Failing to provide evaluations to mentally ill defendants is growing costly for Washington

Jails Contempt Orders

Corrections Deputy Kent Wales looks in on inmates in the psychiatric unit of the Pierce County Jail in Tacoma. According to recently released documents, so far in 2014, judges in King and Pierce counties have held the Department of Social and Health Services in contempt in 24 cases and ordered sanctions of $200 or $500 for each day a mentally ill defendant sits in jail instead of being transported to a state psychiatric hospital.

(Elaine Thompson/The Associated Press)

SEATTLE — Sanctions against the state's health services agency for failing to provide competency evaluation and treatment to mentally ill defendants have reached almost $200,000, according to recently released documents.

So far this year, judges in King and Pierce counties have held the Department of Social and Health Services in contempt in 24 cases and ordered sanctions of $200 or $500 for each day a mentally ill defendant sits in jail instead of being taken to a state psychiatric hospital, the documents show.

Jane Beyer, assistant secretary for the Behavioral Health and Service Integration Administration, said her agency is slammed and the sanctions only make things worse.

"Every psychiatric bed is full, every forensic evaluator has a maximum caseload, and the hospital budget already faces a $6 million shortfall. There is no ability to take on additional patients," she said in an email. The sanctions become part of the agency's budget "and will further limit our ability to provide services."

Pierce County Superior Judge Frank Cuthbertson recently said he is aware of the state's financial problems but said he ordered sanctions because the wait lists violate the defendants' rights and he believes the state must be "compelled to fulfill its constitutional obligation."

When mentally ill people are charged with crimes and there is a question of whether they can participate in their defense, judges order competency evaluations. The state has seven days to comply. If the defendant is found incompetent, the state has seven days to provide treatment to restore competency. But neither of these is happening in a timely manner.

The latest tally shows that 241 people as of Nov. 14 were waiting to get into Western State Hospital and 76 of those had waited longer than 21 days. Another 111 people were listed for Eastern State Hospital.

According to records recently release to The Associated Press by the state Attorney General's Office, lawyers were filing motions in 2013 asking the judges to take action on the wait lists, but most judges struck down the "show cause" motions and the defendants remained in jails. But in 2014, that started to change and judges started holding the state in contempt for not following court orders and imposing fines, the documents show.

Sanctions in three cases had reached $15,500 each by Friday. Two other defendants who were in jail for 42 days resulted in sanctions of $21,500 for each case. All of those defendants are still waiting to be moved. Some of the sanctions topped $9,500 before the defendants were moved to the hospital, the records show.

Beyer said holding mentally ill people in jails while they wait for evaluations and treatment is a violation of their rights, "making legislative action constitutionally essential." Her agency has asked lawmakers to authorize and fund additional forensic beds at the state's two psychiatric hospitals, she said. They also asked for three new evaluator positions and more staff.

It's now in the Legislature's hands.

Sen. Jeannie Darneille, D-Tacoma, said the wait list problem "is a major concern for us all" and they've been trying craft small solutions until adequate funding can be found. One solution in Tacoma was the opening of a 16-bed center for evaluations and treatment, she said.

But finding beds for hundreds of defendants could be a challenge given a newly released revenue forecast that projected a budget gap of more than $2 billion over the next two years.

"It's a situation where we can't go from zero to 60 in three seconds," said Darneille, a member of the Senate Human Services & Corrections Committee.

In addition to trying to find new hospital beds or open space for competency cases at the psychiatric hospitals, the state also faces the challenge of finding and retaining staff, she said. Psychiatrists and psychologists can make more money working in the private sector or for the federal government, so the state must increase salaries if it wants to staff the facilities, she said.

Sen. Linda Evans Parlette, R-Wenatchee, said the blame for the problem lies with DSHS. The Legislative Audit and Review Committee released a report in April saying the agency had failed in several areas regarding the competency issues, and the committee made five recommendations, including to improve reporting, collaboration and training, Parlette said.

"The bottom line is DSHS has not done a very good job of staying on top of this issue," said Parlette, who co-chairs the Adult Behavioral Health System task force. "They were not compliant in doing things they were told to do."

-- The Associated Press

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