his older
3 brother. He said, I can't figure out who that bad person
4 is, but I do know he has red shoes on. And I'm like, has
5 red shoes on. I said, where does that come from? He said,
6 I don't know. He just has red shoes. We go into
7 Comprehensive Mental Health, the person that is going to
8 see him and does see him has red shoes. I tell the
9 counselor that. I said he is not going to stay in here.
10 He's not going to say anything to you. Sure enough, James
11 didn't say anything to him. They guy came out and thought
12 I was crazy. He said, I think you're making too much out
13 of this. I said, no, I'm not. I couldn't get out of the
14 car, because he said if I got out of the car, the
15 helicopter that just drove over us was somebody that was
16 watching us and the were going to shoot me, because I was
17 in danger and he would have to run. And he would be a
18 runner now and have to run away from everybody and
19 everything because he's afraid that I would be hurt. How
20 rational is that?
21 The medical coverage, the stigma. Again, yes,
22 I've been in the field. Yes, I've worked with a lot of
23 people. You can I say I don't have that stigma, but you
24 do. Everybody does because nobody wants to be crazy. It's
25 not crazy. It's like I told my son; it's a disease. We
62
1 don't ask for these things. My granddaughter has CF. We
2 didn't ask for her to have CF. James, I didn't ask you to
3 have bipolar. It just happens. We have to get rid of the
4 stigma from mental health issues. It has to be just as any
5 disease is.
6 JILL SAN JULE: What do you see is the State's
7 role in doing that? What types of programs do you see?
8 FREIDA MORFORD: We have--I don't see a lot of
9 advertising. I don't see a lot of things out in the
10 community. Mental health is a disease. It's an issue that
11 starting to come up. People are talking more about
12 depression on TV, but I think that's a federal think.
13 JILL SAN JULE: Yeah, it is.
14 FREIDA MORFORD: I think every state is doing
15 that. But even locally, we have to get out there and say
16 it's okay, it's okay to take medication. I have a friend
17 that has gone though his whole life unmedicated. And just
18 the last few years, I had an anxiety attack. I have no
19 idea why it happened. They said it might be the post
20 traumatic stress disorder, I don't know. But I went
21 through an anxiety attack, and this was prior to my son
22 going through his bipolar. I couldn't leave the house.
23 This only lasted for a week and a half, two weeks, but it
24 was enough for me to know something was wrong. So I went
25 to the doctor, and they gave me some medications and I went
63
1 through and I've never had another problem. I took
2 medication for eight months. She said I could go off it; I
3 said no, I feel safe on it. So I continued for about a
4 year and a half and I haven't had it in three years. I've
5 never had another problem like that. So I don't know where
6 that came from or what happened, but I know I never want to
7 be there again. So, with that said, I just think we need
8 to let people now that these things happen. The gentleman
9 that I was talking about, the friend, once I started
10 sharing that with him and talking to him about his
11 problems, he started going to the doctor and got on
12 medication. He has never had--he said, I didn't know life
13 could be like this. And why? Because of word mouth.
14 People caring for another person to let them know that
15 mental health is not something that has to be a bad thing.
16 You can still function. You're still a great person. You
17 still have a mind. You can still do anything you want.
18 Mental health should not stop a person or allow another
19 person to discriminate against them because of it.
20 The chemical versus alcohol, when people come in
21 that are on my case load, granted, I've seen this so many
22 times, and actually my son is a dual diagnosis. He drinks
23 because it helps him stay qualm. But they will not help
24 him--and that's another thing. He smokes pot. That's what
25 caused it. He's drinking, that's what causing this. And
64
1 I'm like, it may be but lets's find out if it is. Let's
2 get him to some help so we can figure out what's going on.
3 I have clients and that's the same thing. They are
4 definitely--have been previously diagnosed schizophrenic or
5 bipolar or depression or different things. They cannot get
6 the same assistant--they can't get on their medications.
7 They can't get into the system through mental health until
8 they have been clean for 60 to 90 days. In 60 to 90 days,
9 that person's mental health is going to deteriorate even
10 more. They need help immediately. You have to do it as a
11 dual--if it's a dual diagnosis do a dual. You can work
12 these things together. I know that drugs are not
13 effective the same way when somebody is drinking and they
14 can actually cause harm, but if you are monitoring an
15 individual, it can be done. They need both. Combine the
16 programs. There a lot of programs out there. Some of them
17 need to be combined. Somebody was saying earlier, there's
18 a lot of fingers in the pie. I think the pie is split too
19 many ways. It needs to come together. They need to have a
20 program that is accessible, not to have to be searched for.
