The politics of mental health care

To Senator Joe Fain (R-47th LD) mental health is the underlying cause of so many things in society that can go wrong. “It manifests in homelessness, drug addiction, depression, marriages that dissolve, adverse childhood experiences and broken families. All of that can find some root in mental health. If we do not have some robust way to respond to that, we really are failing to respond to most of the problems we have in society,” said Fain.

The Importance of Mental Health Care

Though Washington has improved its ranking with Mental Health America regarding the state’s access to mental health care compared to the prevalence of mental illness (now 34th up from 48th), Fain is not satisfied. Washington State and the legislature have made positive progress toward pressing health care needs such as tobacco cessation, cardiovascular medicine and in cancer research. That same attention has not been given to mental health. Fain considers the lack of prioritization of behavioral health in the healthcare constellation a failure.

“That can be seen in the homelessness we see on the streets. That can be seen in the decertification of our state hospital, that the federal government has pulled out 10’s of millions of dollars because we failed to get our act together,” said Fain.

In general, the Washington State legislature has mostly been on the ‘yes’ side of furthering mental health care in the state and increasing suicide prevention in recent years. However, according to Fain, there is still a long way to go legislatively. “I think we need to, obviously, solve our crisis at Western State [Hospital] and then make sure the Western State Hospital is serving a specific population and that it is designed to address high acuity cases, very difficult cases, and criminal cases in rare regards.”

“Then, once we’ve really established a successful model that is sustainable at Western State, that we have community-based care for the majority of individuals that are facing mental health crisis in our state,” Fain continued. “That means more social workers that need to be trained and encouraged to enter the mental health area. That means we need more clinics that specialize in mental health.”

Addressing Mental Health, Addresses Homelessness

Addressing homelessness, Fain went on to say “we need more secured care centers so that those on the streets who are drug addicted or mentally ill who are also routinely engaging in low-grade criminal behavior aren’t just being left on the street; because somehow we think it’s compassionate that we don’t arrest them. When in reality they should be taken and placed in a care center where their illness can be addressed and treated. There are definitely some resource and policy conversations that need to take place before we can realize both of those successfully.”

“Of course on housing stability,” he continued, “for individuals facing these problems they need some roof over their head as they’re trying to correct them. Because no one has ever been able to successfully [treat] a mental illness while living under an overpass.”

The Need for More Resources

For Fain, the Alliance for South Sound Health Behavioral Health Hospital that is expected to be ready for patients in January 2019, will be a small but meaningful step in the right direction. The hospital will be dedicated to addressing the mental health needs of south King County and Pierce County. Fain explained that, in his opinion, one of the more significant issues facing the state is the cycle of behavioral health patients that community hospitals face. “A patient with a significant underlying mental health diagnosis that comes in for emergency care for an unrelated injury. They’ll stabilize the emergent situation, and then, in many cases, they’ll start treating the underlying mental health condition.”

“But once the emergent condition is handled,” he continued, “they’re discharged back out into the community, right back into homelessness. Any progress they made on the mental health front evaporates and then they find themselves right back into an emergent care situation; sometimes days later. That’s been a real crisis, and very expensive.”

Tackling Mental Health Legislatively

Recently Fain has been co-sponsor to one Senate bill and one House companion bill that aim to further suicide prevention and raise mental health awareness. Senate Bill 5553 – 2017-18 amends RCW 9.41.080 and 9.41.092, and adds three new sections to chapter 9.41 RCW. Passed as law, SB 5553 permits a person to file a voluntary waiver of firearm rights with the clerk of the court in any county in Washington state.
Senate Bill 6603, a companion bill to HB 2793 – 2015-16, amends RCW 9.41.310 and 43.70.442; adds a new section to chapter 43.70 RCW and a new section to chapter 82.04 RCW. This passed bill provides for suicide prevention and awareness education. The new law also establishes a safe homes task force is to raise public awareness and increase suicide prevention education among partners who are in key positions to help reduce suicide. The task force is administered and staffed by Forefront at the University of Washington school of social work.

