For many years I have been meeting with a small group of friends to play cards. We come from a variety of backgrounds, outlooks, and political perspectives. We tease each other a lot, rarely talk politics, but we do discuss Island County issues and concerns that strike us as important. Topics like the homeless, the ferries, crime, traffic, visitors, the Navy, and local businesses. My objective in writing this blog, grew out of these conversations. I seek to get information from reliable sources for residents of Island County.

My first interview was with Rick Felici and Evan Tingstad. Sheriff Felici manages the Island County Sheriff’s office, and his staff responds to the calls that come in to his department via the Island County Emergency Services Communications Center (ICOM911). His office is often the first point of contact for issues related to public safety and they get referrals from community organizations and individuals as well.

My second interview is with Behavioral Health Manager/Clinical Supervisor, Kathryn Clancy. The behavioral health department in which she works is under the umbrella of Island County Human Services. She supervises staff who provide a variety of services for behavioral health issues. Her staff are often the next point of contact for people in need.

Behavioral health is a blanket term that includes mental health. The American Medical Association (AMA) website says that: “Behavioral health generally refers to mental health and substance use disorders, life stressors and crises, and stress-related physical symptoms. Behavioral health care refers to the prevention, diagnosis and treatment of those conditions.”

We met on Friday, Feb. 24^th, 2023 for an interview.  (M. = Mike Diamanti, K = Kathryn Clancy.)

Initial Points of Contact

M. My understanding of things is that deputies and police officers often serve as the first point of contact with people who are having behavioral health issues. When I look at the Island County Behavioral Health-Outreach staff directory, I see people listed who work in Opioid Outreach, as Jail Counselors, Co-Responders and Recovery Navigator Case Managers. Could you elaborate a bit on this?

K. Well, to be frank, there’s an overlap with all our services. But we do have specific jobs that people are responsible for, and I thought what I could do is explain to you a bit about how we like to organize it in our mind and in our work. I think that will speak to what you just talked about in terms of the Sheriff’s office being the first contact for people with behavioral health disorders. In a crisis situation, deputies and officers are often the first responders, and for quite some time we’ve been working with them, even before we had some of our programs with them, in terms of taking referrals from them.

When they would come across someone who was having a mental health crisis or a substance use disorder crisis, and they weren’t in need of being arrested for a crime, we would reach out. We realized quickly that there’s a model out there in the world that works quite well. It’s been called different things, but essentially it’s having a mental health professional along with a law enforcement officer going to the scene.

M. When did Island County start that?

K. We got that going in 2019. Richard West was our first embedded mental health professional, but that program got interrupted by Covid. Once we were able to start up again, he had moved on to another position, but we realized that we really needed someone. He had been so busy with both the Oak Harbor Police Department and the Island County Sheriff’s Office.

M. You wanted to replace him?

K.  Yes, at a minimum. We felt we needed two people. We fund one position ourselves with the one-tenth of one per cent mental health sales tax funding. We asked for some additional funding from the North Sound Behavioral Health Administrative Services Organization. They are in charge of the crisis services for our five county region.

We realized that having two responders worked best in our county due to our geographical challenge, and because we wanted to be able to respond to referrals on our own, and not just with officers. Those were the two challenges. The way the program works now, is that the Co-Responders are housed at the Sheriff’s office and at the Oak Harbor Police Department. They are asked to go out with officers on calls when needed, and respond to additional referrals.

M. Do the responders go out on calls by themselves?

K. Yes, we realized it was difficult to be paired with an officer all day because the officer would have to respond to different calls and they might be needed elsewhere. So we decided that the Co-Responders would each have their own vehicles. They respond in three ways: a planned ride-along with officers/deputies, they go out on calls with officers/deputies when needed, and respond themselves to referrals.

M. And when you say needed, is that when needed by the officers or when needed via the referrals?

K. Both. The Co-Responders work for Human Services. But Amanda Borman-Ballard responds to whatever the Sheriff’s office needs, and Christina LeClaire responds to whatever the Oak Harbor police department needs. So, the way it looks on a daily basis, they may go out on two or three calls with officers, but they also respond to referrals. If an officer on nights or weekends gets a call that the Co-Responders could help with, the Co-Responders get a referral from those officers and they respond to those later – the next day or later in the day.

M. In a medical setting, the triage system is often used. (Triage refers to a preliminary assessment in order to determine the urgency of the person’s need for treatment.) Is that what you are describing?

