Public Crisis, Private Toll: Key findings of The Seattle Times’ investigation of private psychiatric hospitals in Washington

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.

Major findings by The Times:

• Some private psychiatric hospitals fail to keep both patients and their own employees safe. At Smokey Point Behavioral Hospital, in Marysville, state inspectors repeatedly found inadequate staffing,^(1a) while some patients with medical needs went untreated until their conditions deteriorated – in one case to the point of death.^(1b)
• Patient records aren’t always accurate. At Smokey Point, employees said they were pressured to supplement missing documentation to pass inspections.^(1c) At Cascade Behavioral Hospital, in Tukwila, staffers have filled out or altered records that make it appear patients were checked on after they were found unresponsive or dead.^(2a)(2b)
• At six private psychiatric hospitals in Western Washington, there were at least 350 incidents in which patients or staff were assaulted, suffered an injury, attempted suicide, escaped or died suddenly from 2016 to 2018. Over the same time, the hospitals reported a combined 15 incidents to the state.^(2c)
• At Cascade Behavioral, seven patients died suddenly or suffered injuries that caused or contributed to their deaths over 19 months, an unusually high toll.^(2d)
• Washington state doesn’t make hospital inspection reports available online, in contrast to many states, leaving the public in the dark about violations.^(2e)
• State regulators, eager to preserve inpatient treatment options, haven’t taken an enforcement action against a private psychiatric hospital in more than 13 years despite finding repeated and serious violations at some facilities.^(2f)
• The Joint Commission, an Illinois-based nonprofit that vets hospital quality on behalf of the federal government, has a history of missing serious violations found by state inspectors.
• Some private psychiatric hospitals regularly try to keep voluntary patients from leaving. At Smokey Point, patients complained that staff delayed their release or tried to intimidate them into staying.^(3a) BHC Fairfax Hospital, in Kirkland, has regularly held patients by claiming they wouldn’t be safe if released, only to be contradicted by mental-health officials who find no grounds for committing them.^(3b)

To view company responses, see here for Part 1, here for Part 2 and here for Part 3.