NEWS
A corrections officer stands at the end of the “suicide watch” cell corridor at the Spokane County Jail. YOUNG KWAK PHOTO
THE PROVIDER SHORTAGE
Talk of funding cuts and bed shortages is common surrounding mental health care, but there’s another challenge looming. “I can open more beds, but if I don’t have more psychiatrists, what’s the use?” says Kamal Floura, medical director at Eastern State Hospital, where he counts five unfilled vacancies for psychiatrists. Nationwide, about 30 percent of people — including some in Kootenai and Spokane counties — live in areas with too few mental health care providers. The shortage is especially dramatic among psychiatrists, who can prescribe and manage the medications given credit for allowing many with mental illness to live in the community instead of in hospitals. As a profession, psychiatrists are aging and too few are ready to replace them as the number of medical students specializing in psychiatry dwindles. Area psychiatrists say the profession suffers from some stigma and the fact that, compared to other specialities, it’s among the lowest paid. Offering multiple levels of medical education is one way to attract psychiatrists, says psychiatrist and Washington State University professor Matt Layton. Doctors are likely to stay in the place where they completed their residency, the practical training done after medical school. Currently, the count of psychiatry residency slots in the Inland Northwest is dismal: Less than one psychiatry residency slot is available for every 100,000 people, compared to a national average of 23 slots per 100,000. Spokane’s slots have generally been filled by University of Washington medical students specializing in psychiatry, but during the recession even those few spots were closed due to budget cuts. Now Layton and others are working to bring back the psychiatric residency program. If accredited this spring, the program will accept its first psychiatric residents next year. Not only will they make likely candidates for Spokane jobs once they’re finished, they’ll be available to offer advice about the field to students at the growing Riverpoint campus east of downtown. “You need that whole pipeline,” Layton says, “undergraduate through residency.” — HEIDI GROOVER
“A TATTERED NET,” CONTINUED... working to begin to address shortcomings in the ways the community responds to mental health issues. A recently released report from the Spokane Regional Criminal Justice Commission called for an evaluation of the Mental Health Court, a specialty court run by Municipal and District Courts. The report also called for an expansion of the Spokane Police Department’s training to respond to mentally ill offenders. Priority Spokane, a group of local organizations including the city, county and nonprofit groups, has named mental health care the next biggest challenge facing the region. Providence’s Sacred Heart Medical Center recently added seven emergency room beds in an observation unit specifically for those with mental illness. The rooms are designed to be safer: sharp tools are out of reach and there are fewer stimuli, helping patients stay calm. The beds are nearly always full. “There is not a family in the entire country that doesn’t know or live next door to or work with someone [who has experienced mental illness]. It’s time for us to start stepping up and owning this,” says Sandi Ando, public policy chair for the National Alliance on Mental lllness’ Washing-
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