This story has been updated to reflect a corrected date for a listening session.
When Bevin Croft listens to communities about its behavioral health needs, she wants to hear all the voices — not just from service providers, not just doctors or nonprofit heads, law enforcement officials or program directors.
Croft, a senior research associate with Human Services Research Institute (HSRI), said she wants most of all to hear from the people who use community behavioral health services in Walla Walla County — all of the county, not just folks with a Walla Walla ZIP code.
To that end, Croft and her team will lead two virtual listening sessions with all who want to participate to determine what Walla Walla County should do to have a robust response to behavioral health needs.
The first session is at 4 p.m., Wednesday, Oct. 20, and a Spanish-language session is set for 4 p.m., Wednesday, Nov. 3. Each virtual session requires an advance registration by emailing HSRI Project Coordinator Danielle Rayel at email@example.com.
County health officials contracted with HSRI to take a deep, clear look at where things stand in preparing for mental health needs brought on by the COVID-19 pandemic and more.
“When I got into this role, there were a lot of questions,” said Nancy Wenzel, the county’s public health administrative director.
“People were asking how to spend the mental health (sales tax) money and I had questions, such as ‘What’s the best practice?’ What are the strategies and targets?’”
Under Washington state law counties are authorized to collect money for services, case management, transportation, therapeutic courts and housing as part of a coordinated effort to provide mental-health or chemical dependency treatment in communities.
In 2020, about $1,296,888 came to Walla Walla County via the tax to fund related services, according to county data.
In June, community partners prioritized care access, suicide prevention, connecting more people to primary health care and youth behavioral health as needing funding from the one-tenth of 1% mental-health portion earmarked from sales tax dollars.
Wenzel found she had her own questions.
Wenzel was hired into her current job with Walla Walla County’s Department of Community Health a year ago after working there since 2003.
In doing research into the department’s history of providing and contracting out behavioral health services, she was unable to find a comprehensive analysis of the county’s mental health situation, she said.
When Dr. Daniel Kaminsky was hired in December as the public health director and officer for the county, Wenzel began sharing her questions and concerns with him. The two ultimately realized no organization can take a true measure of what’s needed on its home ground.
“We needed a third party voice,” Wenzel said. “If we did a survey or assessment, it would be biased.”
In smaller rural areas often close connections are formed between service providers and those who purchase the services — such as a county or city. It is natural that relationships are strengthened in efforts to ensure a community has the best health care possible, Kaminsky said.
But that can also lend to a fuzzier perspective and a danger that not all participants in behavioral health are being heard, he noted.
“These are our biases and those are our blinders. We want an honest look at our community,” said Kaminsky.
Wenzel said work done by HSRI’s researchers will help the county understand its own strengths and gaps in services.
“This should give us a good GPS, a plan to get there. And the community will know we got here with no bias,” she said.
To get from here to there means starting at square one with the upcoming listening sessions, Croft said last week.
While those must be virtual at this time rather than in-person, that platform can also be friendlier to folks who hesitate to speak out in a public forum, she said.
The Massachusetts-based Human Services Research Institute (HSRI) has experience in listening, in whatever way the information flows. Founded in 1976, the organization has been an independent adviser to local and state governments and education systems, helping draw a bead on what is right, what is wrong and what can be improved or fixed. Its website is hsri.org.
Using teams of researchers, the institute assesses multiple social issues, including healthcare transparency, housing stability, supports for people with developmental disabilities, school success for children in foster care and healthcare reporting.
The goal is to see all people living healthy, fulfilling lives as full members of their respective communities.
Croft will be at an advantage here. While she has lived on the East Coast for many years, she grew up in Skagit County in Western Washington, a rural area with a population that’s about 20% Latino. She has family in Northern Idaho, she said.
Roadblocks to access appropriate healthcare in such places is not new to Croft.
Still, she said, Washington state offers a bonus in having some of the nation’s best data on behavioral health use; her team can take the parts relevant to Walla Walla County for focus.
Although the county doesn’t have a disproportionate need for behavioral health services, it is a county with “a lot of have and have-nots,” Croft said.
That translates to economic inequality, unstable housing, uneven justice and education systems. And those trickle down to inequalities in behavioral health services, she said.
Walla Walla County, however, appears to be a tight-knit community filled with people who care, Croft added.
“We’ve done a lot of these projects and it is clear you can’t talk about behavioral health without talking about community well-being.”
HSRI’s work after the listening sessions and doing in-depth interviews will be creating recommendations for improving behavioral health options here. Those will be finalized in the summer of 2022.
Guidance given has to be based on reality and an understanding that no one government can enact every change. Once her organization exits the stage, it will be up to community providers and advocates to follow the map drawn out by HSRI’s research, Croft said.
“The county has only so much power and has to work with state and federal health systems, ” she said.
Getting there is going to be a very big lift, Wenzel conceded.
The behavioral health analysis will cost about $175,000 in county and — hopefully — grant dollars, paid out over a year’s time, said Wenzel.
“But if we don’t do it now it may be too late. With all the behavioral issues coming out of COVID, in a year from now all the counties, cities and states will be realizing what they need and fighting to get these services. We want to come out of this and get our county stabilized,” she said.