Editorial: Defending the “indefensible” in the mental-health system
A new federal court ruling blistered Washington state for delaying jailed defendants’ mental-health evaluations and for causing serious harm. So, why is the state still litigating the case?
Seattle Times Editorial
IN early October, a 56-year-old man was arrested at the Burien Transit Center for threatening bus passengers. He had no criminal record, but did have a history of mental illness.
He was arrested and booked into King County Jail on a felony harassment charge, and he soon was found to be incompetent to stand trial because of his deteriorated mental health. By state law, and by the principles of basic humanity, he was supposed to promptly get help at Western State Hospital to restore his competency.
But Washington’s mental-health system is too broken to work like that.
Sixty-eight days after the man’s arrest, he still had not received treatment because Western State is full. By then, his jail stay had been longer than any expected sentence. His delusions worsened in jail, and physically he became “skin and bones,” said his public defender, Twyla Carter.
The delay cost the state, too. As of Dec. 15, it is being fined $400 each day it delays getting the troubled defendant into Western State. The state Department of Social and Health Services, which runs the psychiatric hospital, expects to get him admitted sometime in January, even as the fines increase.
This is the appalling norm in Washington’s dysfunctional mental-health system. DSHS has been fined more than $200,000 in dozens of similar cases around the state for failing to get prompt competency evaluations and restoration for criminal defendants.
Judges at all levels are increasingly incensed about lapses in the state mental-health system. In August, the state Supreme Court found unconstitutional the routine but inhumane practice of “psychiatric boarding” — warehousing psychiatric patients in community hospitals.
On Wednesday, U.S. District Court Judge Marsha Pechman added to the outrage. Pechman, who is hearing a class-action lawsuit on the jail competency wait times, blistered DSHS for allowing defendants to wait up to 60 days.
She noted that while waiting, mentally ill inmates are in isolation cells for 23 hours a day, with their physical and mental health declining so badly that some harm themselves or they are “refusing to eat and urinating and defecating on themselves rather than interact with guards.”
Her ruling should be mandatory reading for lawmakers.
DSHS is in the untenable spot of trying to make do with insufficient resources. In the class-action lawsuit, the agency admitted some delays are “excessive and indefensible.”
Yet the agency, represented by the state Attorney General’s Office, is preparing to go to trial in March to determine how long it can make defendants wait for treatment. It took a similar stance before the Supreme Court in the psychiatric boarding case, defending its right to allow an inhumane and grossly inefficient practice.
Instead of litigating, and prolonging the indefensible, DSHS Secretary Kevin Quigley should pull the plug, settle this case and come up with a negotiated path toward a better system. Pechman, in her ruling, seemed to offer a template, suggesting any wait longer than seven days is “suspect.”
Fixing the wait lists would require more psychiatrists, evaluators, more beds for patients, and community resources to divert mentally ill people from jail in the first place.
There is bipartisan agreement in the Legislature that some $90 million in mental-health cuts during the Great Recession must be reversed, and that more investment is needed in the upcoming budget.
So why is DSHS delaying the inevitable, and litigating the “indefensible?”
Editorial board members are editorial page editor Kate Riley, Frank A. Blethen, Ryan Blethen, Mark Higgins, Jonathan Martin, Thanh Tan, Blanca Torres, Robert J. Vickers, William K. Blethen (emeritus) and Robert C. Blethen (emeritus).