21 Again, the mental health issues for criminals
22 that are in the system. We need to be able to work
23 something like maybe deferring, having deferred sentencing
24 like that for someone that has a mental health issue and
25 does a crime. What we could do is possibly defer
65
1 sentencing then if they comply with these conditions which
2 would be to get assessed from mental health services. We
3 need to be able to have a Court order in misdemeanor areas,
4 not just Superior Court.
5 In Superior Court--I should back up. A Superior
6 Court order will allow conference with mental health to do
7 an evaluation or an assessment on an individual.
8 Comprehensive Mental Health will not do an assessment or an
9 evaluation on a person if it's Court ordered on our
10 misdemeanor cases. So, I've learned how to work around
11 that, but a lot of people don't know how to do that. So
12 they just say, we can't do it because it's a Court order.
13 They don't follow Court orders. I think they need to. And
14 I think we need to have a deferred sentencing so that if
15 they follow through with the mental health, if they're
16 getting the assistance they need through mental health,
17 they're not becoming engrained within the system. I would
18 say I have a very high percentage of returning clients
19 that, the only reason they're returning is that they've
20 gotten off their meds, they've done something that the
21 behavior has caused them to come back into the system. Had
22 they been on their meds, had they been following through,
23 they would not be back in the system.
24 BJ COOPER: Are you familiar with the system in
25 King County through the courts? That's the thing. Around
66
1 the state, there's a lot of different things going on.
2 They're pilot project so to speak. In King County, they do
3 have mental health court system.
4 FREIDA MORFORD: I'm sorry, yes, I do.
5 BJ COOPER: And then in the western part of the
6 state, they have a Medicaid integration project where the
7 person gets all the variety of services as needed, they get
8 access to all those services when they're first treated.
9 And people who are already getting mental health services
10 can opt to be in the program. It's also a pilot program.
11 There's a lot of things being tried around the state. You
12 can go on to the Washington State website. I think it's
13 like through Access Washington. They have some different
14 programs. If you have some ideas--
15 FREIDA MORFORD: I am familiar with the mental
16 health court. We have a drug court here. I know that they
17 start pilot projects and not they're popping up all over.
18 BJ COOPER: This isn't just for drugs.
19 FREIDA MORFORD: They've also started a domestic
20 violence and a family court. They're starting to
21 individualize each of those things, which is fine. But
22 now, you're going to get so spread out. I know this is all
23 going to come together at some point. I'm just saying any
24 case, anywhere, it doesn't matter if it's mental health or
25 whatever, you could still do those things. If somebody has
67
1 an issue with mental health, a parent or somebody comes in
2 and says my child has mental health issues, or the cops
3 says the defendant was acting--
4 BJ COOPER: Delusional or something?
5 FREIDA MORFORD: Yeah, very manic, very hyper.
6 Could be meth, could be something else, but at least the
7 Court could say, let's have a mental health evaluation.
8 Let's look at this closer as Judge Schwab was saying.
9 Family communication is a big, big problem. I
10 know that there's the HIPA Laws and that's a big issue with
11 people who want to be able to say what they want and who
12 they want. I understand that. When somebody's in crisis
13 or delusion, they cannot think. They do not have the
14 ability to make to competent decisions. Those need to be
15 made by a competent individual who's close to that person.
16 My son was very psychotic and he was not able to make the
17 decision on his own. I mean I had to tell him to take a
18 shower. I had to tell him to eat. Eventually, he would
19 start to come in and out of it because I was babying him
20 through this stuff, but he would not have done it on his
21 own. He would not say I need help. People that are in
22 phytosis or manic, they don't know they have a problem,
23 everything is cool. Depression, oh, my God. You can't go
24 get help. You can't even get out of bed sometimes. It's a
25 very difficult thing for people to do on their own.
68
1 So, it's very important that we change the
2 ability for a family member to make the decisions for
3 somebody else, even if they haven't had signed over the
4 release previously.
5 Don't wait for the worst to happen. The
6 gentleman back touched on that earlier. His son, they
7 waited two weeks before they would do anything because it
8 was emergency response. We can't wait that long. I think
9 we should have the opportunity to be on the road to
10 recovery rather the road to who knows where. He goes in
11 and out so quick, he could be the kid that gets shot. And
12 why? Because he did not get the services immediately when
13 he needed them. So we can't wait for the worst to happen.
