New rules for hospital ‘boarding’ of psych patients

SEATTLE — Washington’s Department of Social and Health Services said it complied with a Friday deadline set by the state Supreme Court to stop “warehousing” mentally ill people in emergency rooms and hospitals just because certified treatment facilities are already full.

“We are meeting the Supreme Court’s decision,” said Jane Beyer, the department’s assistant secretary.

The state’s involuntary treatment act allows counties to briefly detain people who present an imminent risk of harm for the purpose of evaluation and treatment.

But without an adequate number of beds available in certified facilities, the state had been keeping people in regular hospitals or emergency rooms without treatment while waiting for space to open up. The average length of such stays was about three days, according to the state.

The high court struck down that practice, called “psychiatric boarding,” in August. It gave the state until Friday to comply.

In response to the ruling, Gov. Jay Inslee authorized the spending of as much as $30 million, and Washington added 140 evaluation and treatment beds to its mental health system in private psychiatric hospitals, community hospitals, and freestanding evaluation and treatment facilities.

Thanks to those additional beds, as well as work by “regional support networks” responsible for local planning for inpatient psychiatric care, as of last week only three patients statewide were being “boarded” because of a lack of beds in certified facilities, the department said. That was down from 47 in October and 36 in November.

Inslee has also included an additional outlay of more than $37 million in his two-year budget proposal to address the issue, sustaining the increased number of treatment beds and opening a 30-bed civil ward at Western State Hospital.

As of Friday, the state could no longer approve the placement of patients at noncertified facilities just because there was no space at certified ones. Psychiatric patients, however, can continue to be held involuntarily at noncertified facilities under certain conditions, such as if they have a complex medical problem that also requires treatment, or if they’re getting the psychiatric care they need while at the hospital.

Under rules that took effect Friday, noncertified hospitals that offer a bed for a psychiatric patient must state that they’re willing and able to care for the patient, set up a mental health treatment plan and provide a mental health professional to see the patient daily.

Mike De Felice, who oversees the King County public defense team at the civil commitment court in Seattle, said those were positive developments. But he nevertheless worries that increasing the number of beds in the system will cause problems in the long run.

“Once these beds are up and running, they’re going to want to keep them filled,” he said. “The trend has to be not to detain more and more people in the involuntary court system. It’s got to be to come up with creative ways to avoid people coming into this court.”

He pointed optimistically to the work of a task force of local and state mental health officials, prosecutors and defense attorneys that has been trying to do just that. Among the ideas under consideration are training police and social workers to look for alternatives to inpatient treatment, such as crisis-diversion centers, and setting up teams to respond to families facing a mental health crisis, to intervene and direct people into voluntary treatment before involuntary treatment is required.

Beyer said her agency agrees and has pushed for funding for such teams. “We don’t want to have a system that gets people services only when they’re involuntarily committed,” she said.

Talk to us

> Give us your news tips.

> Send us a letter to the editor.

> More Herald contact information.

More in Local News

A firefighter stands in silence before a panel bearing the names of L. John Regelbrugge and Kris Regelbrugge during the ten-year remembrance of the Oso landslide on Friday, March 22, 2024, at the Oso Landslide Memorial in Oso, Washington. (Ryan Berry / The Herald)
‘Flood of emotions’ as Oso Landslide Memorial opens on 10th anniversary

Friends, family and first responders held a moment of silence at 10:37 a.m. at the new 2-acre memorial off Highway 530.

Julie Petersen poses for a photo with images of her sister Christina Jefferds and Jefferds’ grand daughter Sanoah Violet Huestis next to a memorial for Sanoah at her home on March 20, 2024 in Arlington, Washington. Peterson wears her sister’s favorite color and one of her bangles. (Annie Barker / The Herald)
‘It just all came down’: An oral history of the Oso mudslide

Ten years later, The Daily Herald spoke with dozens of people — first responders, family, survivors — touched by the deadliest slide in U.S. history.

Victims of the Oso mudslide on March 22, 2014. (Courtesy photos)
Remembering the 43 lives lost in the Oso mudslide

The slide wiped out a neighborhood along Highway 530 in 2014. “Even though you feel like you’re alone in your grief, you’re really not.”

Director Lucia Schmit, right, and Deputy Director Dara Salmon inside the Snohomish County Department of Emergency Management on Friday, March 8, 2024, in Everett, Washington. (Ryan Berry / The Herald)
How Oso slide changed local emergency response ‘on virtually every level’

“In a decade, we have just really, really advanced,” through hard-earned lessons applied to the pandemic, floods and opioids.

Ron and Gail Thompson at their home on Monday, March 4, 2024 in Oso, Washington. (Olivia Vanni / The Herald)
In shadow of scarred Oso hillside, mudslide’s wounds still feel fresh

Locals reflected on living with grief and finding meaning in the wake of a catastrophe “nothing like you can ever imagine” in 2014.

Everett mall renderings from Brixton Capital. (Photo provided by the City of Everett)
Topgolf at the Everett Mall? Mayor’s hint still unconfirmed

After Cassie Franklin’s annual address, rumors circled about what “top” entertainment tenant could be landing at Everett Mall.

Everett
Everett man sentenced to 3 years of probation for mutilating animals

In 2022, neighbors reported Blayne Perez, 35, was shooting and torturing wildlife in north Everett.

Dorothy Crossman rides up on her bike to turn in her ballot  on Tuesday, Aug. 1, 2023 in Everett, Washington. (Olivia Vanni / The Herald)
Everett leaders plan to ask voters for property tax increase

City officials will spend weeks hammering out details of a ballot measure, as Everett faces a $12.6 million deficit.

Starbucks employee Zach Gabelein outside of the Mill Creek location where he works on Friday, Feb. 23, 2024 in Mill Creek, Washington. (Olivia Vanni / The Herald)
Mill Creek Starbucks votes 21-1 to form union

“We obviously are kind of on the high of that win,” store bargaining delegate Zach Gabelein said.

Lynnwood police respond to a collision on highway 99 at 176 street SW. (Photo provided by Lynnwood Police)
Police: Teen in stolen car flees cops, causes crash in Lynnwood

The crash blocked traffic for over an hour at 176th Street SW. The boy, 16, was arrested on felony warrants.

The view of Mountain Loop Mine out the window of a second floor classroom at Fairmount Elementary on Wednesday, Jan. 10, 2024 in Everett, Washington. (Olivia Vanni / The Herald)
County: Everett mining yard violated order to halt work next to school

At least 10 reports accused OMA Construction of violating a stop-work order next to Fairmount Elementary. A judge will hear the case.

Imagine Children's Museum's incoming CEO, Elizabeth "Elee" Wood. (Photo provided by Imagine Children's Museum)
Imagine Children’s Museum in Everett to welcome new CEO

Nancy Johnson, who has led Imagine Children’s Museum in Everett for 25 years, will retire in June.

Support local journalism

If you value local news, make a gift now to support the trusted journalism you get in The Daily Herald. Donations processed in this system are not tax deductible.