Seattle, WA
Seattle’s troubled past and present suggest a new approach to mental health
E
dward Moore, a 32-year-old sailor, was discovered, near freezing and living in a tattered tent on the shore near current day Seattle in 1854. At the time, Washington was still a territory and Seattle was a misty settlement of log cabins and wood-framed homes at the edge of the known world.
“He’d been living in his makeshift tent for months, living off raw shellfish he foraged and being cared for after a fashion by the Coast Salish people who lived nearby,” explained Josephine Ensign, a University of Washington nursing professor, and the author of “Skid Road,” which documents the history of homelessness in Seattle.
“He most likely had PTSD from a really, really bad shipwreck and maybe also potentially some traumas from his childhood back in Massachusetts,” Ensign said. “It does seem like he had schizophrenia or some type of psychosis.”
After having several of his frost-bitten toes amputated with an axe, Moore was taken to a doctor at Fort Steilacoom, which would later become Western State Hospital.
But when the bill came due for Moore’s care, Washington lawmakers balked. They didn’t want to set a precedent that would require the territory to care for the growing number of poor and ill sailors who were ending up on its rugged shores.
They decided Moore’s care was the responsibility of the county, not the territory, and shipped him back to Seattle by canoe. After he returned, Seattleites decided the best thing to do was to send Moore back to Massachusetts.
“Townspeople took a collection to buy him a new pair of clothes, paid a ship’s captain, and shipped him off,” Ensign said.
Living on the East Coast with his sister and elderly parents, without treatment for his mental illness, Moore didn’t last long.
“The cause of death was hanging,” Ensign said. “And it says, ‘Cause: Insanity.’”
Moore’s story and his death carry disturbing parallels to current-day treatment of mental illness and may also contain a message about how the region could better manage both mental illness and homelessness in the years to come. At the core of this message is the ability, or in most cases, inability, to see mental illness from the perspective of those who suffer from it.
RELATED: Vulnerable patients caught in ‘churn’ between Washington mental health care systems face life and death circumstances
Many of the gaps in mental health care stem from the assumptions made about the capacity of people to cope with day to day activities once they are “cured.”
“We have sort of the crisis management of the inpatient unit and then the outpatient treatment, which assumes that you can manage all areas of your life,” said Katherine Jonas, who researches psychosis at Stony Brook University in New York. “You can get yourself to an outpatient clinic. You can fill the prescription and remember to take them. And then there’s nothing in between.”
L
ew Middleton lived in a state of turmoil for years because he heard and obeyed the many voices in his head. The voices drove Middleton into the forests of Washington state, where he lived while they reinforced his delusions.
“What I noticed was the more I collectively listened to them and the more I thought about maybe people chasing me, the more it became people chasing me,” he said.
One night, Middleton ran into an ex-girlfriend. He showed her the bite marks he had on his arm from a fight he’d been in, and she convinced him to go to the hospital, where he was admitted to Harborview Medical Center, one of the only hospitals in the Seattle area with a specific unit for psychiatric emergencies.
Middleton thought he’d been abducted and the anti-psychotic medicine he was prescribed was poison. But he took it and he began to notice a change.
“The voices didn’t go away completely,” he said. “It just kind of brought it down to the point of where they weren’t so loud.”
RELATED: 50 years ago, many psychiatric hospitals closed. Did that cause today’s mental health crisis?
The antipsychotics that Middleton was prescribed in the 1990s hadn’t changed much since they came out in the 1950s and there have been few game-changing breakthroughs in those medications in the 30 years since.
“I work toward de-prescribing because people come out of the hospital with tons of medications, over-prescribed, really just kind of shells of people when they come out,” explained Alix Van Hollebeke, the head of nursing at Seattle’s Downtown Emergency Center, a nonprofit near Harborview that provides shelter, housing, and medical care to people with complex cases of mental illness and substance abuse.
