Introduction

In a significant development for mental health care in Washington State, a Pierce County judge recently granted a preliminary injunction against the Washington State Department of Social and Health Services (DSHS). This injunction is a small victory for the 22 counties that have united to address the pressing issue of meeting the mental health needs of individuals detained in county jails. The case is closely tied to a federal court settlement known as Trueblood, which requires DSHS to provide essential services such as competency evaluations and restoration treatment to defendants to ensure their competency to stand trial.

The Trueblood Settlement and Mental Health Care

The Trueblood settlement aims to address the delays and inadequacies in mental health care services provided to individuals in the criminal justice system. Over the years, wait times for these services have worsened, leaving individuals languishing in jail without the necessary support and treatment. In July, Judge Marsha J. Pechman of the U.S. Western District of Washington fined state officials a staggering $100 million for breaching the settlement agreement. The judge ordered officials to prioritize beds at state facilities like Western State Hospital for individuals transitioning from county jails.

However, this approach has left the counties frustrated, as they believe that another group of patients, known as civil conversion patients, should also receive care at state facilities. Civil conversion patients are initially brought in on criminal charges but lack the competency to stand trial and are ultimately routed to a separate civil system for involuntary treatment. After Judge Pechman’s order, DSHS announced that it would no longer accept most civil conversion patients, prompting the counties to file a lawsuit against the agency.

The Counties’ Lawsuit and Judge’s Ruling

The counties’ lawsuit against DSHS argues that the agency still has a statutory responsibility to provide services to civil conversion patients. They contend that if the state fails to care for these patients, the counties will bear the costs of overcrowded jails and public safety risks on the streets. In response to the lawsuit, Pierce County Superior Court Judge Michael E. Schwartz granted the preliminary injunction against DSHS. The injunction requires DSHS to evaluate patients for civil commitment and give proper notice to county officials when releasing existing conversion patients.

Officials from DSHS requested a phase-in period for implementing the injunction, but the judge denied their request. The ruling affirms the state’s basic obligation to evaluate the behavioral health needs of individuals in the legal system who lack the ability to aid in their own defense and provide them with an opportunity for meaningful treatment. It is important to note that this ruling does not solve the long-standing capacity problems in the behavioral health system caused by funding and workforce shortages.

Implications and Future Steps

With the preliminary injunction in place, counties across Washington State can now move forward with greater clarity, working with the state and other jurisdictions to secure funding and develop strategies to meet the mental health needs of individuals in their care. However, it is crucial to address the underlying issues of long-term funding and workforce shortages to ensure the sustainability of mental health care services in the state.

King County Executive Dow Constantine expressed his support for the ruling, acknowledging that while it is a step in the right direction, it does not fully resolve the capacity problems in the behavioral health system. The ruling highlights the need for collaboration between counties, the state, and other stakeholders to identify sustainable funding sources and strategies to meet the needs of individuals with mental health issues in the criminal justice system.

Conclusion

The recent preliminary injunction granted by a Pierce County judge against the Washington State Department of Social and Health Services signifies a critical development in addressing the mental health needs of individuals in county jails. This ruling emphasizes the state’s responsibility to evaluate and provide meaningful treatment to individuals in the legal system who lack the ability to aid in their own defense. While this ruling provides some clarity and direction, it is essential to address the long-term funding and workforce shortages in the behavioral health system to ensure sustainable and comprehensive mental health care services for all individuals in Washington State.