14 Mental health, transferring from one county to
15 another. Oh, my goodness. I have clients that live in
16 Yakima County who want to move over to Seattle. They are
17 told they can move over there, sure, you just have to go
18 get signed up with the other mental health agency. They
19 will not make a phone call. They will not do the transfer.
20 They will not give them medication. They're going to run
21 out of medication and they're not going to see this other
22 doctor over here for another 45 to 60 days. Sorry, you
23 don't get any meds because now you're not on our case load
24 anymore, and you're not quite there yet. So you're in
25 limbo. When they're going to transfer from one agency to
69
1 another, there needs to be some sort of ability of the
2 person not to be lost, to be able to get that medication,
3 to be able to get the transfer done smoothly and not them
4 having to do it themselves. I mean that's okay. You can
5 call each other, it's not very difficult to do. We do it
6 all the time. Laws need to be changed for crisis
7 intervention. That's on the top of my list.
8 What is working well in regards to mental health
9 services in Washington State? I don't know all of them.
10 Washington State is not working all together. I can't say
11 anything is really working well for the full state.
12 Possible county to county, it may be. We need to all work
13 together.
14 What would a transformed system look like? If
15 somebody needed assistance, they would get it immediately
16 no matter what, when, how or why, for whatever reason, if
17 it was mental health, or anything. I am a die-heart
18 republican, and I know a lot of people say, well, that's
19 why you think that. That's not true. I think everybody
20 that needs assistance should have assistance. Should you
21 get somebody to help themselves, unless they have that
22 ability, unless they are given something, you have to give
23 somebody the assistance so that they can help themselves.
24 Otherwise, it's not going to work.
25 BJ COOPER: Are you familiar with Advance
70
1 Directives?
2 FREIDA MORFORD: Yes.
3 BJ COOPER: You have to be in--
4 FREIDA MORFORD: You have to be somewhat of a
5 recovery.
6 BJ COOPER: Right. There is now that option in
7 this State.
8 FREIDA MORFORD: But that can be revoked at any
9 time.
10 BJ COOPER: They can choose to revoke it
11 themselves.
12 FREIDA MORFORD: Right, exactly. When he was in
13 California and when he went to see a psychiatrist, he got
14 mad at me. So he called up his psychiatrist, I don't want
15 my mom talking to you at all. So those things can be
16 revoked at any time.
17 DIANE ESCHENBACHER: I have one quick question
18 for you too. Have you ever been in any position where you
19 could take you son, like have him stay with a different
20 family member, different RSN?
21 FREIDA MORFORD: I'm sorry. Withing a different
22 what?
23 BJ COOPER: Regional Support Network.
24 FREIDA MORFORD: I live in Yakima. He lives in
25 California. California has actually been working well, as
71
1 well as they can, because he will not allow anybody to work
2 with him. He doesn't accept that that's a problem. He
3 keeps telling me that I'm the making him have the problem.
4 JILL SAN JULE: What types of services is he
5 receiving? I'm just trying to visualize what types of
6 services you would foresee would help him.
7 FREIDA MORFORD: I think what would--I know I
8 can't keep going back--but I think when he originally came
9 down with bipolar, when this originally had occurred, if he
10 had been hospitalized. Could it have been because he hit
11 his head? He came home for Christmas and he had some major
12 knots on his head, and that happened at our house a few
13 years ago, that was pre the bipolar. Could that be the
14 cause of it? I don't know. I would like to have a handle
15 on this. I think if you had the services, been
16 hospitalized, we could have looked at everything to find
17 out exactly what it was. He would have been on medication.
18 He would have come out of psychosis at some point, made
19 some realization that there is something wrong. Maybe he
20 would not have. Maybe he would have said, you know, you
21 guys are all crazy, which I doubt because he apologized to
22 one of his friends about his actions and how he reacted.
23 So I know there was some concept there. I think if he
24 would have been able to come down immediately after this
25 manic phase it may have made a difference, I don't know. I
72
1 think if he could get the services needed, that he would be
2 made to actually get at a level rather than be so out
3 there, have somebody that would be able to talk to him
4 about what bipolar is, how it reacts and make him feel
5 comfortable. That it's okay to have a mental illness.
6 It's okay to have a problem. You're sick. It's like
7 anything else, like diabetes and cystic fibrosis. Theses
8 are things we don't ask for, it happens and that's okay.
