Dimension 1

Strengthen System Infrastructure

Like the roots and trunk that anchor and nourish a tree, the systems dimension provides the foundational infrastructure that sustains the entire behavioral health ecosystem and enables its healthy growth and development.

An effective and coordinated System of Care requires leadership and governance, shared goals, integrated information systems, sustainable financing, and a thriving workforce.

Tree illustration showing roots, trunk, and branches with three core components.

Caregiver story

The Impact of a Fragmented System on Caregivers and Families

“I want to share the reality of what it costs a family to advocate for a child with complex needs, and to implore you to recognize the severe systemic failures that put this burden on parents.”

Jenny’s experience

As a parent, Jenny struggled even with advantages she recognized many caregivers and families lack.

“The process of identifying and securing appropriate resources became a full-time job. I was in a privileged position—a stay-at-home parent with the time and resources to dedicate myself entirely—yet I still constantly felt like I was failing my daughter. It exacted a tremendous toll on my mental health, my marriage, and the emotional well-being of my child, who undoubtedly felt the stress I was carrying.”

Her experience led her to reflect on what the system demands of families with far fewer resources. “If I, with all my resources, felt isolated and exhausted, what chance do they have?”

Read full story

System Governance, Leadership, and Coordination

Coordinated effort requires clear direction, shared goals, accountability, and well defined rules of engagement.

  • Accountable leadership: Leaders must align policies, resolve service gaps, and address conflicts between agencies, ensuring everyone understands their respective roles in advancing shared systems level goals and outcomes related to young people’s well being.
  • Decision making power for young people, caregivers, and families: Ensure that families and youth have actual decision making authority, not only advisory roles, within governance, funding, and program design, and that they are appropriately compensated for their contributions.
  • Cross system coordination: Create clear rules and processes for how system actors work together. Develop shared standards, common definitions, and clear protocols.
  • Shared outcomes and integrated information systems: Unify measures and data systems so leaders can make informed decisions, and providers can seamlessly support young people and families and reflect back to communities the information being gathered to understand their behavioral health.
  • System wide learning and adaptation: Use data and real world experience to drive iterative improvements and accountable change across the system.

Sustainable Financing

Important financing reforms create the sustainable funding foundation necessary for the other system changes to work. The state needs to reform payment models, integrate funding, and establish sustainable funding sources to increase equitable access to behavioral health care.

  • Sustainable rates and payment models: Set rates and structure payment models to cover the true cost of care.
  • Integrated funding: Integrate federal, state, and local funding to more strategically deploy resources and provide equitable access regardless of insurance type.
  • Sustainable funding sources: Develop stable sources of funding that survive budget cuts and federal policy change.

Sustainable Workforce

Washington faces a behavioral health workforce crisis that reflects nationwide challenges. To attract and retain providers, the state must care for the carers, ensuring healthy and sustainable careers so they can continue supporting others.

  • Retention and support: Reduce paperwork and administrative burden, strengthen supervision, and support career growth.
  • Pipeline development: Create accessible training and career pathways with employers and schools.
  • Expansion and diversification: Value lived experience for peer roles and expand beyond traditional therapist positions.
  • Extend capacity with technology: Leverage assistive technology to help existing providers serve more people effectively without increasing burnout.