Eva Westley - June 2019

The 2018 Washington State Legislature directed the Washington State Institute for Public Policy (WSIPP) to conduct evidence reviews on step therapy and step therapy exceptions and to summarize step therapy exceptions codified in other states. One goal of the assignment is to determine whether this type of prescription drug utilization management practice has an effect on health outcomes. In this report, we describe the results of our evidence reviews on step therapy and step therapy exceptions and describe the limitations of the research evidence. We also summarize the step therapy exceptions codified in other states and describe Washington’s codified step therapy exception.

Edie Harding, Beth Keating - November 1995

This study identifies baseline data necessary for the legislature to: 1) understand the scope of current programs with significant public funding for infants and toddlers with disabilities, and 2) examine the commitment that the state made in accepting federal requirements for early intervention programs under Part H of the federal Individuals with Disabilities Education Act (Act) as of October 1994.

Mason Burley, Megan Morris - July 2015

The 2014 Washington State Legislature directed the Washington State Institute for Public Policy to investigate state practices regarding different aspects of the involuntary commitment process. This paper discusses common questions related to civil commitments and includes detail on commitment laws in each state.

Robert Barnoski - July 2002

This report presents preliminary recidivism information on Dialectic Behavior Therapy, a program run by Washington State's Juvenile Rehabilitation Administration. The program features comprehensive cognitive-behavioral treatment for individuals with complex and difficult-to-treat mental disorders.

Julia Cramer, Colin Gibson - December 2022

This is the second report in a two-part series focused on wilderness therapy programs. Wilderness therapy combines therapeutic elements with outdoor activities in a natural setting to help support individuals with a range of behavioral, emotional, and substance use issues.

In 2021, the Washington State Legislature directed WSIPP to research wilderness therapy programs in the context of behavioral health treatment and prevention. As part of this assignment, we were asked to assess the “interest and likelihood of support” for wilderness therapy programs among interest groups like “state prevention coalitions and tribes.” We interviewed ten individuals representing a variety of stakeholder perspectives in Washington.

Generally, we found that interview respondents view wilderness therapy as potentially beneficial for the individuals they serve or those who live in their communities. However, we found that most respondents had concerns about cost, safety, access, and the lack of information about programs. Respondents also expressed wanting legislators to be aware of issues related to program flexibility, equitable access, and ongoing outreach if they consider policy decisions related to wilderness therapy in the future.

The first report on this topic was published in June 2022 and can be found here.

Julia Cramer, Paige Wanner - June 2022

Wilderness therapy programs are set in natural or remote settings and embed therapeutic elements into daily outdoor activities like camping and backpacking in order to build program participants’ personal and interpersonal skills. Some programs serve individuals with behavioral, mental health, and substance use disorders.

In 2021, the Washington State Legislature directed WSIPP to conduct a research review of wilderness therapy programs and assess stakeholder interest in Washington. We identified 88 studies evaluating programs serving youth and adult populations in need of behavioral, mental health, and substance use support. Due to limitations in the literature, we could not estimate whether or not wilderness therapy programs are effective or determine if the approach is cost beneficial. In this report, we describe our systematic literature review and summarize the main themes from the literature including program models, populations served, and general findings.

A second report, due December 2022, builds on this report and will focus on the interest of stakeholders who currently participate in wilderness therapy programs in Washington or want to in the future.

Roxanne Lieb - October 1996

In 1990, Washington State enacted a civil commitment law for persons found to be sexually violent predators. As of September 1996, 38 persons are housed at the Special Commitment Center in Monroe, Washington; 21 have been committed under the Act, and the others are awaiting trial. This paper summarizes records from the Special Commitment Center regarding the residents' criminal history, offense pattern, treatment history, and mental health diagnosis.

Jim Mayfield, Stephanie Lee - April 2009

In 2007, by legislative direction, the Washington State Department of Social and Health Services’ Mental Health Division established the Thurston-Mason Children’s Mental Health Evidence-Based Practice Pilot Project (the Pilot) to provide evidence-based mental health services to children. Multi-Systemic Therapy (MST) is the first evidence-based practice chosen for the Pilot. The Pilot enrolled 114 youth in MST between April 2007 and December 2008. The majority of these children (69 percent) were referred from the juvenile justice and public mental health systems; 14 percent were referred from the state’s child welfare system; the remaining referrals were from schools or other local partner agencies. The Legislature also directed the Institute to study the Pilot. Using linked administrative data from multiple state agencies, we produced a profile of the first 103 youth served by the program.

We found that 96 percent of youth enrolled in MST had prior involvement in at least one state system associated with juvenile justice, child welfare, or mental health; 70 percent of youth enrolled in MST had felony or misdemeanor convictions (50 percent had a history of detention); and 30 percent of enrolled youth had referrals to Child Protective Services that were accepted for investigation. Most (89 percent) youth enrolled in MST were previously enrolled in the public mental health system; the Pilot’s MST program is serving its target population. Subject to funding, a report on outcomes associated with enrollment in MST will be published in December 2009.

John Bauer, Eva Westley, Madeline Barch, Mason Burley, Julia Cramer, Noa Kay - December 2016

WSIPP’s Board of Directors authorized WSIPP to work on a joint project with the MacArthur Foundation and the Pew Charitable Trusts, with additional support from the Robert Wood Johnson Foundation, to extend WSIPP’s benefit-cost analysis to certain health care topics.

We present meta-analytic findings for programs in four health care areas: 1) the promotion of healthy pregnancy and birth; 2) therapies to treat opioid use disorder; 3) the integration of behavioral health and primary care, and 4) patient-centered medical homes.

Polly Phipps - January 2004

The 1998 Legislature significantly revised public safety and treatment policies regarding mentally ill offenders charged with misdemeanors by extending the criminal competency restoration process to misdemeanant defendants, broadening the involuntary civil commitment process for both misdemeanor and felony offenders, and strengthening information sharing provisions of the law. The Legislature directed the Institute to evaluate the outcomes of competency restoration and involuntary civil commitment treatment under the new law. This study addresses whether the legislation influenced the process of competency evaluation and whether the main legislative objectives have been met.