Lawmakers and state officials are looking to reshape the way the state handles patients committed after being acquitted of a crime by reason of insanity.
OLYMPIA — State lawmakers are looking to reform the way the state handles patients committed to a psychiatric hospital after being acquitted of a crime by reason of insanity.
Patients committed to state psychiatric hospitals after such acquittals are more likely to die or be discharged to a civil geriatric hospital than given a conditional release, according to a study commissioned by the state Department of Social and Health Services (DSHS).
Other patients have been put on lockdown or were otherwise harassed when challenging the status of their cases, according to allegations in a lawsuit against DSHS, which oversees the state’s psychiatric hospitals.
Lawmakers Tuesday held a public hearing on a bill, SB 5792, which would direct DSHS to create a central office of forensic mental-health services. The office would oversee how those patients are evaluated for competency and possible release, among other things. A representative of DSHS testified that the agency would like such an office — if state lawmakers provided money for it.
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By law, such patients, whose state of mental health is monitored in the hospitals, can appeal for conditional release. Plaintiffs in the lawsuit, however, allege that DSHS has stopped at least some of them from doing so.
A patient of Western State Hospital (WSH) identified in the lawsuit only as “B.Y.” alleges to have been free from antipsychotic medical treatment at the hospital since 2011 and no longer considered as having a mental illness. But when challenging proposed conditions of release, DSHS staff placed him on “ward hold” and removed “virtually all of the rights and privileges B.Y. had attained through treatment compliance and success.”
“Defendants coercively withheld these privileges for over a month, restoring them only in exchange for B.Y.’s agreement to waive his due process right to judicial review of his release conditions,” according to court documents.
In support of the lawsuit, brought against the state by Disability Rights Washington, public defender Cassie Trueblood submitted a statement describing a client she says had “a one-time psychotic break that led to him being charged with first-degree burglary.”
“The sentence range for someone found guilty of this charge with his criminal history (none) would typically be 14 to 18 months,” Trueblood wrote in the statement. “By the time he became my client he had already been at WSH for over a year.
“A year later,” she added, “he was still at WSH.”
Inslee, Quigley named
Gov. Jay Inslee and DSHS Secretary Kevin Quigley are also named as defendants in the lawsuit.
The creation of a centralized office to oversee forensic mental-health services is a key recommendation from an independent report commissioned by DSHS to examine the state’s handling of such patients.
Released in June 2014 by Groundswell Services, the report concludes that Washington, compared to other states, prioritizes “far longer inpatient hospitalization and far less outpatient conditional release” for those acquitted of crimes by reason of insanity.
“Such lengthy hospitalization is unnecessarily expensive and restrictive, and it is usually unnecessary for public safety,” the report said. It also said: “The goals of public safety, financial stewardship and patient recovery would all be better achieved by inpatient treatment that is briefer but more specialized.”
More funds needed
Jane Beyer, of DSHS, said the agency supports SB 5792, and is attempting to overhaul some processes but needs more funding to do so. The agency and lawmakers are already coping with two other lawsuits forcing the state to address other problems in the state’s mental-health system by investing more money in psychiatric beds and for jailed defendants awaiting mental-health evaluations.
“You need to understand, we’re trying to do it with basically nonexistent resources,” said Beyer, assistant secretary for behavioral health and service integration at the agency.
Beyer told lawmakers the agency is following some of the report’s recommendations to better record and track data for such patients. The report, however, suggests that a centralized office would make this and other reforms more likely.
Other changes would be needed, too, such as finding more affordable housing and group housing options, Beyer said.
She told lawmakers the agency has been in meetings with county-level officials on how to improve competency evaluations and restoration services so patients can be released.
Andrew Biviano, the attorney representing Disability Rights Washington in the lawsuit, declined to comment for this story as did the state Attorney General’s Office, which is defending DSHS, Inslee and Quigley.