The legislation reflects extensive community engagement, modernizes one of King County’s most important behavioral health investments, and renames it the King County Behavioral Health Bridge.
Executive Girmay Zahilay transmitted legislation to the King County Council that would guide one of the County’s largest local investments in behavioral health through 2034, reflecting extensive community engagement to better address the county’s most pressing behavioral health needs.
The legislation proposes a new implementation plan for the longstanding Mental Illness and Drug Dependency (MIDD) Behavioral Health Sales Tax, which the King County Council renewed in 2025. It also renames the longstanding MIDD Behavioral Health Sales Tax the King County Behavioral Health Bridge, or “the Bridge.”
The Bridge strengthens publicly funded behavioral health care in King County by investing in prevention, treatment, and recovery services that are often unavailable, inaccessible, or insufficiently resourced. The tax invests approximately $172 million every two years in behavioral health services across King County. These investments help break cycles of incarceration, hospitalization, homelessness, and crisis by ensuring people receive timely, culturally responsive, and effective care.
“For nearly two decades, this local behavioral health sales tax has helped meet critical behavioral health needs across King County,” said Executive Zahilay. “At a time when federal funding reductions threaten the well-being of individuals and families across our county, protecting and strengthening this local investment is more important than ever. This proposal ensures these resources continue to evolve alongside our communities’ needs and continue supporting the behavioral health services people rely on every day.”
“This proposal is the result of listening deeply to thousands of King County residents — including behavioral health providers, researchers, peers, young people, and community leaders — who shared their experiences, challenges, and hopes for the future,” said Dr. Susan McLaughlin, DCHS director. “Their voices helped shape a stronger, more responsive vision — one that invests in what communities need most and builds a healthier, more connected, and more resilient county for years to come.”
A new implementation plan
The implementation plan, which requires King County Council approval, responds to extensive community feedback and focuses future investments across five interconnected priorities that reflect the most pressing behavioral health needs of King County residents:
- Care transitions and diversion services: Enhance navigation and coordination across behavioral health systems, divert people with behavioral health conditions from unnecessary criminal legal involvement, and connect them to appropriate treatment and supportive services.
- Substance use disorder treatment and recovery: Provide effective, low-barrier treatment and recovery services that address people’s holistic needs and support long-term recovery.
- Equitable access to behavioral health care: Decrease barriers to behavioral health services and increase access to culturally and linguistically responsive care.
- Child, youth, and young adult mental well-being: Address the youth behavioral health crisis by investing in developmentally tailored services and programs that meet youth where they are.
- Behavioral health workforce development: Strengthen and diversify the behavioral health workforce to meet growing community needs.
“The Behavioral Health Bridge is a crucial investment in the future of our communities, closing longstanding gaps in behavioral health care while responding to evolving needs and strengthening supports for the workforce providing these critical services,” said Councilmember Teresa Mosqueda. “By expanding access to prevention, treatment, and recovery services, this package is a key part of our region’s foundation for healthier individuals, more resilient communities, and lasting stability for generations to come.”
By focusing on low-income residents with mental health and substance use conditions, particularly those experiencing longstanding and intersecting inequities, the implementation plan directs investments where need is greatest and where resources can have the greatest impact.
If approved by the King County Council, the plan would update the local sales tax’s current name and guide investments from 2028 through 2034.
A new name for new times
For 18 years, the Mental Illness Drug Dependency (MIDD) Behavioral Health Sales Tax has helped make behavioral health treatment more available, accessible, and effective for King County residents.
Throughout the renewal process, however, behavioral health providers, community partners, and residents consistently shared that the name no longer reflects today’s understanding of behavioral health or the values that guide this work.
In response, DCHS and the Executive’s Office have renamed MIDD as the King County Behavioral Health Bridge, or “the Bridge.”
The new name reflects both the program’s purpose and its impact: bridging gaps in behavioral health funding left by insufficient federal and state resources while helping connect people to prevention, treatment, recovery, and long-term stability. It also responds to community concerns that the previous name contributed to stigma surrounding mental health and substance use.
Robust community engagement
Since July 2024, King County DCHS has engaged with more than 2,000 local residents — including behavioral health providers, subject matter experts, members of the criminal legal system, peers, and others — to learn about the strengths and weaknesses of the behavioral health system. Communities were engaged through listening sessions, community events, online surveys, and workgroups focused on each strategy area.
Their feedback directly informed both the implementation plan and the new Behavioral Health Bridge name.
“At the Garage, we see firsthand that prevention is one of the most effective behavioral health interventions we can provide to the more than 700 teens accessing our services each year. When young people have a safe place to belong, trusted adults to turn to, and access to services before problems escalate, they are far more likely to thrive, achieve stability and avoid the need for more intensive intervention,” said Erin Longchari, deputy director of The Garage, a Teen Cafe. “We’re encouraged that the Behavioral Health Bridge recognizes the value of investing across the continuum of care and responding to the changing behavioral health needs of our communities.”
This engagement effort included people with lived experience (13%); seniors over 55 (16%); youth ages 12–25 (9%); incarcerated individuals (6%); and people who identify as LGBTQIA+ (5%). Participants also included Black residents (29%); Latinx residents (29%); Asian American or Pacific Islander residents (20%); Middle Eastern or North African residents (3%); Indigenous residents (3%); and residents who identify as BIPOC but did not feel comfortable disclosing a specific race or ethnicity (16%).
“Having endured the trauma of genocide and forced displacement, members of our Khmer community have lived with profound anxiety, unresolved trauma leading to what we call ‘broken courage,’ and undiagnosed PTSD. It’s because of MIDD funding that our organization has been able to respond with culturally specific mental health interventions, fostering healing through trust building and social connection,” said Thyda Chhom, executive director of Khmer Community Seattle-King County. “Over the last two years, as King County DCHS deeply engaged communities across the county, countless people and organizations like ours have made their voices heard, ensuring the new Behavioral Health Bridge is responsive to the region’s evolving and diverse needs.”