K. Absolutely. Both of our Co-Responders have mental health and social work backgrounds, and they are both mental health professionals. They bring a lot of knowledge about these areas that currently does not exist in police departments. The Sheriff’s Office and the Oak Harbor police department get a lot of mental health and substance use disorder calls, so the expertise of the Co-Responders is really important.

Outreach vs. Walk-Ins

M. What I often hear from people is: “What are the police doing about the guy who is yelling and wandering around the Dairy Queen in Oak Harbor?”

K. Many of the folks that they are talking about have serious mental illness and substance use disorder. When we’re talking about that sort of complicated combination, it’s difficult unless you’ve built a relationship with that person to be able to help them. And that’s one of the things that I think our programs are uniquely designed to do. A lot of government entities and other counties in particular, are realizing that we need people doing outreach. That’s part of the problem with the current mental health system in our country. It’s built around coming in to the behavioral health office and getting multiple assessments. For people who are having challenges out in the street or with law enforcement, that model doesn’t work for them. There are too many barriers in the world right now for people to get the help they need.

M. We used to have walk-in clinics back in the 1970s and early 1980s. We’re not going back to that model. So how do people get help now?

K. The laws are very strict when it comes to involuntary detainment. And even when someone meets the criteria for that, the stay isn’t very long. It’s just a basic stabilization stay. Unless there’s a plan upon release, which quite often there isn’t, then they are back where they started almost instantly. Our goal is to try to work with people so we can gain some trust in understanding their situation and along with other community providers help them move towards a more permanent outcome.

The Co-Responder program, the Recovery Navigator program, and our other outreach programs help individuals work toward long-term, positive outcomes. We have regular case management outreach, we have counseling outreach, we have early childhood outreach where we go to people’s homes and help them with parenting. I think these services, meeting people where they are, are what helps create more of a long term solution.

Island County Programs

M. I printed out the “Behavioral Health Resource Guide for Island County, WA” and the quantity and variety of resources crammed onto two pages is impressive. https://www.islandcountywa.gov/Humanservices/Behavioral-Health/Documents/2022%20Behavioral%20Health%20Resource%20Brochure.pdf

K. Yes, let’s look at all our law enforcement behavioral health services; the Co-responders are one, the Recovery Navigator program is one -- Bill Larsen is the program manager for the Recovery Navigator program – you’re going to want to talk with him.

 

Jail Programs

K. We also have several jail programs. Essentially it’s three separate programs. We have a jail program where we have a mental health professional who works in the jail seeing individuals Monday through Friday, and that’s Laurel Brown. She does short-term and long-term counseling and daily risk assessments, and she works very closely with the medical staff if there’s any medication needs for people.

And then we have our RSAT Program, which is brand new, and stands for Residential Substance Abuse Treatment. It’s a program that has been around for awhile in prisons, primarily, because it’s up to a 90 day inpatient program. So just like somebody would go to inpatient treatment for 30, 60, 90 days at a substance use inpatient treatment facility, it’s the same in the jail. The people who are accepted into the program live in their own separate “pod”.

They have their own separate expectations, and they attend two substance use disorder treatment groups a day. Plus they get individual substance use disorder treatment and mental health treatment. We have a lot of things in that treatment program that essentially would be just like if somebody was in an inpatient treatment center.

M. It seems that treatment would bring up the issues and the pain that the person is going through, instead of just sitting in their cell.

K. Absolutely, and the third program we have is the jail transition program that we’ve had for many years, and that program has grown. It started out with a half-time position and it’s grown to a full-time position. Leif Haugen is the current jail transition coordinator. He works to assist someone transferring out of incarceration. The service is open to anybody who wants it, even if they are only there for a week. He can follow up for up to six months after they are released. He sets up whatever they might need for success.

A lot of times it’s housing, which you know is a challenge. But it’s also other things like mental health treatment, substance use disorder treatment. He can work with the folks in the jail to get the assessments they need, or other things that might be a barrier when they are released.

M. I see the name Chelcee Lindell mentioned as the Jail SUD Counselor.

K. She is now the Substance Use Disorder professional for the RSAT program. She does most of the groups.

M. She seems like a passionate advocate for helping people with recovery.

K. She is. She started out as a case manager for us and became very interested in working in the jail. She took over the jail transition position and then became a substance use disorder professional in the jail.

M. Can you speak a bit about Jose Briones, who is the Chief Jail Administrator?

K. He’s a great partner. We’ve always worked closely with the jail, and his real insistence is that people are not just warehoused, but that they have opportunities for programs. This has been really helpful and made it easier for us to move forward.