“We want to get to the point where they get to live their life, even if it’s weird and different and we don’t understand what it’s like, but they get to live their life as they want to live it. With maybe a little bit more sparkle than the rest of us,” Van Hollebeke said.
While the antipsychotics helped lower the voices Middleton heard, they did not silence those voices. They also caused side effects such as facial tics and other involuntary movements. Other meds seemed to make the voices louder.
His mom worried he’d wind up dead. But getting him committed was nearly impossible
But the treatment and care gave Middleton the ability to separate from the voices and helped him understand they were a part of him that he could reason with and learn to live with.
“It’s almost like I was playing this role like, almost like a movie, a role where I was believing everything that was going on and as soon as I tested it, the reality came through,” Middleton said. “There was nobody out there chasing me.”
Middleton went on to work at the Downtown Emergency Center and became the longest served certified peer counselor in Washington state history. The center now has a drop-in center named after him.
While some people who suffer from mental illness are able to gain stability through a combination of care and recovery, others require ongoing care that is difficult to find in the current mental health system.
D
onald is a psychiatrist who dealt for years with his son Eli going through “the churn,” spending time in psychiatric hospitals, emergency rooms, living on the street, and seeking relief through alcohol and drugs.
Donald and his wife, who asked that their last name not be used to protect his son’s identity, reached a critical moment when their son was about to be arrested and he turned to his parents and asked, with a look of terror in his eyes, “Please, can’t I stay with you?”
RELATED: A boy named Adam: When psychosis spills onto Seattle streets
They could not turn him down. Donald and his wife now provide their son with 24-hour care. Their lives revolve around Eli’s daily needs for routine and consistency.
They avoid sarcasm and innuendo, which they have found lend to Eli’s paranoia and can erupt into psychosis.
“How do I help him mitigate the terror he’s experiencing?” Donald asked. “The terror is terror, whether it’s internally induced or whether it’s externally induced, it’s terror. And it’s in the eyes, his eyes.”
The process of living with Eli made Donald recognize aspects of mental health care that potentially contributed to psychosis and delusion, rather than offering relief and stability. For example, not being able to sleep in a hospital because a roommate is yelling, or being overdosed on medications, then released without assistance and suffering a fall.
At the core of this frustration with his own field of psychiatry was the mistaken attitude he described as “doctors know best.” Donald did not see a genuine curiosity about the way people in psychosis were experiencing the world. He realized that mental health care, as with the “care” offered to Edward Moore on the shores of Seattle 170 years ago, was based not on the needs of the people who are sick, but on what is expedient for the rest of us.
“The quickest way is to do what we’ve done for centuries, which is to lock people away unseen and to make people invisible and less disruptive so that’s what we do,” he said.
RELATED: Who was Lillian Massey? A journey to Northern State psychiatric hospital
One of the things that offers Donald hope is the compassion he sees in his son Eli when he encounters other people in mental distress. The first thing he thinks of when he sees someone in pain is not how he can change or fix them.
“Most people, if they can calm their minds down, and that takes time, it’ll be the same for them, all of us,” Donald said. “It doesn’t take a lot of know-how to offer somebody or ask them a question. What can I do to help you?”
To listen to the full episode of “Lost Patients,” tap the link above.
Looking for mental health resources? KUOW compiled an “Acute mental health resource guide” that can help.
The Seattle Mariners’ offseason will not be completed in a nice, neat, run-it-back bow, with reports Saturday morning that Jorge Polanco and the Mets are in agreement on a two-year, $40 million contract.
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The number was stunning, with most industry insiders estimating Polanco would be looking at something closer to $12-15 million per year. Even ESPN’s Jeff Passan, one of the few to estimate Polanco would receive above $15 million per year, was likely to be surprised Saturday morning.
