Editorial: Finally, an end to ‘boarding’ of psychiatric patients
The state Supreme Court’s ruling puts an end to psychiatric boarding, and spotlights the need for a more coherent mental-health system.
Seattle Times Editorial
THE state Supreme Court on Thursday invalidated a commonly used but inhumane tactic used by the state to deal with overflowing psychiatric hospital units.
In a short, clear and unanimous ruling, the court found unlawful the state’s practice of allowing involuntarily detained psychiatric patients to linger for days, often without treatment, in hospital emergency rooms as they awaited opening of a psychiatric bed.
“Patients may not be warehoused without treatment due to a lack of funds,” wrote Justice Steven Gonzalez.
Ending the practice called “psychiatric boarding” will have profound impacts because it had become so routine. The Legislature allowed the number of certified psychiatric beds to plunge by one-third over the past decade, so that the state ranks 47th in the nation for psychiatric beds per capita.
With fewer beds and a rising number of people needing them, the state granted itself the power to transform any hospital bed into a temporary psychiatric bed. The number of so-called “single bed certifications” spiked from 1,221 in 2007 to 3,412 in 2013. In King County, two-thirds of people being involuntarily detained are boarded for an average of three days.
The practice returned Washington to a darker bygone era of warehousing people with mental illness.
Hospital managers in Pierce County, called to testify in the case that rose to the Supreme Court, described the harm. “We have no psychiatrists. We have no psychiatric nurses. We have no orderlies,” the hospitals’ attorney told a judge. “We are basically warehousing these people, including kids.”
The ruling poses immediate challenges for state and county mental-health managers triaging scarce psychiatric beds. Lawyers and judges handling involuntary-commitment cases must keep the patient’s health in mind, and not allow critically sick people to be cut loose because they can no longer be boarded and no psychiatric bed is immediately available.
The longer-term solution falls to the Legislature. Although lawmakers face pressure to increase education funding, they also must face up to the consequences of inadequate mental-health funding.
Ending psychiatric boarding was a moral imperative.
Editorial board members are editorial page editor Kate Riley, Frank A. Blethen, Ryan Blethen, Sharon Pian Chan, Jonathan Martin, Erik Smith, Thanh Tan, William K. Blethen (emeritus) and Robert C. Blethen (emeritus).