District Court Programs

M. What are some of the other outreach and connections with the public?

K. Jacob Force is one of our outreach case managers. He spends part of his time at District Court helping people get connected to different services if that was their primary reason for being in court. Why is this person appearing at court? Is it a substance use disorder? Is it a mental health thing? Is it because they are homeless? Is it a combination? If it’s any one of those social determinants of health, then Jacob will try to get them hooked up with services on the front end.

M. And District Court consists of both Island County District Court and Oak Harbor Municipal Court?

K. Correct. Both Judge Hawkins and Judge Costek are great advocates and supporters of having behavioral health services available in their courts. Jacob has also opened up the door with probation. He attends probation hearings where somebody has violated probation. Why did they violate their probation? Was it because they couldn’t get somewhere, or they couldn’t afford an interlock device for their car? What is the barrier? Jacob will try to help with those barriers. We’re trying to divert people out at various different points.

M. So Island County Behavioral Health personnel are trying to help people navigate a variety of systems that could help them?

K. Right. And in jail, once they are in the system, we are trying to get them out permanently. After they are out, we want to get them involved in the longer term services we have, like the jail transition, and our Co-Responders work on post-jail situations as do many of our longer term case managers who do a lot, especially with follow up.

The systems themselves, unfortunately, are so complex. I mean, it’s a challenge for our folks to navigate the systems, let alone anybody else who may have other challenges too, like homelessness. It’s very difficult to navigate the systems. And so we do a lot of navigating those systems for people.

Some folks have fallen through the cracks at various points and may end up back in the criminal justice system repeatedly. And that’s what we’re really trying to prevent. Also, people who have a variety of hospitalizations because of mental health issues. Permanent solutions are tough, but they are there. It just takes a lot of work.

Need for Preventive Services

M. Sheriff Rick Felici said that he believes that 75% of the people in the jail are there because of mental health related behaviors or chemical issues. Do you think that’s a fair assessment?

K. It probably is. It might even be higher than 75%. It’s not untrue that our jails in our country have become the quasi mental health centers, mental health hospitals. And instead of just saying, well that’s too bad, we have to work with what we have. We don’t have any mental health hospitals anymore. We really need to figure out what we can do in the future.

There are big ideas that would be helpful, that are very costly. There are also changes in laws that need to happen, as well as other things, to really solve the problem. Preventive services, in my mind, are key to implement. But we are likely to get less funding for preventive services than we do for any other services.

M. In Island County?

K. Just in general. We do have some prevention programs for early childhood and youth and family that we work on, but again, just not as much funding in those areas.

M. I hope to have another conversation with you about other areas, for instance, Veterans Services.

K. Yes, we can talk about those services. And housing. Housing is huge and our folks here know everything about housing in our county. The Housing Support Center is in our office, which is the place that people come to who are homeless or at risk of homelessness to get services.

But one of the things I want to mention is that we use a model to conceptualize our services. It’s called the Sequential Intercept Model (SIM). It really explains  the different intercepts for diversion, as I was mentioning. And many of the service providers around the country use this model. These are folks who work with both criminal justice and behavioral health. Intercepts for people can take place before anyone is ever arrested.

We need somebody with law enforcement, we need somebody at District Court, we need somebody at the jail, we need somebody for jail transition, we need somebody helping people get into treatment.

Hospital/Emergency Room Services

M. One of the things I hear from people is: Why do we have to have so many people in government involved? It used to be that the emergency room of a hospital was the point of entry.

K. That is still the case, but hospitals are different now. Hospitals as well as emergency rooms are complex entities and understaffed. Most services are funded by different and equally complex funding models.

M. And that’s a huge shift that people didn’t notice until it arrived.

K. Right

M. Can you speak to that?

K. We have a strong relationship with Debbie Ries, RN, who is the Emergency Department Manager at Whidbey Health. Our hospital has challenges that other hospitals don’t have. And partly because it’s a rural hospital, and understaffed. Reimbursement rates and preauthorization from insurance companies dictate medical services now, hospitals included. To complicate matters, you may have people coming to the emergency room with complex serious mental illness and/or substance use disorder as their primary problem, and they are in crisis.

It’s difficult with not enough staff and not enough social workers to manage it. Five years ago there were seven or eight social workers on staff at Whidbey Health. Now there’s one and a half. And the social workers they have are dealing with all the social work for patients, including discharge planning. They’re worn very thin.

M. One of the things Sheriff Felici said was that the emergency room often isn’t equipped or able to deal with the situation. I would imagine that the referrals the police officers and deputies and Co-Responders make are very important.

K. They are the staff who work with the hospital the most. Both Amanda and Christina are working with the hospital and hospital social workers constantly.  