9 You just need to take care of it and you'll be okay.
10 MARINA COVEY: I'm with the Promise Club in
11 Wenatchee, Washington. I think I come here today wearing a
12 couple of different hats. One is as the director of
13 rehabilitation of the programs that I have been lucky
14 enough to be involved with for the last couple of years.
15 The other one is as a parent of a consumers.
16 I just wanted to talk today about what a
17 transformed mental health system would look like. There
18 are a number of ways, I think, our State, our system, our
19 Country fails consumers. Primarily, I think by treating
20 mental illness as a separate distinct problem that is not
21 worthy enough to be treated in the medical care. You know,
22 the fact that these are brain diseases, Brian disorders.
23 If you had a brain tumor, the doctor would treat you and
24 refer you to other services that would be helpful whether
25 that is a support system, whether there's other treatment
73
1 options. What else is available in the community? What
2 else is available out of your area?
3 I think I've heard from a number of people today,
4 and I agree, that when you have a loved one that is
5 suffering and needs help, you don't care what it costs.
6 You're going to find the help that you need. You're not
7 going to leave any rock unturned. We have our daughter
8 that we drove all over the state for years and years and
9 years, to get little pieces of services and paying 70
10 percent of our gross income to pay for those services
11 because our insurance doesn't cover it. And we want
12 Medicaid. And the services, even if you could get them,
13 you couldn't pay for them.
14 I think that mental health care delivery in this,
15 in our State isn't going to get any better until we start
16 looking at educating our primary care physicians and our
17 emergency room physicians, our psychiatric nurse
18 practitioners, our triage nurses, the police department,
19 the jailers, the justice system, probation, substance
20 abuse, and we all start working together. And we start
21 treating mental illness and substance abuse and everything
22 else just as it is, any other medical condition, any other
23 disease or disorder. And we eliminate the stigma every
24 day. When we start providing services that you can access
25 and everyone is knowledgeable about it. Okay. This is
74
1 really not possible and I know that. I get accused of this
2 at work everyday. They tell me that I just dream too big
3 and too far away, but if we don't every aim there, we're
4 never going to get there.
5 We start treating these disorders that same as
6 any other disorder, and we're all knowledgeable about where
7 to go for help and how to work together, people are going
8 to get better. Probation Department can't get any help or
9 relief from all of the people that they're serving with
10 mental illness because the mental illness isn't being
11 treated. And once the mental illness can begin to be
12 treated, people in probation and the court systems are
13 going to see fewer people reoffend, fewer people
14 incarcerated, fewer people put in prison.
15 Same with substance abuse. When people with
16 substance abuse issues get mental health issues. People
17 serving the substance abuse community are going to see
18 fewer people needing those services. And when you're
19 serving people and working towards in a recovery model,
20 people require fewer services and the services that they
21 require are less costly to provide.
22 These services should be available to each and
23 every person regardless of their ability to pay, regardless
24 of what program they're on, even if that means they have to
25 pay for it and can't afford it now. We made payments for
75
1 years and years to try to make sure my daughter got
2 services. We owed money to everybody. But we paid for it
3 because she needed it. Regardless of the ability to pay,
4 regardless of what programs you qualify for, these services
5 need to be available to everyone, medical management.
6 And then also, I have personally seen in this
7 system, in our community and all over the State and
8 Country, the tremendous success the clubhouse programs have
9 had in the recovery of individuals with mental illness. I
10 know that in our community where we have tried to work
11 together and make sure that people are educated and all of
12 the different systems know about what we're doing and how
13 we can help them and help the people we really care about,
14 the consumers. By working together, we will all experience
15 success in educating people so that they do make referrals
16 and people do get involved in our programs. I have seen,
17 in our own community, crisis calls, the necessity for
18 crisis calls reduced. We've seen among our own membership
19 incarcerations reduced. We've seen people be released off
20 of probation early because they're doing wonderfully. Now,
21 that's not the typical thing. And we've seen people return
22 to work and gain more than we could have ever imagined in
23 just participating in our program.
24 So I would envision a transformed mental health,
25 in addition to involving everybody, is not just a
76
1 transformed mental health system. It's a transformed
2 system period, for the people we're here to serve,
3 available to everyone regardless of their ability to pay
4 involving clubhouse.
5 SPEAKER: I'm a consumer and a mother of a
6 consumer. We have an excellent family physician. He knows
7 the family very well. He's educated yet isn't educated.
