Community Paramedic Program

Walla Walla Fire Department employee Cody Maine chats with a man at the Walla Walla Sleep Center on Tuesday, July 27, 2021, part of a community paramedic program to encourage less costly treatment than through ambulance rides and emergency room hospital visits.

The expectations, frustrations and hopes of nearly 60 people poured forth in the first of two public listening sessions regarding the state of mental health care in Walla Walla County.

Facilitated by Massachusetts-based Human Services Research Institute, the afternoon meeting on Wednesday, Oct. 20, revealed multiple issues in serving people who use behavioral health services here.

HSRI has been contracted by the county to explore and define what care is in place, what gaps need filling and how to get to a more robust level in behavioral healthcare.

The Zoom conference was filled with users of services, workers in the field and people in partner organizations. Represented was justice, long-term care, corrections, medicine, city governments and nonprofit agencies.

After participants talked in small-group breakout sessions, a joint conversation in the second half of the meeting allowed for naming the most pressing issues found.

The combined lists of needs, deficits and options includes:

Coordination of care — Numerous people pointed out agencies often duplicate and overlap some services. Primary care doctors don’t always know where to refer clients for brain health, communication between providers can lag and Walla Walla County lacks a directory listing all providers.

Cody Maine, a community paramedic with the Walla Walla Fire Department, said he sees a lot of really good, well-intentioned organizations for a county this size, “but we’re really badly networked.”

Several people raised the idea of the “air traffic controller” model, where a dedicated person or organization directs people to available care, help and resources of many types.

A quarterly forum among care and help providers would allow updated information to be disseminated to all.

Housing — Years of insufficient affordable homes means more people are unhoused, which means more barriers to good health, participants said.

Professionals — Walla Walla needs more than one psychiatrist, several people noted. There is demand for more trained counselors, including ones who speak Spanish, more behavioral health providers, staff trained to divert people away from emergency rooms to the right care, peer supporters, more “in person” help and less telehealth.

Trained behavioral health staff can be embedded in law enforcement departments, and a liaison between courts and families for clients with behavioral health challenges would be a boon.

Education — Walla Walla County commissioners should have a better grasp of mental health needs to direct funding to resources. Agencies need training in what Washington’s recent police reform law means for response to mental health crises.

Providers can learn to ask clients what more they need help with outside the scope of what an agency provides, such as food.

Doctors and counselors can be educated in trauma-informed practices and alternative therapies.

Emergency dispatchers who have been trained in behavioral health can triage crisis calls and patch people through to the appropriate agency.

Money — Appropriate reimbursement for mental health care, disbursed in an appropriate timeline, is needed, as is the ability for more agencies to accept private insurance. Services should be streamlined to better use available funding.

Services — More after-hours and weekend services are needed, designed for working people. There should be more availability of walk-in appointments. Protocols put into place can help meet the cultural norms of the different populations of people using behavioral health services.

A medical detox center closer to Walla Walla would help families stay connected, which improves care outcomes. Behavioral health help needs to be readily available before people are in a full-blown crisis. Finding higher levels of care unavailable locally is a problem now, and clearer steps in obtaining services should be outlined.

Keeping elders with mental illness safe in their own community was mentioned, as was implementing a supervised “safe sober” model and a program that gets medication refills or long-lasting injectables to those unable to get their prescriptions.

Without those, Maine said, “It’s a self-induced roller coaster of symptoms and not reaching therapeutic levels of medications.”

Meeting participants listed the local chapter of National Alliance on Mental Illness as of great community benefit. The family advocacy group has been going strong and providing trainings for the Walla Walla Valley for many years.

Bevin Croft, lead HSRI researcher who facilitated the listening session, said it’s sometimes hard for community providers to hear what’s said in public forums around mental health care.

It can be difficult to listen to real and perceived shortcomings, Croft said.

“But you can’t solve a problem if you don’t name it,” she said.

Her team received valuable information from the event and will get more from the Spanish-language session scheduled for 4 p.m. on Nov. 3.

HRSI will next conduct in-depth interviews with numerous community members, then gather all the information and use multiple data to prepare a report about actions Walla Walla County can take to improve behavioral health care here.

Dr. Daniel Kaminsky, the county’s public health director, said Thursday, Oct. 21, he participated in Wednesday’s event as a listener.

“I was impressed with the fact that people were willing to be open and honest with their opinions and insights.”

Kaminsky agrees with Croft that such moments can be raw.

“But we need to do that to get better and heal and build something great. I’m happy that at the end we’ll have a clear look. This is just the beginning.”

Sheila Hagar can be reached at sheilahagar@wwub.com or 526-8322.

Sheila Hagar has written for the Walla Walla Union-Bulletin since 1998. Sheila covers health, social services and city government in Milton-Freewater, Athena and Weston in the Walla Walla Valley.

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