Our work with the hospital and other community partners is all about our relationships with them. The relationships that we are building through our different programs are helpful and successful. We are working toward agreements between the hospital, the Designated Crisis Responders (DCR), law enforcement, and other community providers so that we have protocol that can be followed and can offer assistance when needed.

My thanks to Kathryn Clancy for spending time with me explaining some of the services Behavioral Health provides for those in Island County who need assistance.

Putin’s Invasion

After Russia built up troops, ammunition, and supplies on the shared border with Ukraine starting in March of 2021, my first question was: would Putin invade? I thought it was a Russian ploy to weaken Zelensky and scare the Ukrainians, a muscular shaking of a strong fist. Then the question became: when will he invade, which finally happened in late February of 2022. I wanted somebody to tell me what the heck was going on, so I turned to someone who had been there, someone more than qualified: Marvin Kalb.

Our Man in Russia

Being in the right place at the right time gives depth to any history, and Marvin Kalb was an eyewitness to a lot of history, serving as a translator, journalist and news man throughout his long and varied career.

He enrolled in City College, New York City, in February 1948. He worked part-time for a lawyer he admired, but could not decide on a major. Mr. Kalb came to Russian studies partly at the urging of his older brother, Bernie, who was then a reporter for The New York Times. Bernie suggested to Marvin that, besides pursuing a degree in English literature, he should have something special: that something special turned out to be the Russian language. After graduating from City College, he felt drawn to study at Harvard’s Russian Research Center, considered to be the best in the country. Once there, his adviser stressed the importance of learning the language for understanding Russian society.

In July of 1953 he enlisted in the Army, and in September he did four weeks of basic training at Fort Dix, New Jersey. Following that, he was off to the Army Security Center at Fort Meade, Maryland “…where I found myself in an elite army unit of Russian-speaking soldiers who had studied Soviet communism.” As a military analyst, Mr. Kalb’s focus was on the inhumane treatment of American POWs during the Korean War, and he also delivered lectures about communism to senior officers. His army service ended in June of 1955.

While doing his doctoral work, he was recruited for the State Department in late December of 1955, by Marshall Shulman, associate director of the Russian Research Center. Shulman asked him if he would accept a Moscow assignment as a State Department translator, and be prepared to leave in a week or two. He immediately answered yes. The top-secret clearance he retained from the Army plus his experience qualified him to work for the State Department. He arrived in Moscow in January of 1956. He returned to Harvard in January of 1957.

Published in 2017, his book, “The Year I Was Peter the Great”, goes into what that year was like for him. He kept an unclassified diary from which he was able to draw much of the material. The book is a fascinating and warm account describing his time as a reporter and as a keen observer of all things Russian. Mr. Kalb loved going out and spending time with Russians from many different backgrounds. For a young man in his mid-twenties, every day was intoxicating.

Then Edward R. Murrow called and invited him in for a chat in June of 1957; they talked for three hours. Murrow wanted to know everything Mr. Kalb knew about Russia. At the end of their meet, Murrow put his arm around him, called him “’Professor’” and asked him to come work for CBS.

Mr. Kalb’s 2021 book, “Assignment Russia,” covers his time working for CBS, but he also provides additional insights and background from all of his time in Russia. He describes how Khrushchev wanted to initiate some reforms in 1956, and in fact, denounced Stalin in February, but the conservatives said no to increased reforms. Instead, in November Khrushchev ordered the tank-heavy response to the Hungarian uprising.

Concerning the Cuban Missile Crisis of 1962, Mr. Kalb believes that Khrushchev wanted to solve the Berlin Crisis, which he called a bone in his throat, by frightening the United States. He hoped he could strike a deal which would lead to Russian control over all of Berlin, and that the United States would withdraw from western Berlin. The possibility of nuclear war loomed until a deal was struck: no United States invasion of Cuba, and Russia removed the missiles.

Bhreshnev replaced Khrushchev in 1964, but Russian internal governance stiffened and only modest reforms took place until Gorbachev took over as general secretary, and opened the doors once again to reforms. He was gone by 1991. Yeltsin held power until he abruptly resigned at the end of 1999. His deputy, Vladimir Putin, took the reins until presidential elections were held in March of 2000. Putin got a four-year term and won in the first round of elections.

Since that first win in 2000, we have witnessed Putin gain full control over Russia’s oligarchs, strengthen the power of the secret police, and destroy those who oppose him. Of Putin, Mr. Kalb observes: “Putin and his people are trying to paint the West, and American democracy, as bad stuff, poisonous….we (Russia) are separate, we are great.”

