Sales tax hike sought for mental health

If the mental health professionals in Island County had it their way, the commissioners would exercise their right to impose a sales tax increase to help beef up mental health programs.

Mike Merringer, Island County’s administrator for Juvenile and Family Court Services, and Jackie Henderson, Human Services director with the county health department, made a presentation to the commissioners Monday afternoon. The duo laid out exactly what a sales tax hike of one-tenth of one percent, the amount allowed by the state code, would buy.

The recommendations were formulated by the Mental Health Initiative Task Force, a group formed last November.

The code stipulates that the sales and use tax would be used exclusively for chemical dependency and mental health treatment services. In 2006 the tax would have netted $877,000 in Island County.

Prior to the presentation, Stan Baxter with Compass Health described a dire mental health situation. The community mental health center serving Whidbey and Camano islands has been forced to contend with staff cutbacks and a population with sizable needs.

“The bottom line is that Compass can only serve Medicaid clients,” Baxter said. “We can’t respond to the needs of people with private insurance or no insurance.”

Baxter said the county tax initiative would be an opportunity to design and deliver mental health services locally.

Merringer, coming from a legal angle, described the therapeutic court program that the tax dollars would fund. Therapeutic court has special calendars or dockets designed for the intense judicial supervision, coordination and oversight of treatment provided to parents and families who have substance abuse or mental health problems, and who are involved in dependency proceedings.

Merringer said therapeutic drug courts are designed to reduce child abuse and neglect, out of home placement of children, termination of parental rights and substance abuse or mental health symptoms among parents or guardians and their children. A four-year study of therapeutic drug court programs in California showed an overwhelming effectiveness.

The funds would also help enhance the county’s adult and juvenile drug courts.

Merringer said the financial benefit for the programs speaks volumes. Taxpayers would benefit to the tune of $353,900 per year for the three programs alone.

Henderson stepped in to tackle the mental health services side for the uninsured, what she called the biggest problem in Island County.

“The cracks have become huge holes and many, many people are falling through them,” she said.

Thousands need mental help

According to the 2006 Behavioral Risk Factor Surveillance System, 30 percent of Island County’s population has a diagnosed mental illness and at least 10 percent of the residents do not have health insurance. The percentages equate to an estimated 2,300 people who have mental illness and no way to pay for treatment.

Depression is a particularly costly and prevalent mental health issue for Americans. Estimates show that the economic burden annually is as high as $89 billion translating to $278 per person and an impact of over $21 million dollars each year for Island County.

Henderson said the reality is that uninsured and underinsured residents ultimately end up in the emergency room. And compounding the problem, 89 percent of frequent ER visitors reportedly have an alcohol or other drug disorder, a mental illness, or both.

“The hospital has nowhere to refer them. And so the revolving door begins,” Henderson said, adding that the average cost of an ER room psychiatric visit is $3,000 to $4,500 and the cost of an inpatient psychiatric hospital bed in Washington is more than $1,000 a day.

What would the new tax funding buy? It would double the mental health professionals in the four county school districts. Henderson underscored the gravity of the mental health problems in schools.

“Mental health problems affect one in five children,” she said. “These numbers are pretty astounding.”

Depression in middle school and high school students is prevalent. Twelve percent of eight-graders, 16 percent of 10th-graders, and 12-percent of 12th-graders said they have seriously considered suicide in the past year, studies show.

“Severe depression hits Island County youth really hard. More students reported being severely depressed than using illegal drugs,” Henderson said. The contingent of mental health professionals in the room Monday could attest to the problem, she continued. “They see a lot of this.”

Through counseling, education, outreach, consultation and referrals, approximately 80 students or families could be served on a weekly basis.

The Senior and Vulnerable Adult Outreach Program is another important piece of the mental health puzzle. The older demographic struggles with prescription medication and alcohol addiction, leading to devastating side effects and ultimately an untimely demise.

“They become very isolated, very fearful,” Henderson said. “And then they call 911.”

Calls to I-COM from seniors can cost the county between $15,000 to $20,000 a year.

“This program would assist them in getting the services they need,” she said. Referrals would come from senior services, law enforcement, the hospital, and other agencies. Between 35 and 50 seniors would be served; a drop in the bucket, but a very important drop and in a very important bucket.

The situations in the county jail and juvenile detention center are equally dire. Forty to 80 percent of jail inmates have a mental illness and/or a substance abuse problem, and 20 percent of those have a severe mental illness.

Expanding the mental health services at the jail and juvenile detention center would provide crisis counseling, mental health assessments and treatment, and referral services. The program would serve 10 individuals a week in the jail and between one and two in the detention center.

The advisory committee was made up of a cross section of the community. It will work on planning and budgeting and finalize the phasing in process and timeline.

“This initiative is an opportunity we can’t pass up,” Henderson said, urging the county commissioners to act as soon as possible.

Drug court prosecutor Colleen Kenimond implored the commissioners to impose the tax, which would provide more money for treatment of the uninsured.

“The best we’ve got right now is drug court,” the Mount Vernon attorney said, adding that it reunites families strengthens the workforce and in the long run increases the tax base. She said the initiative would be a boon for the program. “What an opportunity.”

Island County Prosecutor Greg Banks said the initiative would help bring the drug court up to national standards. Additionally, the mentally ill are frequently victims of crimes and can make unconvincing witnesses, precluding convictions. Offering treatment would help stem the problem.

“It’s good policy, it’s humane,” he said.

Island County Sheriff Mark Brown said the jail staff members are not mental health professionals, but they are often serving in exactly that capacity. He emphasized the need to reduce recidivism and expressed his concern about the vulnerable senior population that often resorts to unnecessary 911 distress calls. Further, Brown is worried about the youth. Suicide and depression can ultimately result in violence in schools, he said.

Tom Pacher, county public defender, said the county is already paying for the mental health issues as victims, and through assaults, property damage and the drain to families.

“We see it on the back end,” he said.

Sen. Mary Margaret Haugen said she is distressed by the lack of human services. She voiced her support for the initiative.

“Do this today so that we can start tomorrow,” she said.

The board was not able to vote on the initiative Monday. The county code will first need to be changed and a public hearing held. Commissioner John Dean applauded the work of the professionals assembled at the presentation and took no pains to hide his support for the tax.

“You’re all on the front lines of what is tantamount to a war,” he said. “It’s a no-brainer for me.”


raises doubts

Commissioner Mac McDowell was concerned that higher levels of government could vacate funding granted in the past and leave the lower level “holding the bag,” in this case the taxpayers. He also said for the group of county residents on fixed incomes, the tax increase could prove substantial. He qualified his concerns by saying that he was not denouncing the initiative.

Commissioner Mike Shelton has been involved with mental health since being elected. He said a problem lies with a system that deals with a person after they become seriously ill. Placing the issue in perspective, he summed up the mental health quandary with levity and candor.

“Mental health, in terms of exasperation, is even worse than land use,” he said with a chuckle. “That’s saying something.”

The commissioners will likely set a public hearing date at today’s staff session.

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