Pierce County Behavioral Health System Study

Addressing behavioral health needs in Pierce County, WA

Working with the Pierce County Council, we helped create a comprehensive picture of the county’s behavioral health system and needs, and a roadmap for improvement.


A complex array of agencies and service providers deliver behavioral health services in Pierce County. Our research provided a clearer picture of the system and identified higher-than-average need in the area. We provided targeted recommendations that leveraged existing strengths and were mindful of limited resources.

The County decided to implement the recommendations, and we’ll be working with them on that effort.

  • Gap Analysis
  • System Analysis
  • System Redesign

Analyzing a behavioral health ‘system’

Pierce County commissioned a study to better understand the challenges for its behavioral health system and to identify areas where it could focus improvement efforts. 

The first step was to develop a clearer picture of the complex and interrelated elements that make up the behavioral health system. Synthesizing and triangulating data from several sources (national surveys, epidemiological data, health claims, etc.), we produced a comprehensive picture of the county’s treatment and prevention needs, resources, services, utilization rates, and gaps. 

We also sought the perspectives of diverse stakeholders—including consumers and families—to get their take on strengths and weaknesses and to hear their vision for an optimal system. We did this through interviews, community listening sessions, and web surveys.

The results

We found some indicators of unmet need in the county, including higher-than-average rates of suicide, violent crime, homicide, and domestic violence compared to the state as a whole. 

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In addition to looking at prevalence rates, we examined other indicators of need for behavioral health services in Pierce County—including trauma—and compared these with the state average.

Our recommendations

Our overarching recommendation was for the county to establish a central coordinating body to promote the well-being of all Pierce County residents; and we identified a number of services and supports to help provide a roadmap for the County’s improvement efforts. 

We also identified opportunities for the county to:

  • Meet the needs of military veterans and service members;
  • Support families of people with behavioral health conditions; 
  • Promote shared decision-making and other strategies to enhance service-user engagement and education; and 
  • Ensure a trauma-informed system.

Read the report here

Project Partner(s):

Pierce County

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