Propaganda and Misinformation

On the topic of propaganda techniques, Kalb stresses that the Russian state has decades of experience and is very good at taking ideas and twisting them, and then putting them out in circulation. “What they are doing now, is using this old technique, pinning it to modern technology and then aiming it at a target…..” Mr. Kalb states that he is astounded today that: “… tens of millions of Americans are prepared to accept a Russian version of reality…”

Mr. Kalb titled an April 16^th, 2018 episode of “The Kalb Report” program “Putin’s Trump Card.” (The show is available on YouTube or see https://www.thekalbreport.org/). One of the panelists, Leon Aron, is Russian and an expert/scholar from the American Enterprise Institute. He talked about the “very peculiar nature of the Putin regime” and said that Putin based his legitimacy on his foreign policy –, i.e. confrontation with the West. His popularity rides on that approach. Then Mr. Kalb asked Mr. Aron if we should be concerned about Putin. Mr. Aron said: “…Putin is there forever…and my greatest concern is his poking on the eastern flank of NATO.” He also warned: “These [(referring to Putin and China’s president,Xi Jinping)] are wartime presidents, presidents for life, and wartime presidents need wars. This is my concern.”

In a PBS interview with Judy Woodruff on May 31^st, 2021, Mr. Kalb said that going to Moscow  (early in his career) was challenging and dangerous and intense and exciting. “I spoke the language, I spoke to the Russian people, I tried to find out what they were thinking.”

This is the key element for me from both books. Mr. Kalb’s curiosity and interest kept him engaged. The majority of Russians had little to no understanding of Americans and what we were like, as a people. Their one approved version of news and information came from the state. During the Stalin years, you kept your head down and your mouth shut. Reading Kalb and watching current events, it’s clear that state control in Russia remains the defining element in Russian lives.

Mr. Kalb, in talking about Putin, once mentioned that Putin admires Stalin in certain ways. “Russian history has always been split between Russians who want to tilt toward the West, and Russians who feel that they represent something unique.” It shouldn’t be surprising that Putin thinks of himself as a modern version of Peter the Great.

Mr. Kalb is a tremendous resource for anyone who wants to understand Russia and its people. His aim has always been to pull out information by talking to others, getting their views on people and events, and presenting it via his books, “The Kalb Report”, and public appearances. Ed Murrow knew what he was doing when he hired Marvin Kalb.

My suggestion is to read “Peter the Great” first, as it covers early parts of Mr. Kalb’s life and initial time in Russia. Reading both books provides an in-depth look at Russia through Mr. Kalb’s experiences and his excellent journalism.

https://www.pbs.org/newshour/show/journalist-marvin-kalb-on-dangers-thrills-of-reporting-from-russia-during-the-cold-war

 

 

 

For many years I have been meeting with a small group of friends to play cards. We come from a variety of backgrounds, outlooks, and political perspectives. We tease each other a lot, rarely talk politics, but we do discuss Island County issues and concerns that strike us as important. Topics like the homeless, the ferries, crime, traffic, visitors, the Navy and local businesses.

What I have noticed is the lack of information and answers we have about our concerns. The local newspapers are owned and managed by Sound Publishing, which claims 43 independent media outlets and was founded in 1987. Their coverage is limited and insufficient. “Whidbey Weekly” is owned and published by Eric Marshall as: “The island’s only locally owned newspaper and print shop.” Two local newspapers.

The Whidbey Camano Islands tourism website is funded by the 2% lodging taxes and other grants and: “…oversee a comprehensive marketing and public relations program.” The targeted audience is visitors. And we have Chambers of Commerce in Oak Harbor, Coupeville, Freeland, Langley and Camano Island. They serve and promote the business interests of Whidbey Island. The Coupeville Chamber states that it: “…provides assistance to visitors, businesses, and locals alike.”

My objective is to get information from reliable sources for residents of Island County. I often hear Whidbey Islanders complain about the homeless. The issues surrounding the homeless are often front and center in Seattle and Tacoma media coverage. What about our area? Is anybody doing anything about it? What are they doing, and how are they doing it?

My first choice for an interview was easy: newly re-elected Island County Sheriff Rick Felici and his Chief Criminal Deputy, Evan Tingstad. Here is Part One of my interview with them, conducted on December 13^th, 2022 at the Island County Sheriff’s department. (M. = Mike Diamanti, R. = Sheriff Rick Felici, E. = Chief Criminal Deputy Evan Tingstad.)

