EDITORIAL: Mental health isn't driving Tacoma youth violence -- but the system is failing our kids | Opinion

May 11—OPINION AND COMMENTARY — Editorials and other Opinion content offer perspectives on issues important to our community and are independent from the work of our newsroom reporters.

Let's start with two statements of fact. At first blush they may seem contradictory, but they're not.

The violence we see in our communities — and in particular the epidemic of youth violence that has recently rocked Tacoma — cannot be boiled down and attributed to simply a lack of "mental health" services. Whether it's well-meaning elected officials doing the talking or those trying to score political points, applying a broad brush, in this case, is both dangerous and disingenuous.

Equally true: Pierce County desperately needs a functional youth mental health system, one capable of serving the complex needs of kids and families in Tacoma and beyond. Right now, what we have is a patchwork of underfunded providers working in silos, often competing for limited resources — or, just as counterproductive, forced to shape the services they offer based solely on what the government has decided to pay for. When kids can't access mental health services, bad things can happen. And when bad things happen, providing kids with access to mental health services is essential.

Recently, journalists at The News Tribune have been working on a series of stories related to the troubling increase in youth violence across Tacoma. As a team, reporters Peter Talbot, Liz Moomey and Jared Brown have sought to provide a comprehensive look at the many factors that contribute to youth violence, and just as important, shine a light on the places where our collective response is falling short. Last week, in partnership with the Safe Streets campaign, a wide-ranging panel discussion was held at Bethlehem Baptist Church on Tacoma's Eastside, including News Tribune Editorial Board member Jim Walton, who was instrumental in the creation of Safe Streets more than three decades ago.

While access to youth mental health services is only one small piece of the puzzle, as an editorial board we decided it was an issue that demanded our attention.

In April, we invited a collection of local youth mental health experts to join us, in hopes of better understanding the challenges they face.

So what did we learn? It's straightforward enough — and at the same time sobering.

A shortage of mental health services like counseling and treatment isn't driving youth violence, the experts told us, but there's little doubt that a lack of behavioral health options — and the gaps kids and families too often fall into when trying to access help — continues to hamstring our ability to raise healthy, supported children, let alone respond to the trauma violence creates in our communities.

Here's the reality we face:

— Pierce County doesn't have what the experts described as a "coordinated system of care." We do have a number of dedicated providers, and in recent years Kids' Mental Health Pierce County — a group that grew out of a 2018 children's mental health summit — has been working to create one, but we're not there yet. As a result, there are too many barriers for kids and families trying to access services and too many barriers for constructive collaboration between providers.

— There are very legitimate reasons kids are struggling. In 2021, the U.S. surgeon general warned of a "devastating" mental health crisis among adolescents. Feelings of isolation, depression and hopelessness have increased, as are suicidal thoughts and behaviors. Even before the COVID-19 pandemic, it's a problem Pierce County faced. Between 2017 and 2019, Mary Bridge experienced a 400 percent increase in the number of children visiting the emergency department with serious mental health concerns.

— Youth mental health services — and behavioral health services in general — are criminally underfunded. While the state Legislature recently took several steps to address low Medicaid reimbursement rates and staffing at hospitals, Washington hasn't made anywhere near the investment needed to create something better than the system we currently have. Employees are leaving and not looking back, while patients have nowhere to turn. It can take more than two dozen phone calls just to schedule an appointment with a mental health provider in our region, Tim Holmes, the president of MultiCare's Behavioral Health Network, told The News Tribune in late 2020.

— As a community, we should be more concerned and outraged by all this than we are.

In the experts' words

The first thing youth mental health experts stressed to The News Tribune Editorial Board is the danger of attributing the recent violence we've seen — like the five Tacoma young people who have been murdered so far in 2023 — to a lack of services in the area.

Yes, mental health can play a part in violence, just like it can play a part in every other aspect of life. But "it's just so much more complex than that," said Jamie Kautz, the assistant vice president of the pediatric behavioral health network at MultiCare health systems.

Specifically, the panel of experts cited many of the factors that contribute to youth violence — from poverty to generational trauma and a general lack of hope.

"It's challenging, because there's sort of a clarion call about the youth mental health crisis, and I really do think kids are feeling bad because they probably should feel bad — because of things that are happening around them," Kautz said. "I think that kids are trying to tell us something, and as their grownups, we have a responsibility to listen to them. ... Right now, formal channels of support are very difficult to access. It's getting into community mental health, or it's getting into private practice, or it's finding access to crisis care."

As a board, we found this framing helpful, because if we avoid the temptation to gravitate toward simple fixes — like ambiguous and generally meaningless calls for more mental health services without addressing the underlying causes of youth violence — we at least stand a chance of achieving meaningful change, as a community.

The question, then, is: What would something better look like?

According to Joe LeRoy, the president and CEO of Hope Sparks, which provides behavioral health services to children and families in Pierce County, improvement would start with creating what local stakeholders have described as a "coordinated system of care."

In other words, LeRoy said that what Pierce County lacks is systemic alignment among service providers and their funders at the local and state levels. Such a system would reduce barriers to funding for providers, he said, while centering the actual needs of the kids and families seeking help.

"We really don't have a system, still," LeRoy told The News Tribune Editorial Board last month. "I think what we're seeing now is truly decades of underfunding. Really, we didn't put any value on this system for a very, very, very long time, and now we're stretched so thin, it's crumbling underneath us, and we're wondering, 'How do we fix it? And how do we fix it fast?'"

According to Carly Kurtz, who has provided support for youth at Remann Hall through Comprehensive Life Services for the last five years, the failures in our youth mental health system only exacerbate the shortcomings of society at large. Kurtz said that she regularly witnesses the cruelty of this intersection and the lasting ripples it creates, particularly among historically underserved and disenfranchised populations.

Kurtz said that realities like housing scarcity, food insecurity, low wages and inadequate healthcare — along with the epigenetics of trauma, which allows it to be passed down through generations — too often trap people. And those were just some of the challenges Kurtz was able to quickly list.

"It's system failure," Kurtz said. "I see these kids every day; they do get shot, and their friends get shot, they get murdered. My youth get violent charges, and then they get sent back into the community with what's really just a Band-Aid, right? They cycle through the child welfare system into the juvenile system and back into our outpatient mental health system, and it's just a cycle. ... The government oppresses people into these margins, and then we see youth violence generations and generations and generations later."

"Yes, mental health is a part of it," Kurtz added. "But mental health is not the reason why people are getting murdered."

Here's the cold, hard truth: There will be no quick fixes to what ails Pierce County — or the youth mental health system we've created to serve our young people. It's taken years to reach this point, and it will likely take years to dig ourselves out of it.

But if we come together with a sense of urgency and commitment — and finally acknowledge that our children deserve better — we can do better, the experts believe.

As Ashley Mangum, the director of Kids' Mental Health Pierce County, put it: "There should be some way to navigate (Pierce County's youth mental health system), where no matter how you enter, whether it's school, or the hospital or whatever, that you are pointed in the same direction. No matter where you live, no matter what insurance you have, you should be able to access the level of service that you need."

"There should be no wrong door," Mangum added.

Tacoma's youth violence crisis is only the most recent impetus for action.

The News Tribune Editorial Board is: Matt Driscoll, opinion editor; Stephanie Pedersen, TNT president and editor; Jim Walton, community representative; Amanda Figueroa, community representative; Kent Hojem, community representative.

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