A Reminder: Good Policy Saves Lives

While the City Slept, the new book from Seattle journalist Eli Sanders, is a harrowing story of a terrible crime and its aftermath. In case you haven’t read Sanders’s Pulitzer Prizewinning story that made the basis for the book, it’s about an assault and murder committed by a mentally damaged man who slipped through the social safety net. In While the City Slept, Sanders accounts for how much money the assailant, Isaiah Kalebu, is costing the state of Washington now against how much money preventative care might have cost the state. For the Seattle Review of Books, I interviewed Sanders about the entirety of While the City Slept, but I thought this passage, about the way policy might have prevented this tragedy from happening, would be of interest for readers of this blog. Here’s the passage in its entirety:

I think one of the great parts of this book is that you do the full portrait of America’s failing mental health system that I feel like you’ve been nosing around for a long time and haven’t had the time and resources to go into. I think readers are going to want to come away wanting to do something to fix the broken system.

You talk a little bit about this in the book, but are there any signs of change or of hope with this subject? Are there any politicians making a difference? If a reader reads your book and wants to do something, where should they direct their resources?

First of all, the challenges here in Washington state are just a microcosm of the challenges that exist all over the country. We’re probably talking mostly to people who live here in Washington or here in Seattle, so I’ll talk about what’s going on in Washington. As I try to show in the book, this state — particularly in the wake of the Great Recession, but over many many years — has slashed and slashed our social safety net. That includes our court system and our public mental health system. Both of these systems remain underfunded. Though you were asking about reasons for optimism; some of that funding has begun to come back.

People in need of help are subject to the cyclical winds of our budget crises in the state: why should that be? It shouldn’t be. If people want one larger-picture thing to do, it is to not stand back and accept cuts to essential programs at a time of financial crisis or panic.

More broadly, [we need] to reform our state’s revenue structure so that it doesn’t gyrate as wildly and give people excuses or false senses of urgency about cutting back on mental health funding, for example.

In terms of even more specific things, a lot of these decisions go back to the state, so elect state leaders who care about public services. Let your state leaders know when you feel that public services are in danger. Even saying that, I know that it sounds boring to a lot of ears. I worry that that’s the case. Fight that sense of, “this is too complex or too big to get involved in.”

People need to stand up for basic services for their neighbors and for themselves. That means basic health care and robust mental health care for people who don’t have money to get that care independently, without state help. There are specific policies that can be changed — aws that could be tightened or enacted — but I really think that if people can be more focused on the tremendous harm that’s done by cutting back on essential services, essential social goods, and the value of investing in prevention, that would do more good over the long term than any specific thing I could point to right now.

I try to show in the book how much we have spent as taxpayers to pay for the consequences of this one crime. Of course, the impacts of this crime are not calculable on a money ledger, but voters are constantly bombarded with messages that they should make decisions based on the money ledger, on their feelings about taxes and so on. Who’s going to save them money?

So, all right. Here’s a way to save taxpayers money. Invest in the front end on promoting healthier lives for everyone in our community and reduce on the back end the tremendous cost and harms associated with our failure to invest in prevention.

We just did that, by the way, in King County. We just approved Dow Constantine’s Best Starts for Kids measure. All of the arguments that he made in that push we could be making at the state level and we should be making more at the state level. I wish that voters around the state would respond the way voters in King County responded to Best Starts for Kids.