The Mental Health Project is a Seattle Times initiative focusing on mental and behavioral health issues. The project is funded by the Ballmer Group, a national organization focused on economic mobility for children and families. Additional support is provided by City University of Seattle. The Seattle Times retains editorial rights to the work produced by this team.
King County will soon begin its largest expansion of its mental health system in decades, opening five centers aimed at helping people in crisis.
The Metropolitan King County Council voted unanimously Tuesday to finalize rules that will determine who can operate crisis care centers and how they will be run, the final step before the county begins selecting cities to host the centers and the organizations that will run them.
All of this effort is aimed at building something that doesn’t currently exist in King County: a dedicated mental health center where anyone can drop in and get urgent mental health care. County officials believe the center could serve up to 70,000 people a year.
“We have an opportunity here to make King County a national model for crisis care,” City Council Member Reagan Dunn said at Tuesday’s meeting. “As you know, behavioral health challenges of all kinds are hitting our community harder than they’ve ever been before.”
The funding will come from the $1.25 billion property tax that voters approved last year for mental and behavioral health services. The first center is scheduled to open in 2026, with more to follow. All five centers are expected to be open and operating by 2030.
It took five months of discussion and revisions before the council approved the implementation plan, a detailed 150-page document outlining how the centers will be located, funded and evaluated.
The county currently has no such center, and people in crisis often end up in hospital emergency rooms, jails or don’t get help at all. County officials and mental health advocates hope the center will play a key role in building a stronger mental health system that could also include mobile teams and more psychiatric beds.
Each crisis center will include a behavioral health urgent care clinic where people can be screened and triaged for the appropriate services, an observation unit where people can stay for up to 23 hours, and a short-term stabilization unit where people can stay for up to 14 days before being discharged or referred elsewhere. People are voluntarily admitted to a crisis center regardless of health insurance coverage or ability to pay.
“We’ve been through a lot of throwing spaghetti at the wall and hoping it will stick,” City Councilman Pete von Reichbauer, a co-sponsor of the proposal, said Tuesday. “I think this will stick.”
Months of debate
Transportation to and from the center came up multiple times during council discussions. Plans call for the facility to have “meaningful access to public transport” and be close to major highways. Councillors were concerned about where people would be discharged from the center and how they would access transport back home.
The council added language requiring the centers to work with local health care providers, mobile crisis teams, emergency responders or police to facilitate transport to the centers. The county also will collect and report data on how people in crisis get to the centers.
The proposed amendment would have required the Department of Community and Human Services to work with King County Metro to help people who use public transit or are in public transit centers access the centers. Councilwoman Sarah Perry withdrew the amendment after other members of the Community Policy Committee expressed concern about giving more responsibility to public transit operators.
The council also removed language limiting the number of centres any one operator could manage to three. Earlier this year seven operators expressed interest in running the centres.
“We want to make sure the best organization in the area is running the center, and we don’t want to be prevented from doing that just because there are three other organizations there,” Redmond Mayor Angela Barney said at the May 8 commission meeting.
The new language also allows counties to directly purchase property in “exceptional circumstances,” with approval from the County Council and support from the host jurisdiction.
County Vision
These centers are a key part of King County’s vision for a stronger mental health system, and Susan McLaughlin, the county’s director of behavioral health and recovery, said she wants to use the levy’s funds to build “the behavioral health system of the future.”
“We’re looking at rebuilding inpatient psychiatric beds, but we’re not going to rebuild the same ones we had before,” McLaughlin said in an interview ahead of the plan’s passage. “We’re going to rebuild them based on what the system needs and what the future of behavioral health care looks like.”
The Crisis Care Center implementation plan outlines three elements of a robust behavioral health crisis system: The Center is the “place to go.” The Countywide Mobile Crisis Team is the “people to respond.” 988 and the Crisis Hotline are the “people to call.”
Before the center is built, other funds from the levy will be used to expand mobile crisis services, a service in which teams of mental health workers and peers travel around the county to de-escalate crises, provide initial assessments and help people in crisis find further care. The county said the $3 million in initial funding will allow it to increase the number of mobile response teams in the county from 20 to 32.
The county plans to solicit proposals from groups interested in providing mobile emergency services this spring and announce a new contract this summer. The county currently contracts with the Downtown Emergency Services Center.
The county also plans to add teams to its contract with the YMCA of Greater Seattle, which runs a children’s crisis response system.
What’s next?
The county can now begin searching for a location and operator for the center, and a request for proposals seeking behavioral health organizations interested in running the center is expected to open this fall.
The levy would divide King County geographically into four crisis zones, with one center in each zone, and a fifth center focused on serving youth.
Earlier this year, the county surveyed interest from cities and providers. According to King County documents obtained through a public records request, the following cities expressed interest to the county:
- Bothell
- Lake Forest Park
- Brien
- Kirkland
- Kent, Renton, Auburn
- Kenmore
- Redmond
- Bellevue
- Seattle
The following providers have expressed interest:
- RI International is an international nonprofit providing crisis response in Pierce and Thurston counties.
- Highline United Methodist Church is the church that runs the Berean Day Center and Severe Weather Shelter.
- Sound, a nonprofit mental health and addiction treatment provider in King County.
- Pioneer Human Services is a Seattle-based nonprofit that helps people with mental health issues and substance use disorders, as well as those transitioning back into society after incarceration.
- Connections Health Solutions is an Arizona-based for-profit operator of behavioral health crisis care centers.
- Fairfax Behavioral Health is a for-profit subsidiary of national health care company Universal Health Services.
- The Downtown Emergency Services Center is a Seattle-based nonprofit that provides homelessness, substance use disorder and mental health services. DESC provides similar services but operates a Crisis Resolution Center for those who need a referral from police, a Mobile Crisis Response Team or a mental health professional.
Another center in Kirkland, run by Arizona-based Connections Health Solutions, is scheduled to open this summer. Before the levy was approved, the city announced plans to partner with Bothell, Kenmore, Lake Forest Park and Shoreline to build their own mental health crisis centers.
If the county selects the center as one of its sites, it could speed up the goal of opening the first center in 2026.
“The City of Kirkland would like to see the benefits of the tax felt locally and, if that is the case, would also consider having the Connections facility designated as one of five dispensaries for the county,” Vice City Manager Julie Underwood said in an email.
