A federal judge was asked to weigh whether Washington state social services agencies should bear the consequences for significant delays in providing mental health services to people in prison.
Disability Rights Washington has filed a motion in federal court accusing the Department of Social and Health Services of violating a 2018 settlement to provide timely capacity restoration services to thousands of people waiting in jail. The nonprofit civil rights group is asking the court to consider reinstating fines and using other methods to force DSHS to comply.
These defendants either did not understand the charges against them or were unable to assist their attorneys in their defense; in both cases, they were entitled to an evaluation by a mental health professional who would determine their capacity to stand trial. If they don’t, the state is obliged to provide psychiatric services to rehabilitate them before their cases move forward.
In a Wednesday meeting with DRW and the states, U.S. District Judge Marsha Pechman described the new motion as “very serious” and said she expected to schedule a hearing as soon as February to review the evidence and Take testimony.
The state has long struggled to divert people from prisons to these services. The state must begin providing mental health care within seven days of a capacity assessment, according to the settlement in the federal court case known as Trueblood. In recent years, however, wait times have ballooned to weeks or months while people are stuck in jail. DRW says that as of October 2022, the average wait time for mental health services has reached 83 days.
Washington is building a new 350-bed facility on the Western State Hospital campus to shorten wait times, but construction will take several years to complete. Meanwhile, the state has closed hospital rooms to make way for new facilities, but has yet to open enough new mental health beds in the community to make up for the closed beds.
The demand for these competency assessments and mental health services is only getting worse, DSHS data shows. Taking 2022 as an example, there will be 2,397 orders for capacity restoration services, a year-on-year increase of 37%.
In response to the DRW motion, DSHS said last week that it was investing hundreds of millions of dollars and making progress on its promises, but that the settlement would take years to materialize.
The state agency added that large numbers of people who are too ill to stand trial are being sent to state psychiatric institutions — known as “citizen conversion” patients — who are taking up beds that would otherwise be used for resiliency.
DRW’s Kimberly Mosolf said the state should have anticipated a bottleneck caused by an increase in citizen conversion patients.
“It’s like a freight train going off the track,” she said. “You can’t convince me that it’s not absolutely foreseeable and preventable, and that the state is going ahead with that without really providing enough beds or other options for this population while closing hospital beds.”
The bottleneck is not surprising, however, “the level of demand may be higher than expected,” said DSHS spokesman Tyler Hemstreet.
On Wednesday, DSHS officials acknowledged that the new western state facility will take years to complete, but said two new wings — a total of 58 new capacity recovery beds — could open in early February or early March. Hemstreet said a new 16-bed inpatient treatment facility is expected to open in Thurston County in February, which will move civilian patients from the western state and make more room for those who need to recover.
The controversy dates back to 2014, when a disability rights group in Washington sued, and won in 2015, a case that forced Washington to provide timely capacity assessments and treatment for detainees. Pechman twice found the state in violation of the 2015 order, which has resulted in tens of millions of dollars in fines.
In 2018, Pechman approved a settlement between DRW and DSHS designed to compel the state to comply. The settlement calls for Washington to increase capacity recovery beds and reduce the number of capacity assessment orders by, among other things, strengthening outpatient programs. In exchange, contempt fines continue to accrue, but the state can avoid paying them if they abide by the settlement.
DRW’s latest motion claims the state failed to meet its obligations and asks the court to reinstate those fines.
King County, Snohomish County and Pierce County have also joined the fight, filing a brief last week detailing the urgency of county governments and local ratepayers as delays in restoring services to capacity reach new heights. cost. For example, the counties wrote that the county jail is where defendants wait to serve their sentences. Counties are responsible for hiring and maintaining designated crisis response personnel, running involuntary treatment law courts, and contracting behavioral health providers who provide court-mandated care.
At Wednesday’s meeting, Pechman outlined questions she’s likely to ask at the hearing, including how far the state has come since the 2015 decision, how the state made decisions to place people in state hospitals and why The state has been working to expand its ability to evaluate the workforce.
“One of the questions we have to answer is whether it’s too little, too late,” Pechman said.