Initial Call

M. “A call comes in about a disturbed individual – then what?”

R. “A deputy will most likely make a contact with that person and make an assessment of the situation and find out which tool is the best option. Whether there’s an immediate need for some sort of intervention, whether it’s an ITA (Involuntary Treatment Act) situation and takes them into custody because they’re a danger to themselves or others. Whether it’s a situation where we can have a conversation and we can put a band-aid on this particular moment, and get you a referral for a mental health follow-up or a social services follow-up. Whatever the deputy deems as the appropriate thing.”

R. “Sometimes – if it happens to be at a time when we have a mental health worker within reach, they will co-respond and show up with them, then we can do a ‘warm hand-off’. A ‘warm hand-off’ is a way better way for a deputy to get them introduced to some kind of service, rather than a follow-up the day after tomorrow.”

M. “You want to have the immediacy?”

R. “Yeah. In the mental health field as well as the medical field, they use the term ‘warm hand-off’ a lot because it makes sense. One thing about people who are in crisis, whether it be a chemical crisis or a mental health crisis, or both, which I would bet 75% or 80% of the time it’s both, it’s more effective to have a ‘warm hand-off.’ Hey, the deputy came, and he’s not necessarily the right tool for the job. But, there’s the follow-up that we’ve got people who might be able to provide you with a service, provide you with a direction.

The two embedded mental health workers that we have, the grant funding that pays for that, the Oak Harbor police department got one and the Island County Sheriff’s department got one. And they work together, but separately.”

R. “Where we fall short in this region especially, but also in the state and the nation, is the availability of what’s the next step. Let’s just take a typical mental health behavior example. Deputy gets a call, goes out there and makes an assessment, they usually consult with a mental health person either by phone or in person, and the deputy determines that this person’s behavior is imminently dangerous to themselves or to others, and they make a decision to take them into custody for involuntary treatment.”

R. “The law says you take them to the nearest mental health treatment facility, and if there isn’t one, you take them to the local emergency room. In our county we don’t have an emergency mental health treatment facility so we take them to the local emergency room. The local emergency room is completely overwhelmed and ill-equipped to deal with mental health situations. And it gets more complicated than that because the doctors are contractors and the chain of command at the hospital doesn’t necessarily have control over what the doctors’ decisions are. The doctors aren’t bound by the same laws as the mental health situation. So an MD can overrule, for example, a Designated Crisis Responder (DCR), who has made a mental health decision that this person needs to be on ITA status. The physician, by educational seniority or by law or whatever, can say; ‘I disagree.’ So it gets a little crunchy when it comes to the actual resources, when it comes to treatment. Even when people are voluntary, finding bed space for them downstream is a crap shoot at best.”

M. “You start the steps, but there are often hurdles that slow things down.”

R. “Yeah, I think we’re doing a better job and the problems are getting more attention within the system. They are getting more attention than they have historically. And the legislature is throwing a whole bunch of money at the problem and it takes a long time for it to trickle out of King County.”

M. “So it’s up to the deputy, using their assessment skills, to decide where to go next.”

R. “From the deputy’s perspective, they aren’t trying to figure out a treatment path, they’re trying to figure out what the next step is to deal with this particular situation in this moment.”

Mental Health Related Behaviors

M. “What is the biggest number of calls that you get?”

R. “Honestly, dealing with mental health related behaviors has taken the forefront. It’s interesting that, in the time that I’ve been in this profession, I would say that once they get into the criminal justice system, on any given day, I would be willing to say that 75% of the people that are in our jails have either mental health or chemical issues, or both disorders occurring. Mental health and the related drug use clearly are the front part of this problem. And I would include in that, the issue with people living in RVs and the homeless issue. These are all part and parcel. It’s the same group of our population that are involved, more often than not, in all of those things.”

M. “It seems that dealing with mental and behavioral health issues is usually due to a lack of resources, or a coordination of resources. However, so many Island County departments have a common goal of getting someone the help they need.”

R. “I think that the results that we have and the programs that we have speak for themselves. We have done so many things to try to help people get where they need to go, mental health-wise or addiction-wise. So, here’s the thing: what if you don’t want help? What if you are happy living the way you live or you don’t have the ability to make the decision to improve? That’s where we run into some real problems. You have to be voluntary in order to be treated. The rare cases where people are involuntarily treated is often a band-aid, a temporary fix. Sometimes it works. They go back to their life and they don’t pop up on the 911 screen anymore. What we deal with most often are people who have co-occurring disorders or they self-medicate because of their mental health issues – they’re not comfortable, they’re not happy, they’re not functional, so they take amphetamine, heroin, fentanyl now. There’s no path to success once that decision has been made.”     

M. “People will say they are out there because they want to be out there, and they’re behaving that way, because they want to behave that way.”

