Washington’s limited resources, ad hoc strategizing and second-rate treatment of those living with mental illness were thrown into relief earlier this month, when the state Supreme Court ruled that the practice of psychiatric boarding — de facto warehousing of the mentally ill in hospital emergency rooms because of a lack of treatment space — is unlawful. As Justice Steven Gonzalez writes in the court’s unanimous Aug. 7 decision, Washington’s involuntary treatment act permits “initial brief detention…for the limited purpose of evaluation, stabilization and treatment.”
Pursuant to the ITA these patients are, Gonzalez ruled, entitled to individualized treatment. The court affirmed an earlier trial judge’s ruling that the law had been violated.
Today marks the deadline for other parties in the boarding lawsuit to respond to an Aug. 22 motion by the state requesting a 120-day delay to the ruling. As Attorney General Bob Ferguson told The Herald, this is “not a stall.” It’s a motion supported by the plaintiffs as well as a range of health care organizations and disability rights groups. The alternative would be to release patients back into the community, sans treatment.
For now, the stopgap involves Gov. Jay Inslee directing $30 million for the Department of Social and Health Services to purchase mental health services for patients involuntarily detained.
“We all want to implement the decision, but we need to make sure patients receive the treatment they need and that the community is protected,” Inslee said.
Inslee and Ferguson both have commendable records in support of mental health care. And buy-in from mental-health advocates underlines the motion’s credibility. But this is just an initial step in a broader, comprehensive strategy to improve treatment and services.
With the exception of journalists such as the Seattle Times’ Jonathan Martin, inadequate services are off the public radar — unless there’s a crisis. Snohomish County Sheriff Ty Trenary is tackling the problem head-on with additional medical support and clearer protocols at the county jail.
When lawmakers return to Olympia next year, they also need to give serious consideration to a proposal conceived by retired University of Washington pediatrician Dr. Abe Bergman: A bond-funded capital construction program to create supportive housing for Washington residents with serious mental illness. As Bergman notes, “The lack of supportive housing for individuals with psychotic illnesses is arguably the most critical unmet mental health need in the United States.”
At last, the state is on the right track. Now, the follow through.