The manager of Whatcom County's Correctional Health Services is making a public case for treating jail-based behavioral health care as essential infrastructure, not an optional expense. Rachel McGarrity, writing in the Cascadia Daily News, argued that jails have become one of the primary points of contact for people with untreated mental illness and addiction in Whatcom County, and that the response from the system needs to match that reality.
"Because jails are already a major point of contact for people with untreated mental illness and addiction, then correctional mental health care cannot be an afterthought," McGarrity wrote. "Adequate medical and behavioral health space and staffing, access to medication-assisted treatment and strong connections to community providers are not luxuries."
The Whatcom County Jail, operated by the Whatcom County Sheriff's Office, processes thousands of bookings annually, many involving individuals who are in active mental health crisis or in withdrawal from drugs or alcohol. McGarrity's position reflects a growing recognition across Washington State and nationally that jails often function as de facto behavioral health facilities, even when they lack the staffing, space, and clinical resources to do that job well.
Central to McGarrity's argument is access to medication-assisted treatment (MAT), which uses FDA-approved medications to treat opioid and alcohol use disorders. Research consistently shows that continuing or starting MAT during incarceration significantly reduces the risk of overdose death after release, a period when the risk is especially high after a period of forced abstinence. She also stressed the importance of what happens after someone leaves custody, arguing that strong connections to community providers are essential for continuity of care.
The Whatcom County Jail has been the subject of ongoing attention around behavioral health capacity, particularly as the region has grappled with an opioid and fentanyl crisis that has placed increasing pressure on both law enforcement and the health care system. Community organizations like Sea Mar Community Health Centers and the Whatcom County Health Department have worked alongside the jail to build discharge planning and linkage programs, though advocates say demand consistently outpaces capacity.
McGarrity was clear that the argument is not about expanding incarceration. "Investing in healing inside the jail is not about expanding incarceration. It is about recognizing the reality of those who enter our jails and ensuring that when people arrive in crisis, the system responds with appropriate care." The distinction matters in local political discussions, where some argue that improving jail conditions implicitly endorses more arrests, while others contend that humane care and decarceration goals are not in conflict.
The conversation in Whatcom County mirrors a statewide push. Washington's 2023 legislative session included expanded funding for correctional mental health services, and the state's Trueblood settlement has reshaped how courts and jails handle defendants deemed incompetent to stand trial, a population with high rates of serious mental illness. Local implementation of those changes continues to evolve.
Residents interested in the intersection of criminal justice and behavioral health in Whatcom County can follow coverage from the Cascadia Daily News, which has reported extensively on these issues, as well as updates from the Whatcom County Health Department and Sheriff's Office on jail health programming.