As the Legislature prepares to convene and advance the Washington Thriving strategic plan, this work deeply matters and has implications that extend well beyond our state.
I recently discovered an advocate in Oregon describing the same systemic failures families experience in Washington. His account mirrors what parents here have been saying for years: children with complex trauma and serious behavioral health needs are routinely denied timely care, misunderstood by systems that label trauma as bad behavior, and pushed into crisis responses that rely on emergency rooms, law enforcement, or juvenile justice rather than treatment. (I’ve included his recommendations for Oregon below.)
The consistency of these stories across state lines makes something clear. This is not a Washington specific problem. It is a regional and national one.
Many Washington families already cross state borders to access care. Oregon and Idaho have become destinations for behavioral health treatment, in part because these states manage behavioral healthcare consent in ways which allow parents to make decisions for their children when they need it most. Families should not have to leave their home state to keep their children safe.
Advocates agree that passing the Washington Thriving strategic plan is a critical step forward. It creates the foundation for better coordination, prevention, and accountability within our own systems. But it should also position Washington as a leader in something bigger.
Once this plan is in place, I hope we can move toward convening leaders across the Pacific Northwest to address shared challenges and align solutions. Our children move across state lines. Our workforce shortages cross borders. Our failures and successes do too.
This effort must also include our national representatives. Senators, members of Congress, and federal agencies have a role to play in addressing workforce development, Medicaid policy, consent laws, crisis infrastructure, and accountability standards. Cultural attitudes that blame families and criminalize mental illness are not confined to any one state. They are embedded in systems across the country.
Washington Thriving offers an opportunity to lead with clarity and courage by building systems that act before crisis, value lived experience, coordinate across agencies, and respond to trauma as a health issue rather than mislabeling it as a moral, behavioral, or legal failure. Families are asking for leadership that strengthens outcomes for children and families in our state while setting a standard that drives regional and national change.
Oregon Advocate, Andy Neal, Shares His View on What Needs to Change
When I say we need to do better, I am not speaking in abstract terms. I am talking about specific, documented failures in how our mental health system responds to children and teens with complex trauma and how it treats the families trying to keep them safe.
Oregon currently ranks 51st in the nation for mental health services for children and teens. That ranking reflects access, availability, workforce shortages, and outcomes. In practical terms, it means families wait months or years for evaluations, therapy, psychiatry, or higher levels of care. It means children are routinely denied services until they are in full crisis and by then the response is emergency rooms, law enforcement, or juvenile justice instead of treatment.
We also need far better understanding and education around reactive attachment disorder and complex developmental trauma. RAD is not a behavioral issue. It is not bad parenting. It is a severe trauma response rooted in early childhood neglect, abuse, and disrupted attachment during critical developmental periods. Research consistently shows that children with early relational trauma have altered stress responses, difficulty with emotional regulation, impaired trust, and survival based behaviors that cannot be addressed with standard talk therapy alone.
Despite this, families are often met with disbelief or minimization. Practitioners, social workers, schools, hospitals, and law enforcement frequently misunderstand RAD and related trauma conditions. Foster and adoptive parents are routinely gaslit and treated as if they are the problem rather than partners in care. Parents who are asking for help are labeled as overreacting, dramatic, or controlling instead of being listened to as people who live this reality every day.
That blame culture does real harm. It silences families. It delays care. It pushes children further into crisis. And it discourages parents from reaching out again the next time things escalate.
We also need to stop criminalizing mental illness. Too many children with trauma based diagnoses are pushed into probation, detention, or police involvement simply because there are no appropriate mental health placements available. That is not treatment. That is system failure.
Crisis response is another major area where we need to do better. Families are repeatedly told to call 988 in moments of acute crisis with the assurance that crisis response teams will help. In our case, after a hospital released our child prematurely despite clearly documented risk and explicit statements that they would run if released, we were told to call 988 when the crisis escalated.
When we did, we were told that a crisis response team could not be sent because it was midnight and the teams only operate from 8 AM to 8 PM. This happened after a midnight hospital release on a Friday night, knowing full well that many agencies do not operate on weekends and that families would have little to no recourse within the system.
A crisis line that cannot deploy crisis response teams during overnight hours is not a functional safety net. Mental health crises do not stop at 8 PM. Trauma does not keep business hours. If we are telling families to rely on crisis services, those services must actually exist when families need them.
We also desperately need coordination across agencies. Child welfare, hospitals, mental health providers, schools, law enforcement, probation, and state agencies often operate in silos. Families are left trying to relay information between departments that do not communicate with each other, even during active crises. One agency often does not know what the other is doing, and parents are expected to manage that coordination while their child is in danger.
Doing better means integrated care where agencies are communicating in real time, sharing responsibility, and working from the same information. It means hospitals being held accountable for unsafe discharges. It means crisis response teams that operate twenty four seven. It means clear pathways to higher levels of care instead of endless referrals and waitlists.
It also means real support for foster and adoptive families. These families are asked to take in children with extreme trauma histories and then are left without adequate services, respite, training, or backup. When they ask for help, they are too often blamed, threatened, or told to handle it themselves. That is not sustainable and it is not humane.
When I say we need to do better, I am talking about systemic change. Better funding. Better training. Better coordination. Better accountability. And a shift away from blaming families toward actually supporting them.
Families like ours are not asking for perfection. We are asking for a system that intervenes before things fall apart, listens to lived experience, and treats trauma as a health issue instead of a moral, behavioral, or legal failure.
That is what doing better looks like.