‘Almost unconscionable.’ Tri-Cities families struggle with critical youth mental healthcare

What happens when a mentally ill student threatens classmates?

For one Tri-Cities family, it took years of desperately searching for help and direct intervention from the Washington governor's office to get the care he needed.

In that time the teen, now almost 16, was arrested over and over, hospitalized multiple times and failed to get help from treatment facilities that couldn't manage the level of care he needed.

His mother says she worries every day that he might hurt himself or someone else.

The teen told the Herald he doesn't think about the future — it's pointless. And while he's open to help, the system has let him down too many times.

He and his mom met recently with the Tri-City Herald to talk about his struggles and their frustrations with a dysfunctional system.

The Herald agreed not to use their names so they felt free to share their story and shed light on the critical need for better youth mental healthcare in the Tri-Cities and the state.

"This mental health system is broken for adults and much more for the youth," his mother said.

Her son's sense of hopelessness, coupled with moments of crisis due to not getting proper treatment has led to drastic behavior such as him wandering into traffic. His mother worries about the day when they won't be able to find him in time.

"He's going to hurt himself because of his suicidal ideations," she said. "He just checked himself into the hospital the other day for his mental health, and they wouldn't even call crisis (response officials). The system is broken around mental health and how to help our kids."

Since he's been kicked out of school permanently and unable to attend an alternative school due to his mental health concerns, the family has dealt with his violent outbursts, more runaway calls than they can count and roadblock after roadblock trying to help get him care.

They've called police to report him as a runaway, but his mother said officers are limited when it comes to getting him any real help.

In the two years since he suffered an episode and threatened classmates, the teen has attended just three days of school.

Since then, he's been in trouble with the police dozens of times, because the Tri-Cities area has no other alternative for youth in this kind of crisis.

He doesn't think about finishing high school or attending college someday. He says he can't even imagine life getting better.

"I don't care because I'm not going to go to school, I just gave up on my future a long time ago," he said. "I see things getting better when I'm an adult and out of the house. Right now I don't see it getting better."

They've seen multiple psychiatrists, who've all said he needs specialized care and long-term, in-patient treatment, but access to that is hard to find and statewide the Legislature only funds 109 youth in-patient beds.

"It's almost unconscionable ... that longer term in-patient psychiatric treatment for youth takes three months and sometimes up to 6 to 7 to get in," said Gordon Cable with Greater Columbia Behavioral Health . "You're saying a kid needs that most intensive treatment but they cant get in."

"We've been told there are waiting lists 100- kiddos long, and that it's not going to be days or months, but years depending on the agency you call," he said.

Still, he's seeing some progress. It's just not fast enough.

Desperate for answers The mother who spoke to the Herald said until getting help through Gov. Inslee's office they struggled the most with crisis response and where it should have intersected with getting her son to a place of safety and effective treatment. They felt written off and neglected.

"To be told by crisis (responders) that my son would have to be running in the road naked and not responsive to put a hold on him, really blew me away," she said.

"He's had mental health issues even as a young guy, just lying in the road trying to get a car to run him over. These last couple years, he threatens to kill people, he threatened to kill his class ... crisis intervened, they did nothing."

Because they had nowhere to take him except to the emergency room, no consistent treatment ever came from the crisis response calls.

One of the biggest roadblocks in getting necessary care has been an insurance issue.

Having private insurance disqualifies a family from many state programs.

It took dozens of arrests and the teen being involved in the criminal justice system for them to qualify for Washington's Apple Health Care program.

Cable said he's seen many families with private insurance struggle to get their service provider to pay for recommended treatment.

Cycle of crisis "Now we have this pattern of violence and people calling crisis repeatedly, and crisis does nothing," said the teen's mom. "He's catching felony harassment charges in detention because he's in a manic state, and they're not recognizing it."

"It's just been a repeated pattern. He can't control himself physically or mentally when he's in these episodes."

He's qualified for in-patient treatment twice.

The first time they were told he needed a higher level of care. Then, at a private in-patient facility he was sexually assaulted.

"They were mandatory reporters , but they didn't report it," his mother said. "It's a continued failure of society and the system."

In Washington state medical professionals, law enforcement, teachers, social service workers and others are required by law to report suspected abuse, neglect, abandonment or exploitation of vulnerable youth.

While the assault happened at a privately run facility, sexual abuse at youth detention centers across the state has led to several class action lawsuits.

Violence of all kinds has increased in youth treatment facilities as well. A special report to the Legislature showed that by August 2024, the number of assaults against staff members at youth treatment facilities had already doubled compared to all of 2023.

That kind of mistreatment at facilities has just made the teen more leery of seeking help. They say they're still trying though.

"We're dealing with mental health, we're dealing with diagnoses, so while right now he's on board with the plan, a mood swing could change that," his mother said.

Finally after two years of trying to find help, she was able to connect with Inslee's office and staff members helped them navigate getting the teen onto Apple Care, which opened the door to accessing other support services they previously didn't qualify for.

Now she wants to help spread awareness so no other family has to go through what they have.

"We need to figure out a way to get a facility up and running to help these kids," she said.

Lack of services Cameron Fordmeir is a member of a Tri-Cities group trying to improve access to addiction treatment and mental healthcare in the Tri-Cities.

He is a board member of the Benton Franklin Recovery Coalition and the regional administrator for Greater Columbia Behavioral Health's Recovery Navigator Program.