“He’s not getting $20 million a year,” Passan told Seattle Sports’ Brock and Salk on Tuesday. “I think at the end of the day, it’s probably going to be $14-17 million a year. If there are two teams duking it out at the end, maybe it goes up a million a year. It looks like it is going to be a three-year deal, but something along the lines of three (years) for $45-50 (million). I think that’s about right.”
The one move Passan says could make Mariners the AL favorites
The estimated $17 million salary sounded outrageous to the show hosts, but a lot can change this time of year, namely the Mets losing Pete Alonso to the Orioles. In comparison, Polanco is not exactly a splash after the loss of Alonso, but his versatility and offense when healthy (an .821 OPS in 2025) were attractive to the Mets.
Polanco going elsewhere was certainly a possibility – perhaps established as a good possibility when he failed to sign quickly, unlike the Mariners’ No. 1 target of the offseason, Josh Naylor. They were well aware of this with president of baseball operations Jerry Dipoto recently admitting the odds were technically against them with numerous teams involved. The Mariners valued Polanco but were outbid by a team that needed to make a move. So they must move on.
While the Mariners remained engaged in talks with free agents this week, it is the trade market where the most attractive candidates reside, with the Cardinals expected to trade Brendan Donovan and the Diamondbacks making Ketel Marte available.
Donovan and Marte would be great fits on the field and on the salary spreadsheet for Seattle, but they would come at the cost of prospect capital with the Cardinals, and to a lesser extent Diamondbacks, dealing from a position of leverage.
The Cardinals do not have to deal Donovan, who has two years remaining under club control, but his value presents new president of baseball operations Chaim Bloom the opportunity to make a significant early organizational mark.
In the case of Marte, the leverage he brings the Diamondbacks is short-lived as he will become a 10-and-5 player in the first weeks of the season, meaning he will be able to veto any trades at that point.
Can the M’s give up what Arizona wants for a Ketel Marte trade?
On the free agent market, despite reports that agent Scott Boras reached out to the Mariners about third baseman Alex Bregman having some interest in the team, the big-ticket players appear to remain off limits for the Mariners. They have maintained that the door would be open for Eugenio Suárez in the right circumstances. Assuming that would be a one-year deal, that signing seems unlikely to happen. The remaining free agent infielders appear to be more stopgap options of the take-a-chance variety with names like Willi Castro, Luis Rengifo or even Adam Frazier available.
The loss of Polanco and his production at the plate put Dipoto and general manager Justin Hollander in the position where they are going to have to make a gamble. They have a track record of making trades that end up requiring lower-ranked prospects than expected. If that is not the norm this winter, then do they make that painful prospect trade, or trade a starter from the big league roster? Does ownership decide it can make a gamble in expanding the budget for a higher-priced free agent, or does it take the gamble of making smaller moves, essentially staying where they are, seeing how it plays out and attempting to make big moves at the trade deadline once again?
The Mariners and Mariners fans have just been hit with a large dose of uncertainty. In the uncertainty are opportunities, however, and the remainder of the offseason should not be quiet.
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SALT LAKE CITY (AP) — Dylan Guenther scored a go-ahead power-play goal in the third period and the Utah Mammoth beat the Seattle Kraken 5-3 on Friday night to snap a three-game losing streak.
Utah Mammoth 5, Seattle Kraken 3: Box score
Nick Schmaltz had a goal and two assists, and Kailer Yamamoto, JJ Peterka, and Lawson Crouse also scored for the Mammoth. Kevin Stenlund had three assists and Karel Vejmelka stopped 32 shots.
Mason Marchment had two goals and Ben Meyers also scored for the Kraken in their seventh loss in eight games. Phillipp Grubauer had 26 saves.
After a scoreless first period, Marchment put Seattle on the board with a backhand shot at 3:35 of the second.
Schmaltz tied it at 8:09 with an unassisted goal. He attacked off a breakaway and chipped the puck over Grubauer’s shoulder from close range.
Yamamoto then gave Utah its first lead with 6:36 left in the middle period.
