Monitor: Too many in jails awaiting competency services

SEATTLE — Efforts by Washington state health officials to shorten the amount of time mentally ill people wait in jails for competency services are failing to keep up with a growing demand and urgent measures are needed to deal with the backlogs, according to a court-ordered monitor.

U.S. District Judge Marsha Pechman issued a permanent injunction in April, ordering the Washington Department of Social and Health Services to cut the wait times to seven days, saying that holding mentally ill people in jails for months while awaiting competency services is unconstitutional.

She set a January deadline and appointed Danna Mauch, an expert in public mental health systems, to monitor the state’s progress.

In her first quarterly report, Mauch said the state should be commended for taking steps to address the waitlists, but the measures have not provided relief for those waiting for services.

“The critical conditions in the jails suggest that interim urgent measures to clear backlogs are in order,” Mauch said in her report filed with the court Tuesday.

She also questioned if the state’s long term plan will meet the judge’s deadline.

Messages sent to state health officials seeking a response to Mauch’s findings were not immediately returned.

Judges order competency evaluations when they have concerns about whether a person arrested for a crime is able to assist with his or her defense. If the person is found incompetent, the judge orders treatment to have competency restored. But in Washington state, people have languished in jails waiting for both services because of a lack of bed space and staffing at the state’s two forensic hospitals.

Lawyers with Disability Rights Washington and the American Civil Liberties Union filed the federal class-action lawsuit on the behalf of these individuals and secured an injunction that requires services within seven days of a judge’s order. The state has appealed the part of the order that requires evaluations to be done in seven days.

In a letter to Mauch, the lawyers questioned the state’s ability to meet the January deadline.

“It is concerning that in the three and a half months since the court’s order, the time that it takes defendants to provide competency restoration services has not significantly trended downward,” the letter said. “They didn’t start the hiring process for forensic evaluators until July – three months after the order.”

State reports on cases show that 16 people have waited more than 100 days for services, the lawyers said. Five of those people waited between 150 and 398 days to get into the hospital to have their competency restored, they said.

In her report, Mauch cited problem areas that put compliance with the federal order into question.

The volume of orders for competency services is growing, she said. In April, there were 336 competency cases, although officials said that was an incomplete count. The state reported 918 cases in May and 1,486 in June, she said.

Some people are waiting more than 60 days for competency evaluations at Eastern State Hospital, and are held in jail for 15 to 44 days to receive treatment at Western State Hospital, she said.

Mauch said when she spoke with officials about the $4.8 million it secured to work on competency issues, they “underscore” that the funds will “solve” the lags in services and help to prevent people from entering the criminal justice system.

Mauch said that total “is modest given the scope of need for these services in Washington.”

She also had concerns about the state’s ability to hire staff to fill positions at both forensic hospitals. When the budget was passed in July, the state made offers to nearly a dozen psychologists to fill evaluator positions, she said. Eight were hired for Western State Hospital, but not one wanted to work at the eastern site, she said.

When Mauch asked state officials if they would consider emergency hiring, department officials said they plan to have Western State Hospital Staff cover Eastern State hospital cases and that “constitutes its interim response.”

The department should report within 30 days whether this plan has been implemented and if so, whether it helped reduce wait times, she said.

“In the face of these challenges, other steps need to be taken to meet the seven-day time frames ‘as soon as practicable’ for competency evaluation services,” the monitor said.

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