8 He tries to find other services for you and goes to bat for
9 you. So we have that in our corner. The other thing, the
10 clubhouse model, I'd be lost without it today. I've been
11 able to return to full-time work and am living a productive
12 individual life supporting two children. So that's what
13 working well for me.
14 What's not working well is being trapped in
15 between not qualifying for Medicaid or insurance to cover
16 medications. Not being able to get the help you need. I
17 think that's the main one. The second one would be not
18 being able to get the counseling because you don't qualify
19 for the Medicaid services to get into services that require
20 only Medicaid. Yet, if you have insurance there's a cap on
21 it and it's not covered so you stuck between a rock and a
22 hard spot.
23 A transformed system, I'd like to be able to see
24 all them working together with all the services. Doesn't
25 matter what you have.
77
1 BJ COOPER: I just wanted to say something. A
2 lot of people have mentioned parity, which is that mental
3 illness is treated the same way as a physical illness by
4 the insurance industry. The Parity Bill has passed in the
5 State. The only thing, it's over a period of time and it's
6 not as good as everybody wanted.
7 MARINA COVEY: It's put in over a period of time.
8 It's gradually being enacted.
9 BJ COOPER: Gradually.
10 MARINA COVEY: Only for employers that employ 50
11 or more people. So that means the majority of people
12 working in Washington State, who have private insurance but
13 they work for a small employer, fewer than 50 people, do
14 not qualify.
15 BJ COOPER: Well, there is something they're
16 working on this year, and I don't know where it stands
17 right now to change that. I'm not sure where it stands,
18 but it was before our legislators this year to make that
19 change.
20 SPEAKER: The Federal government back in 2000,
21 they took Parity because I was a Federal employee back
22 then, and full Parity--
23 BILL HARDY: But I think what your' taking about
24 is that real catch-22, where you're not offered any help by
25 your employer but making too much to qualify for Medicaid
78
1 or for other type of coupon, what we call the working poor
2 who cant' get--you make too much to get one, but you don't
3 qualify for the other. That's the real bind. In Parity is
4 going to impact that.
5 MARINA COVEY: Even with being covered on
6 insurance, you know you plan only covers six visits a year
7 and you're seeing--
8 BILL HARDY: It's not adequate.
9 MARINA COVEY: It's not adequate.
10 BJ COOPER: But it is supposed to change. That's
11 one of the things they were changing this year is that
12 they're not allowed to put a cap on it, that they have to
13 be equal. And I don't know--
14 BILL WATERS: But it doesn't change her issues.
15 BJ COOPER: What I mean is they're not going to
16 be able to say you can only have six visits.
17 MARINA COVEY: But like I said, that's only for
18 employers with 50 or more.
19 CHRISTINE GILL: It concerns number one, what is
20 working in regards to mental health services. I have to
21 say the Clubhouse, the Promise Club. They have a program
22 there that has scores of things to help people. One of the
23 things that really helped me was the employment. They have
24 transitional employment. When I first started the Promise
25 Club, I was in pretty poor shape. I had just moved to
79
1 Wenathcee and I didn't know anybody. I was suffering a lot
2 from depression. What this job has done for me is changed
3 my life. I have something to get out of bed for in the
4 morning and it's helped with my sell-esteem. I've met new
5 people. I have lots of friends at work.
6 There's a problem with it. Not with the Promise
7 Club. I lost Medicaid when I got the--I just work part
8 time, 20 hours a week and make minimum wage. I lost
9 Medicaid because of that. So my services at Behavioral
10 Health, I no longer can see a psychiatrist, I had to see a
11 nurse practitioner. I wasn't able to have any counseling
12 with just Medicare. I know about HWD, but I think it's too
13 expensive. It would be over a $100, and think it's just
14 too expensive. So the Promise Club has helped me out a
15 lot, but I run into roadblocks with no Medicaid. That's
16 it.
17 GARY HODGES: Hello. My name is Gary Hodges and
18 I'm a member of the Rose House in Tacoma. And that's my
19 director right over there, Bill Waters; and my supervisor,
20 Diana.
21 What works for me at the Rose House--the Rose
22 House has been there for me for 15 months. They did a lot
23 for me. They helped me out with problems that I had. And
24 also, this stuff that I cannot pick up real fast. I have a
25 lot of help on it. I'm doing as much as I can. I try to
80
1 help out as much as I can. I go to these meetings and the
2 first coalition, yesterday. I really love the Clubhouse.