Seattle had several shots at an equalizer during a two-man advantage lasting nearly two minutes, but the Kraken came up empty.
Marchment then got his second goal of the night and fourth of the season at 7:50 of the third, slapping the puck home from long distance to tie it.
Guenther gave Utah a 3-2 lead with 7:05 remaining, successfully converting a power play.
Peterka and Crouse added empty netters over the final three minutes, and Meyers scored for Seattle with 43 seconds to go for the final margin.
Up next
Kraken: Host Buffalo on Sunday.
Mammoth: At Pittsburgh on Sunday.
Seattle Kraken dealt another tough blow on the injury front
The Seattle Seahawks focused heavily on their offense during the draft this past spring, using nine of their 11 selections to pick players on that side of the ball.
Just two of their picks were defenders: safety Nick Emmanwori and defensive lineman Rylie Mills.
Seattle Seahawks waive 2 players, have options to fill their roster spots
After returning from an injury suffered in the season opener that forced him to miss three games (and essentially four since he played on four snaps in Week 1), Emmanwori is making his case to be in consideration for NFL Defensive Rookie of the Year.
Mills, on the other hand, has yet to play a snap while recovering from an ACL tear suffered last December during his final season at Notre Dame. But the fifth-round pick appears to be nearing his NFL debut. Mills, who was designated to return to practice from injured reserve Nov. 26, was a full participant in practice for the first time last Friday. He was ruled out of Sunday’s game against Atlanta, but practiced in full on Wednesday and Thursday as Seattle prepares for a matchup with Indianapolis this Sunday.
The Seahawks have until next Wednesday to decide if they will activate Mills to the 53-man roster or place him on IR for the rest of the season. So it may be another week until he makes his debut, and it’s no guarantee that he will play this season. If he is activated to the 53-man roster, how will he fit the Seahawks’ standout defense? Former NFL quarterback Brock Huard shared his insight about the role the Notre Dame product could play during his Blue 88 segment on Seattle Sports’ Brock and Salk on Thursday.
“I do remember watching him a number of times and just, gosh, he was a good college football player,” Huard said. “He’s big now. He’s 6-5, 290 (pounds), and to be honest with you, you know where he fits a little bit more? He would fit a little bit more in a traditional, kind of old school Pittsburgh Steelers 3-4 defense. He would be that five-technique defensive end that could play that spot and be very stout.”
Mills is similar in size to star Seahawks defensive lineman Leonard Williams, who measures in at 6-5 and 310 pounds. But one key difference is Williams has more length, which is a concern Huard has about Mills.
“The challenge and what I’m anxious to kind of see in how they utilize him eventually is he’s not real long (Mills had 32 5/8 inch arms at the draft combine)” Huard said. “He’s not like Leonard Williams with that length. He’s not necessarily like a (Quinton) Bohanna and a (Brandon) Pili at 330-plus pounds either. (He’s) 6-5, 290, fairly athletic, super smart, super savvy, but he’s a little different than all the rest of these D-linemen.
“He’s certainly not an edge player and he doesn’t have some of the size or the length of some of the interior (linemen).”
Every Rylie Mills sack (17.0) 👀💪
The best of @ryliemills99 ➡️ https://t.co/tBCRILE4Eh#GoIrish☘️ pic.twitter.com/kdxRT6F6c5
— Notre Dame Football (@NDFootball) March 21, 2025
However, Huard is confident the Seahawks can figure out the best way to utilize Mills’ skills just like they have with another player on their defensive line who lacks some of the ideal measurables: 2024 first-round pick Byron Murphy II.
“Like they’ve done with Murphy, who also is not prototypical in some of the size, they will play to his skill set,” Huard said. “(Mills’) greatest skill set, frankly, might just be his brain.”
Hear the full conversation at this link or in the audio player near the top of this story. Listen to Brock and Salk weekdays from 6-10 a.m. or find the podcast on the Seattle Sports app.
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