R. “Some of them do! For a fair portion of them, I believe that’s true. And no amount of intervention is going to change their behavior.”

M. “A lot of people don’t know what to do and need help.”

R. “The very nature of mental health and addiction is counter to accepting treatment or having the ability to make the decision to change. You’re so far gone that this is your normal. The system fails in that when you have people who are forced into the system or go in voluntarily, there is a significant lack of resources for long term care.”

M. “Then they raise the flag that says I have the right to do what I want.”

R. “And they do. But the public has rights as well. The other thing that really  grates at me, is I have yet to hear any conversation whatsoever  about are we dedicating any resources to discovering and determining the cause of this epidemic of mental health that we have. Do we have more mentally ill people than we’ve ever had? Or do we just have a higher population so the numbers have become more visible?

From my perspective, having started in 1994 as an Island County deputy, at that time we dealt with one or two mentally ill people that we were aware of and they were regulars. We all knew them by first name, we all knew their behaviors. Today, you can’t drive down the street without seeing somebody behave in a bizarre fashion somewhere in the visibility of the main traffic routes. And it’s not an Oak Harbor problem, it’s not an Island County problem, it’s a cultural problem and it’s nationwide.

So, is there a huge influx of people that are mentally ill or dealing with chemical issues or both, and if that’s true, why did it start, why did it grow so rapidly? Ten years ago we weren’t talking about this to the extent we are today. The population hasn’t increased that much in ten years. It has obviously increased.”

R. “It seems more visible now maybe because we’re finally paying attention to it and maybe it’s because we’re more aware of it, the laws have changed. It used to be that if somebody behaved a certain way there were treatment facilities. The numbers weren’t so high and the beds weren’t so full. We used to take people to North Sound at Sedro-Woolly on a fairly regular basis. They would go there and take treatment and we wouldn’t see them again.

And there’s a stigma attached to mental health treatment. I call it the ‘One Flew Over the Cuckoo’s Nest’ stigma, where people have this vision of mental health treatment being a warehouse of mentally ill people that are abused and neglected. We certainly don’t want that  as a solution.”

Public Perceptions

M. “Public perceptions can be easy and quick and people use them as an arguing point.”

E. “I think one of the problems with perception is that they only see the people who don’t succeed from the programs. They don’t see the success stories because the success stories are relatively quiet. They happen slowly and it may or may not be because of a police interaction, or a series of calls to the police. Sometimes it is. A lot of times, these individual programs that are in place, the programs attract the people who want the services. In drug court, even if you are a little bit cynical it’s still a success. If you measure it by objective measures, it’s still a success.”

R. “I know people in this community who are successful graduates of drug court who are now working and are functional people in our society. I also know people who have failed drug court, or graduated and relapsed. That’s the horrible nature of addiction. Treatment can certainly be successful, but it’s directly related to the commitment of the person who needs to be treated.

I hate the fact that one of the best interventions tools we have is incarceration, because it’s less than ideal, for sure. But there’s an opportunity created there. So, somebody spends three months in the Island County jail. They sober up and they clean up, they’re getting regular food, so there’s an opportunity, which is why we heavily invest in that treatment and all the other things we’ve got going on in jail. Here’s a break in the action and it gets people focused. But it’s not the best solution in the world. It’s just an option we have in the tool box.

Mentally ill people don’t necessarily belong in jail, although sometimes mentally ill people commit crimes that they need to be held accountable for just like anybody else. Addiction, on the other hand, if your issue is just drug addiction, there’s an opportunity there for intervention. There’s also an opportunity for mental health intervention, we do that too. But it doesn’t seem like enough; we don’t want people to have to get arrested just to get treatment.”

M. “Who wants treatment? People can be lying to you, they can honestly be asking for help….”

R. “In a perfect world, if we treated all the people who were willing to get help, and they were all successful, we’re still going to have a significant population of people that aren’t. What do you do with that? At the same time, the community still has that issue in their backyard. I don’t know the answer.

Now, there are people out there whose mindset is: ‘I don’t care – I just want it gone.’ And no amount of rational is going to change some of those personalities.”

M. “You mentioned that mental health issues and behaviors represent the bulk of what you deal with.”

R. “And all the associated stuff that comes with that, whether it be trespassing, or burglary, or shoplifting or whatever. All of that is sort of the mouth of the funnel, if you will, of how they get into the system, right? That’s not to say that we don’t have people out there that are just flat out criminals and will steal your stuff. But one of the things that is an absolute truism, and you will never convince me otherwise, is that drug use absolutely, is the biggest driver in criminal behavior. And we’ve proven it locally when we’ve been able to be proactive in drug enforcement. We see an immediate drop in property crime. Burglaries go down because the people doing burglaries are involved in the drug culture.”     