3 I think that people who want help and are in crisis or have
4 mental problems, medication, to call and talk to people who
5 understand it. You need to be active and doing stuff, to
6 get a job or go to school, or whatever. I want to be
7 there. If it wasn't for one of our counselors at the VA
8 Hospital in Tacoma, I wouldn't be here right now. I
9 thanked him real, real much for me to get in there.
10 And also, what's not working in regards to mental
11 health services. I've seen a lot of times where people
12 will go to talk to their provider, talk to them, and the
13 minute you say something, the thing that they want to do is
14 judge, not hear what you have to say, not do what they
15 think is right for them. But to take them and put them in
16 a lock-up facility, restrain them to the bed, so they don't
17 hurt themselves. I think that is wrong. I think that
18 should at least see what's going on instead of putting them
19 on a lot of medication until they know exactly what is
20 going on. I don't think you should fill them up with a lot
21 of medicine and get them sick worser than they are now. I
22 don't think it should be that way, and I think, you know--
23 Another thing, I think you should talk to their
24 family to see the family has to say or whatever, you know.
25 I strongly feel that the professionals in mental health are
81
1 not doing their job the way they should do it and stop
2 giving a lot of medications until they know what is going
3 on. This is the way that I feel about it, myself.
4 What should a transposed system look like? I
5 don't know exactly how to say that one. I think they
6 should look over everything that was said and you should
7 talk about in this system and do what you need to do
8 without judging the person. That's the way I feel about
9 it.
10 BETH DANHEART: My name is Beth Danheart. I'm
11 not a consumer, but I run the Drug and Alcohol Treatment
12 Center here in Yakima. Obviously, we have many clients
13 that are in common. When we talked about co-occurring
14 disorders and I think this is an issue that I would really
15 like to see more things happen. I don't necessarily think
16 that funding needs to be combined in order to treat people
17 with co-occurring disorders, but I think that the funding
18 needs to be able to work together. I ran with
19 Comprehensive Mental Health a dual diagnosis program in
20 Bulla, Washington for a year and it's closed now because we
21 couldn't get the money to work together. The Drug and
22 Alcohol money was there, but trying to get the money to
23 flow into the mental health system in the program was damn
24 near impossible. We had our local RSN trying to get
25 assistance from somewhere else and they weren't going to
82
1 send their money out of their local RSN.
2 What is not working? The RSN system is not
3 working as far as I can see. Some will work for the
4 client. Talk about someone moving from one RSN to another,
5 and they can't. It's not a seamless system. It needs to
6 be seamless. People need to be able to move around in the
7 State of Washington. We all should have that ability and
8 we can't because there's a big gap, or if you can even get
9 into the next RSN. It took me a long time to figure out
10 how the RSN system worked, because I'm used to the chemical
11 dependency system which follows the client, where the money
12 follows the client. Here, the client just has to stay
13 stuck with the money, you know, where the money comes from.
14 So I think that system is a bad system and impossible when
15 you try to make it work for people with cooccurring
16 disorders.
17 I think that I'm really delighted and hope to
18 hear the word "recovery" when it comes to mental health.
19 You know, recovery has been a word that used in the
20 dependency films for a long time, but it's not equated
21 across the board with people who have mental illness and it
22 should be. You know, isn't any different--of course it's
23 different to some extent--but it's a brain dysfunction and
24 people can get into recovery, they can lead lives that are
25 compelling and they can participate to their utmost ability
83
1 if they can get the right services. So I like the idea of
2 recovery. I've heard people jokingly refer to the mental
3 health system as the mental illness system, you know. I
4 think sometimes the system itself does not support people
5 who are going into recovery. It doesn't support a concept
6 that, you know, you can get better. You can function and
7 feel good and do things to the best of your ability. The
8 chemical dependency system uses the word all the time,
9 recovery.
10 I think in talking about consumer-based programs,
11 I was trying to figure out what that meant. And then I
12 went, oh, we do that all the time. We have recovering
13 people all the time working in our program and some of them
14 are run by recovering people, in fact a lot of them are run
15 by recovering people. And why not because you really
16 understand. People have talked about, I want to go and
17 talk to someone who understands me and what I'm all about
18 and when I'm experiencing the problems that I have. I
19 think when we talked about the Clubhouse model, that's a
20 great model.
