Twenty-eight Washington counties have dropped a lawsuit they filed last year against the Department of Social and Health Services over the state’s handling of certain patients seeking admission to its psychiatric hospitals.
The counties sued the state last August in Pierce County Superior Court, concerned about psychiatric patients being sent back to their communities because there wasn’t room at Western State Hospital and other state facilities. The counties also said they were not properly informed that patients would be returning.
Bound by a federal court settlement, the state was prioritizing placements for patients facing criminal charges, who needed mental health evaluations and treatment before their cases could move forward. But the counties said that left no room for another group of patients — “civil conversion” patients who were found mentally unable to stand trial and then moved to a separate system. The state hospitals began discharging some of these patients, and while the state said it would try to find them appropriate placements and care, the counties feared that releasing these patients could affect public safety in their communities.
Just over a year later, the counties agreed to drop the lawsuit after the state agreed to once again begin working with all civil conversion patients and to give counties adequate notice before sending those patients back to their communities.
“Part of this agreement, and the reason it took some time, is that we needed to see that the state was in fact going to perform their obligations,” said Michelle Luna, the assistant chief civil deputy for the Pierce County prosecutor’s office. “They showed good faith over the course of the last 11 months.”
The state initially pushed back on the lawsuit, stating it was federally mandated to prioritize patients who have been charged with a crime and must be evaluated to determine whether they are mentally competent to stand trial.
Under a 2014 court order known as the “Trueblood” case, named for its lead plaintiff, the state is required to evaluate and admit patients from jail to the state hospital on strict time limits to ensure those who need mental health treatment are not languishing in jail.
The state struggled for years to comply with that order and was fined $100 million last year in federal court over its failure to do so.
Due to backlogs, it stopped admitting most civil patients to its state hospitals in December 2022, evaluating only those it determined the most seriously mentally ill or a risk to their communities.
Last October, a Pierce County Superior Court judge ruled that the counties were justified in their complaint, stating that DSHS’s failure to evaluate civil conversion patients was “likely to result in substantial harm” to the patients and their communities.
In the months since, the state has whittled down the backlog of criminally charged patients waiting for competency evaluations, with patients waiting an average of just five days as recently as June. More bed space has eased the pressure on Western State Hospital: Since the counties filed the lawsuit, the state has opened a large hospital facility in Tukwila that houses only civil patients, and it anticipates opening another in the next few months.
Tyler Hemstreet, a spokesperson for the Department of Social and Health Services, said part of the state’s ability to begin evaluating civil conversion patients again is thanks to its progress admitting those waiting in jail.
“I’m not going to say it’s not an issue anymore, but it’s probably not as critical or sounding the alarm,” Hemstreet said. “We’re in a different place because of the waitlist and wait times.”