The recovery coalition has been instrumental in helping Benton County bring the Columbia Valley Center for Recovery to fruition. The future regional addiction and mental health crisis treatment center is officially under construction, kicked off by a groundbreaking ceremony Nov. 12, and should be up and running by early 2026. That's only for adults though. Potential services for children and teens could take several more years.

That's too long to wait for families in crisis, though.

"For a community of our size, similar to our detoxification problem, we're lacking services and there's a big gap in our sequential intercept model ," Fordmeir told the Herald.

The sequential intercept model starts at Zero, which is typically contact with a crisis hotline and moves through the criminal justice system to services and eventually reentry into the community with support, which is step 5.

Most families in the Tri-Cities are likely stuck at step 1 or 2 in that process — diversion into treatment. These intercept points are critical junctures where service providers can step in.

On Step 1, law enforcement in the Tri-Cities doesn't have anywhere to refer a child or teen in crisis, outside of an emergency room.

"We do not have a social detox, we do not have a secure withdrawal management and treatment facility for youth, so our families have to go all the way to Yakima and Spokane," Fordmeir said.

"When you're asking a family that's in crisis with a vulnerable youth to uproot their job and take them out of school, plus other kids they might have in the home, and go place somebody outside of (the area), it's quite a burden on the system, let alone the family and the child."

Because of these limitations, many families rely on emergency departments for youth mental health stabilization in Washington.

It's not ideal. The Seattle Times wrote about one family whose son spent more than a year in an emergency department because specialized care wasn't available. His condition worsened significantly because of it.

Fordmeir said the longer it takes for a patient to get treatment, the greater the strain it creates on the family and the patient's condition.

"It's not ideal for the youth's safety. It's not ideal for their symptoms," Fordmeir said. "There are a lot of studies that show that when you're having a psychotic episode or a manic episode, that's doing damage to your brain. So while you're not being stabilized or where we can prevent further damage, that's potentially effecting the development of their brain."

He said it can also be costly for the family trying to stay in hotels nearby and create new safety concerns, such as the need for restraint and seclusion that emergency departments simply aren't equipped to provide on a long-term basis.

Fordmeir said that while the emergency departments can consult with psychiatrists and lean on the hospital's resources, the type of care is drastically different than what the patient needs.

"The emergency department is supposed to, which is the key word, be providing a similar service that an in-patient psychiatric (facility) would be doing. And if anyone would think about it, the ED is really not equipped to do that," he said.

"So you're asking the ED to do something they're not equipped to do, that they don't have the staff on hand for ... From a service standpoint, they're unable to provide what the youth need for treatment."

What can be done? The good news is, Tri-Cities leaders are working on getting the recovery center built and adding youth beds to future phases seems to be in the cards. The bad news is, that's still several years away.

Fordmeir said once the first phase of the recovery center is complete, they'll be able to reevaluate finances and see what's left.

Benton County also is actively working on grants for future additions. They're currently applying for funds to turn some of the old hospital rooms into stable housing for recovery patients.

Initial plans for the center show that there's plenty of room in the nearly 200,000-square-foot former Kennewick General Hospital to add youth services.

Best case scenario, they could begin to add some youth beds and youth crisis and detoxification services by 2028.

Fordmeir said it's possible to do it more quickly if there was an existing facility available, such as Sana Behavioral Health which was a planned 16-bed geriatric psychiatric service that never opened in Kennewick.

Turning something like that into a youth treatment facility would take a lot of community buy-in and fundraising though, he said.

Mental health resources In the meantime, there are resources in the Tri-Cities to help families navigate these difficult mental health issues.

Fordmeir said the school districts are a good place to start, with expanded access to resources they can help families get on the right path.

The Tri-Cities also helped pilot the state's Youth Access and Resource Program, or YARP . Their role is to help bridge the gaps between services for families and facilitate multi-disciplinary team meetings to address the needs of school children with complex mental health needs.

Families that get involved with YARP will have access to a resource navigator who participates in these meetings with professionals from across the area and can help advocate for the patients.

Gordon Cable helps run the YARP program through Greater Columbia Behavioral Health . He said their focus is on educating families and helping them navigate the complexity of the mental healthcare system. They also work with the state to ensure these concerns are being heard.

"We don't provide direct services, we help find care for complex needs," he told the Herald. "... What I tell people is we don't ride in on unicorns. Even if we don't have great options, because sometimes we don't, we collect that data. We have the state's ear for what the gaps in barriers for kiddos with complex needs are."

Cable said the biggest needs they're seeing are the lack of in-patient services for youth with complex needs, especially those with intellectual delays.

He said the family the Herald spoke with appears to be one of many running into the same walls. Those are the kinds of hurdles that YARP is working to change.

Cable said YARP is advocating for the state to step up and say that private insurers can't dictate what services youth in crisis get access to.

"It's exhausting to families to try and navigate the system and advocate for your kiddo, it's almost a full-time plus job," he said. "We can help parents with that, make sure everyone is on the same page and feeling heard."

He said the data collection they do is especially important, because it can help drive legislation .

Cable said that kind of collaboration will help the state continue moving toward a future where every kid has access to the mental health care they need.

"We're actually moving in the right direction, albeit slowly," he said. "At a national level there's certainly more recognition for behavioral health needs. There's a lot more attention and people feel a lot more comfortable talking about it."