Introduction

Mental health is a critical aspect of overall well-being, and it is the responsibility of the state to ensure that individuals with behavioral health conditions receive the necessary evaluation and treatment. Recently, a lawsuit filed by 28 counties in Washington State has shed light on the importance of holding the state accountable for fulfilling this obligation. In a landmark ruling, a Pierce County judge has ordered the state’s Department of Social and Health Service (DSHS) to immediately evaluate patients with behavioral health conditions and provide sufficient community notice when patients are released from treatment. This ruling emphasizes the state’s basic obligation to assess the needs of individuals in the legal system who lack the ability to aid in their own defense and provide them with meaningful treatment.

The Lawsuit and Ruling

The lawsuit filed by prosecutors from 28 counties challenged the agency’s decision to stop evaluating and treating mentally ill criminal defendants whose charges were dismissed due to their inability to understand the charges against them. The counties argued that this denial of access to treatment violated state law, strained county resources, and posed a risk to public safety. In response to the lawsuit, the Pierce County Superior Court granted a motion for preliminary injunction, and an additional six counties joined the suit.

In a significant victory for the counties, Judge Michael Schwartz ruled in favor of the lawsuit, ordering the DSHS to evaluate all new conversion patients. Conversion patients are individuals whose criminal charges were dismissed after being found incompetent to stand trial. This ruling ensures that these individuals receive the necessary assessment and treatment, acknowledging their right to access mental health care.

Addressing Capacity Issues

While the ruling is a significant step forward, it does not solve the capacity problems in the behavioral health system. Long-term funding and workforce shortages have created challenges in meeting the needs of individuals with behavioral health conditions. King County Executive Dow Constantine acknowledges this issue, stating, “It does not, of course, solve the very real capacity problems in the behavioral health system born of long-term funding and workforce shortages.” However, the ruling provides greater clarity for counties across Washington, allowing them to work with the state and other jurisdictions to address funding and strategies to meet the needs of the individuals they serve.

Strain on County Resources

One of the key concerns raised by the counties in the lawsuit was the strain on county resources caused by the denial of access to treatment for individuals whose charges have been dropped. When the state does not offer mental health treatment at facilities like Western State Hospital in Pierce County, the only recourse is often to release the former defendants back into the community. This puts an untenable strain on county resources and poses challenges for public safety.

Wait Times for Treatment

The issue of wait times for mentally ill defendants to access treatment has been a pressing concern. According to the KING 5 Investigators’ series “Mentally Ill, Waiting in Jail,” wait times for defendants to access treatment and understand their charges have reached all-time highs over the last two years. Currently, defendants are waiting approximately seven months in jail to access a bed at Western State Hospital, far exceeding the state law and federal court orders that call for a maximum wait time of seven days.

The prolonged wait times not only infringe upon the individuals’ rights to timely treatment but also hinder their ability to comprehend the charges against them and participate in their defense effectively. Additionally, these extended wait times place an additional burden on county jails, which are ill-equipped to provide the specialized care needed by individuals with behavioral health conditions.

The Department of Social and Health Services’ Response

Following the ruling, the Department of Social and Health Services released a statement expressing their disappointment with the decision. The agency reiterated its commitment to following state law while caring for the state’s most complex patients when others are unwilling or unable to provide such care. However, the preliminary order puts the agency at odds with a federal court order that limits admissions to state hospitals. The DSHS also emphasized its intention to continue following the 30-day notice requirement to counties outlined in the Involuntary Treatment Act statute.

The agency acknowledges the impact of the ruling on their patients and expresses a commitment to assessing the situation and identifying opportunities to add additional bed capacity. This suggests that the DSHS recognizes the need for increased resources and capacity within the behavioral health system to effectively evaluate and treat individuals with behavioral health conditions.

Conclusion

The recent ruling in the lawsuit against Washington’s Department of Social and Health Services is a significant step towards ensuring that individuals with behavioral health conditions receive the necessary evaluation and treatment. While there are still challenges to be addressed, such as capacity issues and strain on county resources, the ruling provides greater clarity for counties to work with the state in meeting the needs of the individuals they serve. It highlights the importance of timely access to mental health care and the obligation of the state to fulfill its responsibilities in evaluating and treating patients with behavioral health conditions. By prioritizing the well-being of these individuals, we can create a more inclusive and supportive society for all.