Washington state has approved or expanded 10 private psychiatric hospitals since 2012, promising to transform the way mental-health care is delivered in a state with a chronic shortage of treatment options. Yet on the inside, these new institutions have failed patients in ways both known and unknown to regulators and all but invisible to the public, according to an investigation by The Seattle Times.

See here for major findings by The Times.



A primer on Washington state’s mental-health crisis

Published August 23, 2019 | Read story »




How a company’s push to expand psychiatric care brought peril

Published August 25, 2019 | Read story »




At private psychiatric hospitals, a hidden safety record, a human cost

Published September 8, 2019 | Read story »

SIDEBAR: Behind Joint Commission’s ‘Gold Seal of Approval,’ a history of missed safety violations at psychiatric hospitals




Free to check in, but not to leave

Published October 6, 2019 | Read story »








Smokey Point Behavioral Hospital is photographed in Marysville, Wash. August 14, 2018. 207262

A health-care system in Massachusetts said it was conducting a review of US HealthVest, its partner in a proposed psychiatric hospital, two days after a Seattle Times investigation of the company’s operations in Washington and other states.

Washington State Governor Jay Inslee and Tulalip Tribes Chairwoman Marie Zackuse cut the ribbon at the Smokey Point Behavioral Hospital grand opening. 2017

ok to publish – Cara

Gov. Jay Inslee said the state’s oversight of private psychiatric hospitals is “inadequate” in response to a Seattle Times investigation.

A health system in Massachusetts ended its plans to operate a new psychiatric hospital there with US HealthVest, a company specializing in mental-health care whose expansion in Washington state has drawn regulatory scrutiny for repeated violations.

The entrance to Western State Hospital is seen Tuesday, April 11, 2017, in Lakewood, Wash. Gov. Jay Inslee toured the facility, the state’s largest psychiatric hospital, to get an update on its efforts to address safety problems that got it into trouble with federal regulators. Western State Hospital is at risk of losing millions in federal funds over health and safety violations that were discovered last year. (AP Photo/Elaine Thompson) OTK OTK

The Washington state Department of Health is asking lawmakers for stronger enforcement power over private psychiatric hospitals after a Seattle Times investigation found that the department hadn’t taken any action against those hospitals in more than 13 years despite finding repeated, serious violations.

Community Health Plan of Washington temporarily stopped sending patients to Smokey Point Behavioral Hospital in Marysville after concerns were raised about care there. Then it called the state agency it works for, the Washington state Health Care Authority. (Erika Schultz / The Seattle Times, 2018)

The Washington state Health Care Authority has the power to audit doctors and facilities that receive Medicaid funds, and restrict them from the taxpayer-funded program for serious violations, but it has remained almost entirely on the sidelines, The Seattle Times has found.

Earlier this decade, Washington had the third-highest rate in the nation of adults with a mental illness, and the second-highest rate for those whose illness interfered with major life activities. At the same time, a government survey ranked Washington’s inpatient psychiatric bed capacity almost last in the nation.This gap between need and specialized care has led to more patients waiting in facilities that aren’t equipped to treat them, and left nearly a quarter of adults with mental illness unable to get the help they needed.Yet one source of mental-health care has expanded rapidly: private psychiatric hospitals.State payments to five private psychiatric hospitals nearly tripled over five years, totaling almost $67 million in 2018.Seven such hospitals have been built or expanded in Washington since 2012. And when three more come online, they will have added more than 850 inpatient beds. All but one of the facilities are for-profit.Until 2012, state regulators hadn’t approved a new psychiatric hospital in years. What changed?As legal pressure mounted on Washington state to add psychiatric treatment beds, the expansion of Medicaid coverage and mental-health benefits created a potentially lucrative opportunity for health care companies.When all the approved psychiatric hospitals open, there will be almost three times as many beds in such facilities as there are in the psychiatric wings of medical hospitals.On paper, this expansion looks like a salve for Washington’s mental-health crisis.

On Episode 120 of The Overcast podcast, reporter Daniel Gilbert explains what his reporting over the course of the past year uncovered — and what Washington state is doing to fix some of the problems at private psychiatric hospitals.