Fain explained that SB 5553 was a bill of experimental nature. Though he likes to be very data-driven in decisions, he shared that sometimes the legislature will take actions that don’t have data behind it, to help gather the data. Though Fain is uncertain the voluntary waiver is going to be a widely used tool, or if it will be used at all, he feels that it was worth passing. Fain explained, “it is not a difficult program to stand up and should not be objectionable. A person using it should have the support of the State if they think they are personally at risk of harming themselves. And so under Senator Pedersen’s (D-43rd LD) leadership we wanted to create this low barrier to entry as it doesn’t require a lot of bureaucracy and can be streamlined in its implementation. If it is used only one time, it would be worth the passing of the legislation.”

Working with Representative Orwall

As a legislative representative, there are people that you work with that you trust and want to support. Representative Tina Orwall (D-33rd LD) is one of those people for Fain. “I have incredible respect for the work that she has done on a number of issues, but she has really been the leader on suicide prevention. Rep. Orwall, with individuals from Forefront, approached me to sponsor the companion bill [to HB 2793]. I was absolutely honored to be asked to do so, and to help her get her version across the finish line at the end of the day.”

Fain, Joe Fain, Senator Fain, Forefront
Senator Fain receives The Legislator Award from Forefront | Courtesy Photo

In society, there are frequently hyper-polarizing issues that cause individuals to end up on either side of a black and white line. “Guns so often are on that list,” said Fain. “To see the partnership and thoughtfulness that Rep. Orwall and Forefront put in place to engage with the NRA, or other groups, and the thoughtful ways to address what is the largest cause of gun deaths in our state – which is suicide. To see both sides of the gun issue or gun interest groups, come together on something – I think that is just miraculous. I was really just pleased to be a part of that.”

Fain credits Rep. Orwall and Forefront with developing the Safer Homes task force. “The values that went into generating [the task force] were ‘how can we create as inclusive a group as possible,’ while also recognizing the training programs and where the rubber meets the road to make this successful would come from pharmacists, health care providers, and mental health experts, etc., as well as gun dealers and individuals in that space. In the composition of the task force, there were really a lot of obvious places to go to.”

In November 2017 Fain received the Legislator Award at Forefront’s fifth annual Restoring Hope suicide awareness dinner fundraiser. Being in awe of the work Forefront and Rep. Orwall have done, Fain was humbled and honored to receive the award. To Fain, being honored with this award several years after Rep. Orwall was a “big step down compared to how deserving Rep. Orwall was. I have always tried to be a wingman for her and follow her lead. She has been an unstoppable force on these issues for the legislature. And done so in a way that doesn’t divide people, but rather finds a way to bring everybody together to find consensus. I have such great respect for her and her work.”

Support Starts In Our Communities

Giving support to those with mental and behavioral health needs starts within our communities. “What a lot of folks don’t realize is there are a lot of great nonprofit mental health organizations that are doing this work each and every day, and they need community support, and volunteers in many cases,” said Fain.

In Auburn, Nexxus Youth and Families addresses youth homelessness and school-age depression and mental illness. Valley Cities has a variety of mental health and substance abuse services for adults and families. Battlefield Coffee House, off A Street in downtown Auburn, supports Battlefield Addiction an addiction recovery organization comprised of “an army of soldiers, [who] believe those who’ve been through the “war” have a purpose, and that is to put their experience, strength, and hope into action and fight for, and stand with, those still in the battle.”

Proud of those based in the Auburn area, Fain highlights these such organizations as “unsung heroes, that don’t get the type of attention, accolades or donations that other types of groups get. Knowing the groups in your own community providing that kind of service and asking, ‘how can I help?’ they will always have an answer of what that looks like.”


This article was planned and interview occurred prior to the allegations made against Senator Fain.  The Auburn Examiner recognizes the seriousness of these allegations.  Considering it’s content and relevancy, we do not have enough information to determine this article should not be run without a full investigation or further legal steps taken by Fain’s accuser.  

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