Opioid Outreach

M. “Approximately when did the Opioid Outreach get started in Island County?”

R. “The conversation started in 2015 and 2016. We actually started hiring people in 2016 and getting boots on the ground in late 2017. We started out with one, then there were two people. The frustration for a lot of citizens that I talk to is: how many people have you cured? Well, there’s a fundamental misunderstanding about addiction out there. And how long it takes to do that.

When I’m talking to a group, and this comes up, I say, raise your hand if you were ever a smoker and you tried to quit smoking and how difficult was that for you? Some say I just quit cold turkey, some people say it took me 10 years to quit smoking. And that’s the nature of addiction. Emotionally, what people see, is a problem that they want to go away. And I don’t think there’s a shortcut on how to get that done. We have to keep trying different things and we have to keep applying different tools until we figure out what combination works.”  

Behavioral Outreach

M. “Can you tell me more about the Behavioral Outreach programs?”

R. “We’ve developed a co-responding program where referrals are made. All of our Opioid Outreach workers have done ride alongs and established relationships with deputies so they can work together better. They do a combination of referrals and ride alongs and they get a lot of referrals from other places as well. Faith based operations, other mental health contacts may occur, other community health contacts may occur, maybe nursing programs or other providers.”

E. “Also, we have a very robust opioid outreach on Camano and one of our deputies is key to that. It’s a core competency and an interest that he has…This deputy embeds with an outreach opioid coordinator who is assigned to Camano.”

Homeless Situation

M. “How do you handle clearing homeless encampments?”

R. “My frustration is, sometimes, the level of bureaucracy that plays a role in these situations. There are a couple of very significant Supreme Court decisions that limit what we can do, and I’ve tried to make the public aware of that. Common sense says, why do we allow that behavior? The public wants the problem to go away and we would like it to go away too. We would like the whole problem of homelessness, and drug addiction and mental illness and all those things, those visible problems that we    deal with, to go away too. But there is no one solution and that’s why we’ve had to be so collaborative in our approaches.”

R. “The only even remotely effective way we’ve been able to deal with that is try to take a multi-faceted approach. We apply mental health professionals to it, we apply what limited housing opportunities are available by folks who have expertise in housing, and we try to coach, counsel and control these people into making some kind of change. Every once in a while it works. But for the most part, they’re like: No, I’m good, I’ll stay right here.

Another involvement to look into is code enforcement, and Mary Engle is the department head and has code enforcement officers. They have a perspective, especially as it pertains to RVs and housing.”

E. “Because some of the time the problem isn’t a group of people in an RV. Sometimes the neighborhood problem is a group of people in a residence, or on a property that they own. They have every legal right to be there, but still, there’s a problem there that needs to be addressed. And we can’t just go and arrest people.”  

Deputy Hiring and Training

M. “I would imagine the training for your deputies is extensive.”

R. “The application process is far more stringent than most job applications. All of our applicants go through a public safety testing process where they take a basic knowledge assessment test. Depending on their score, they get placed on a civil service list, and after that we do a complete background check. We contact previous employers, neighbors, family, do a fingerprint check and get an assessment of their character. In addition to that, they are all required to take a mental health evaluation and a polygraph before they even enter any training. This is before they are offered a job. Then, once they go to their training, it’s a minimum of 12 weeks training with a field training officer, very well laid out, best practice oriented from state guidelines. And then, they are shadowed for awhile, placed on a shift with someone they can bounce things off of for the first year of their appointment.  And they are on probation for a year, from the completion of their academy date, not their hire date. So it’s a pretty extensive application process.”     

“Their training includes dealing with mental health issues and substance abuse disorders and all the legal portions as well as some coaching about how to interact with people who are in some sort of crisis. It’s a foundational training, and then of course, experience builds on that. And there’s ongoing training throughout the year.”

M. “I have not heard anyone question the competency of your deputies.”

R. “We are super fortunate, well, fortunate combined with process. We don’t just hire the next person who comes through the door, we use a pretty good vetting system, and we have a culture that leads to professional interactions. That’s not always the case in some other places in the country. Sometimes things don’t end well. But I think we’ve done everything we can to prepare to prevent that.”

My heartfelt thanks to Island County Sheriff Rick Felici, and his Chief Criminal Deputy, Evan Tingstad, for their time and candor in helping me better understand what happens when an Island County deputy answers a call.  Mike Diamanti