YAKIMA — Valerie Thompson felt herself losing control.
She started seeing imaginary men, then hearing knocks on her door.
In a past life, these types of symptoms ended in suicide attempts and involuntary detentions. But this time, Thompson knew what to do.
The 58-year-old woman, who had been diagnosed with bipolar disorder, called her case manager, whom she had grown to trust through repeated home visits.
The case manager made sure Thompson went to the Sunrise Club, a support center for mentally ill Yakima residents. She went with Thompson to a doctor, who prescribed a medication change. And she continually checked on Thompson’s status.
Thompson was yanked back from the ledge, without needing to go to a hospital.
Experiences like Thompson’s are common in Yakima, which employs an innovative approach to mental health that officials here say has saved lives and largely shielded patients from a mental-health capacity crisis gripping the rest of Washington state.
Statewide, thousands of involuntarily detained residents have already this year been “boarded,” or forced to wait for hours or days in hospital emergency rooms and medical units before receiving psychiatric treatment, a Seattle Times examination found. In King County, the traumatizing experience is now occurring in nearly two-thirds of detentions.
But in Yakima, Kittitas and Klickitat counties, only 11 patients out of 320 involuntary commitments this year have endured that kind of wait without treatment. And for seven of those who were boarded, it was because they had other medical problems that needed to be addressed before psychiatric treatment could begin.
Some of the region’s methods may be difficult to implement in larger cities.
But experts say that nonetheless, there are lessons to be gleaned from a rare success story.
The area’s approach, crafted over two decades, centers on a set of intensive outpatient and early-intervention programs aimed at preventing hospitalizations. Keeping patients out of hospitals saves money, allowing for investments in local efforts to help the mentally ill.
That positive cycle has led to the state’s lowest per capita psychiatric patient hospitalization rate: The region is currently using just 19 of its 31 allocated beds at Eastern State Hospital.
The chief executive officer at Central Washington Comprehensive Mental Health, a private nonprofit that conducts almost all the psychiatric services in the three-county area, said the success shows that while more mental-health treatment beds are sorely needed in Washington, there are also other ways to address the problem.
“There’ll never be enough dollars and there’ll never be enough beds,” said the CEO, Rick Weaver. “You have to do something about it. You can’t be a victim.”
The Yakima area’s efforts were born out of a crisis that was similar to what the rest of the state is facing.
In 1990, Yakima County involuntarily committed more residents per capita than anywhere else in Washington — and didn’t have nearly enough space for them.
The detainees poured into the ER at Yakima Valley Memorial Hospital, untreated and preventing nurses from helping other patients, as they awaited a spot in the hospital’s psychiatric unit.
Then frustrated hospital officials abruptly decided to stop accepting mental-health patients in the ER altogether. With no other option, the county began sending all detained residents who were severely mentally ill to wait for treatment in jail.
The state intervened, demanding a new plan.
The next year, Yakima responded by opening Washington’s first Triage Center, a 16-bed, unlocked facility where residents who are in a mental-health crisis, or impaired by drugs or alcohol, can connect with experts, get medication and stay until their needs are met.
Other areas have recently opened similar centers. King County opened one, called the Crisis Solutions Center, last spring.
But in Yakima, it was the first of many moves funded by grants and, eventually, savings from reduced hospitalizations.
In all, Weaver and Vice President Paul Nagle-McNaughton said, their organization now runs 104 programs aimed at serving mentally ill patients in the community and reducing the likelihood they will need to go to a hospital.
Comprehensive also has an “assertive community treatment” team, which provides what supervisor Courtney Hesla described as “inpatient care without walls.”
“The team goes to people’s homes, makes sure that they’re taking medication, helps them with housing, everything,” Hesla said.
Yakima is not allowing more dangerously mentally ill patients out on the streets, Weaver and Nagle-McNaughton said; it’s allowing more safe mentally ill patients out on the streets.
Pete Schoordyk agrees.
The 75-year-old man recently decided to move his family from Seattle because he believed his son would get better mental-health treatment in Yakima.
“They really care about the patient,” Schoordyk said. “It’s a good system.”