Meeting the Youth Mental Health Need in Rural Washington
One of the things parents and educators have seen the last ten years is how many young people are struggling with issues related to mental health.
I say ten years advisedly, because that’s when my window into the issue opened after I joined the school board and my kids entered middle childhood. Those working in the space will surely tell me it’s been even longer. We can all agree it didn’t start with Covid.
Washington state has generally higher rates of both adult and youth mental illness. Using one definition, our state gets particularly low marks for the share of our youth who are “flourishing.”
This is a complicated policy space, where Washington appears to be doing better in some areas than others. Inseparable, an organization working for better mental health policy, gives Washington high marks in areas like Medicaid and commercial plan design. That matches a finding from the Mental Health America 2025 report, where Washington has above-average rankings for adult uninsured rate (#19), as well as adult (#18) and youth (#15) having private insurance that covers treatment for mental health problems.
Unfortunately, we see much worse figures for things like adults with mental illness reporting an unmet need for treatment (#44) and youth with a major depressive episode who did not receive mental health services (#37). That speaks to access, a particularly challenging point here in the 16th legislative district.
The extent of the need is far beyond the capacity of our local providers. Parents seeking help for their kids often struggle to find one that will take their insurance. That same Inseparable report I referenced above finds people in Washington state must go out of network for mental health care at a rate 7.1 times as high as for medical/surgical care. That’s one of the nation’s higher rates.
I’ve heard similar stories from parents for years. Their kids need help, but wait times are long and often it’s only those who can afford to pay out-of-pocket for providers outside the area who are able to get timely supports.
Recently, I reached out to a former colleague of mine who works in this space. You will never meet someone more enthusiastic about tackling the challenges of mental health workforce development. I wanted to know what he thought could be real solutions in our small city / semi-rural context.
Ben told me we need to build a much broader pyramid of care. It can’t just be about finding more terminal-degree clinicians.
This whole-community approach starts with training and supporting trusted community members like faith leaders, barbers, librarians, coaches, and other local “helpers” to provide brief, low-intensity, evidence-informed support and to connect people to the right level of care when needed. It supplements clinical services by helping people earlier, before problems become crises, but then provides a pathway into higher-level treatment when it’s necessary.
He also told me that the model is especially powerful in rural communities, because the biggest barriers are often workforce shortages, long travel distances, and small-town stigma.
We have community leaders and nonprofits in our area that are working to provide these services, but the state needs to do more to support this infrastructure in eastern Washington.
The breakdown of community has been an accelerant for our society’s declining wellbeing. Rebuilding it is one step back to better.