21 And there's another model called AA. Why can't
22 we have mental health. You can't call it AA, but you can
23 call it something, Peer Support. I think part of that has
24 to do with stigma too. When you're in recovery, there are
25 other people in recovery. You know the poster, I don't
84
1 know if you all have seen it, where people who are
2 addicted. And it say, what does an addict look like? And
3 there're like 10 people on this poster. Well, they look
4 like all of us. What is somebody who is mentally ill in
5 recovery look like? Looks like all of us. I think people
6 have this idea that it's the bum on the street. Well,
7 maybe it is, maybe that person hasn't got to recovery.
8 But, we're everybody. There isn't any of us that's not
9 touched by mental illness or addition. So I think there
10 needs to be a continuum of care.
11 I think in the transformed system would be a
12 continuum of care. And you would be able to get the help
13 you when you first need it, when you're in a crisis and
14 that something would follow you through and you wouldn't
15 just be picked up just for the crisis. You would be able
16 to get the services you need in whatever that continuum of
17 care looked like. And then, after that happened, there
18 would be something like a case manager who would help you.
19 One of the problems we have in our system is that when
20 people get into recovery and they're doing well, we get
21 them into housing, we house people who have been mentally
22 ill, and then no one follows them. They maybe still active
23 in the system, but there's no case manager following them
24 because they move. And then they're in crisis again. And
25 where's that case manager? So there needs to be something
85
1 underneath that helps people when things start to fall
2 apart, unravel. When you're in the recovery process, and
3 sometimes the process kind of goes astray from time to
4 time. We need to pick it up before someone falls apart and
5 they're at their bottom most, like she was talking about.
6 There needs to be someone there so she doesn't need to go
7 through all of that before she gets some help.
8 And Medicaid. I think the funding, you know, the
9 Feds came through and said there was no Medicaid funding
10 for people on mental health. I think that the State needs
11 to take a look at the funding that's allocated for people
12 who don't have Medicaid. You can pull the Medicaid funding
13 out, the matched dollars, and use it for people who fall
14 through the cracks. There's never going to be enough money
15 to serve everybody. You know with people being able to
16 provide services for everybody who needs it whenever they
17 need it. We should always strive for that, but it's not
18 going to happen.
19 I think looking at the mental health funding a
20 little differently, when saying there's some flexibility in
21 this funding. Yes, we get most bang for the buck when we
22 match the dollars to the Federal dollars which is Medicaid
23 money. But we have to pull out some of those State dollars
24 and serve the people who don't have medical coupons because
25 most people don't have medical coupons. Medicaid is a
86
1 pretty limited group of people and it's getting smaller.
2 And there's a new thing that's come about. Last
3 year with the Hargrove Bill, where he wanted universal
4 screening for chemical dependancy and mental health
5 problems. There's a screening, but that's too short, which
6 was going to be put in place in most mental health programs
7 and chemical dependency programs. On those simple
8 questions said they'd be referred where they need to be
9 referred and hopefully all of the interventionists will
10 eventually use this. If that happens, that would be nice.
11 I don't know if it will or not, but that's the goal. The
12 question is, do they get referred? They get referred to
13 Central Washington Comprehensive Mental Health who is only
14 going to be able to see people on Medical Coupons, and they
15 don't have a coupon. They're not going to do one.
16 MARINA COVEY: We're talking about not being able
17 to see everybody. We can't pay for everybody. I wasn't
18 meaning that necessarily that they would provide the
19 services for free, but definitely make them available.
20 Whether they pay for them or they don't pay for them,
21 whatever. There are clinics and hospitals all over the
22 place that cannot turn anyone down. Cannot turn anyone
23 down if they cannot pay for services. So why is mental
24 health any different. You could have pneumonia, they're
25 going to see you. You could have a sinus infection,
87
1 they're going to see you. And they're going to treat you.
2 For mental illness, they will not. They same thing should
3 apply to everybody. If you need it, you're going to pay
4 for it, or you're going to get it for free or at a reduced
5 rate, but eventually--by providing adequate services to
6 everyone, you're going to save yourself money in the long
7 run.
8 BARB NOAKES: It just amazes me that the head is
9 connected to the rest of the body and everything and why is
10 it separated? Do you know what I mean?
11 FREIDA MORFORD: I just want to say that I agree
12 with what you are all saying today and I think what's
13 working well in regards to the mental health services is
14 that there's a lot of very dedicated individuals who really
15 give it all try to make the system work. But the system
16 just doesn't work together. It's too fragmented. They
17 have to work together.
