(The Center Square) - The city of Spokane is considering whether a mental health emergency room could bridge the gap between jail and the typical ER for individuals with addiction and mental health issues.
City officials highlighted this option on Thursday during a discussion on sequential intercept mapping. The model helps identify gaps between the criminal justice and behavioral health systems, allowing for more strategic and potentially impactful investments.
There are six levels of intercepts: Intercept 0 focuses on services; Intercept 1 includes contact with the police; Intercept 2 is the initial detention and court hearings; Intercept 3 follows with more jail time and appearances; Intercept 4 deals with reentry and Intercept 5 with probation.
Deputy City Administrator Maggie Yates said Thursday that roughly 60% of the local jail population has been treated for mental health issues; to alleviate this strain, she suggested focusing on Intercept 0 by expanding services, housing, data sharing, and establishing a "third place."
"A behavioral health emergency room, basically a third place," Yates said. "Right now, we have the jail and we have the emergency departments that really our first responders are choosing between, law enforcement specifically."
Police Chief Kevin Hall mentioned the need for a "third place" earlier this month. He recently transferred from Arizona but said an old neighboring jurisdiction found that it took officers roughly 60 to 70 engagements to get people to accept treatment.
The Spokane Police Department increased its presence downtown earlier this fall as part of a CORE plan; the month showed a small number of people responsible for a disproportionate amount of crime, with only 13 service referrals out of the 143 people contacted.
Yates said a mental health ER could provide immediate stabilization care for individuals in a behavioral crisis rather than a medical emergency. The option would save time for officers, who frequently wait hours for a bed at the jail, and critical space in local ERs, all while providing a more tailored route to stabilize and connect people with the appropriate services.
"Our biggest challenge," SPD Assistant Chief Mike McNab said Thursday, "is to not have to rely on the emergency room for medical detentions or mental health detentions."
McNab agreed that this new option would help SPD get people into treatment more quickly. He said the CORE plan illustrated a treatment-resistant population, but that doesn't mean individuals will refuse services tomorrow.
Other key priorities in closing gaps across both systems included expanding access to crisis stabilization services, sobering beds and medication-assisted treatment, as well as reentry and treatment services in jail, which Yates noted are few and far between in Spokane County.
She and the other officials intend to use the priorities to draft proposals for the city council, which, if approved, would utilize opioid settlement funds to prop up and expand services.
None of the priorities included expanding the bed count at the local jail, which Councilmembers Michael Cathcart and Jonathan Bingle took issue with. They feel that jail time also acts as a deterrent to crime, but the lack of capacity isn't helping, a sentiment often shared by Spokane County Sheriff John Nowels.
The Spokane City Council held a town hall last Tuesday after an extensive series of roundtable discussions on homelessness. One of the findings shared was that participants supported expanding Spokane's "Sit & Lie" ordinance citywide, which Bingle proposed months ago but ultimately stalled due to a lack of support from the progressive majority.
"The earlier you can intervene, the bigger the impact you're going to have, and that's according to the authors of the intercept model who are mental health clinicians," Yates said. "It has better financial outcomes for us as well. The deeper in you get, the bigger the cost is to the system."