18 What's not working in mental health is, I believe
19 there's a lot of waste being done because there's so much
20 of a guessing game, like this gentleman pointed out. I
21 would like to see in a transformed system where we would
22 become more of a part of the medical field and use the
23 instruments that are available to measure brain waves, to
24 see what's actually happening in the brain, instead of a
25 guessing game. I think in the long run, we'd save billions
88
1 of dollars. I know a lot of the family members from NAMI.
2 I can't tell you the medications I've been tried
3 on, and over and over and over and it's such a guessing
4 game. I know there are ways to this in a medical system
5 where you take a picture of the brain. They have an EEG
6 put out now where it works like a heart attack, measuring
7 for a heart attack; it measures your brain waves. And then
8 the can tell you what area of your brain is not functioning
9 properly. It would help get rid of the stigma because
10 people can see it instead of it being a guessing game.
11 DIANE ESCHENBACHER: They already do CAT scans.
12 FREIDA MORFORD: They have head scans, but they
13 even have things that are cheaper than that and just as
14 accurate. It's just how is it made known to the general
15 population. In fact, there's a lab right in the Tri-Cities
16 here invented one. I went to the research presentation,
17 and it was incredible. He had two kids he tried it on.
18 One was acting out mental illness. How did he find out?
19 This showed that this young man, in fact, had a brain
20 injury so he was treated for a brain injury. Otherwise,
21 it's a guessing game, he might have been treated for a
22 chemical imbalance, but it was because of a brain injury.
23 So I would like to see us have more updated ways of
24 diagnosing people with mental illness and it would help get
25 rid of the stigma. It would get more people to want to get
89
1 treated and it would save money at the same time.
2 And the outcomes, I would hope would be we would
3 have less forensic beds being built and we'd have more
4 community services being sought. One thing that I would
5 like research, because I would like to see if the advance
6 directive actually works. I'd like to know how many people
7 use it. I don't know of anybody that uses it. Maybe some
8 of the more people who are higher in recovery have, but it
9 doesn't work for the ones--like our son who repeatedly
10 refused to think they're ill and there's no way they're
11 going to use an advance directive. So I would just be
12 interested in how many people actually use it, follow it
13 through. Because I don't think it works.
14 Another thing I would like to see happen is
15 there's such a big flexibility of care from county to
16 county. If you go into our RSN, what Yakima has compared
17 to what Tri-Cities has, I always tell people, you guys have
18 Hollywood, we have ghetto. I don't know why that it. I
19 wish everyone had the same access of care. That would be
20 something I want to see happen.
21 JILL SAN JULE: We just want to say thank you to
22 everyone who came tonight and gave testimony. It was a
23 long three hours and a lot of hard work on all of our
24 parts.
25 We will take everything that you've shared back,
90
1 and if you're email is here, we can also email it back to
2 you and let you know what the final product is. This is
3 our third one now in gathering this testimony and
4 everything has been documented that you've shared. And
5 again, we appreciate all of your comments and input. It
6 helped make this Transformation a reality, because it will
7 be.
8 DIANE ESCHENBACHER: You can keep track of this
9 on the website, on the Mental Health Transformation
10 website. It's all broken out.
11 JILL SAN JULE: Right now on the website, there's
12 just a filler page on the actual DSHS site under mental
13 health. But we have--the Grant just hired a web master
14 who's going to be putting together, for the grant, a really
15 thorough website that's going to have everything up to
16 date, interactive. So if you have any thoughts on what
17 you'd like to see from that too, you can send it to us by
18 email, that would be great.
19 Thank you for coming.
20 (Whereupon the meeting concluded at 7 p.m)
21
22
23
24
25
91
1 CERTIFICATE
2
3 I, Valerie R. Allard, do hereby certify that
4 pursuant to the Rules of Civil Procedure, the witness
5 named herein appeared before me at the time and place
6 set forth in the caption herein; that at the said
7 time and place, I reported in stenotype all testimony
8 adduced and other oral proceedings had in the
9 foregoing matter; and that the foregoing transcript
10 pages constitute a full, true and correct record of
11 such testimony adduced and oral proceeding had and of
12 the whole thereof.
13
14 IN WITNESS HEREOF, I have hereunto set my
15 hand this 15th day of March, 2006.
16
17
18 ___________________ _____________________
19 Valerie R. Allard Commission Expiration
20
21
22
23
24
25
Related docs
