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In a first, King County moves against WA for mental health failures in jails

In a first, King County moves against WA for mental health failures in jails
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The King County Prosecutor’s Office is filing several civil contempt orders against the Department of Social and Health Services, alleging state officials have failed to provide timely mental health services to people in jail.

This is the first time King County officials have intervened in this way. They’re also asking judges to sanction DSHS $219.90 a day — funds that will go toward reimbursing the county jail for the cost of caring for people with severe mental illnesses who would otherwise be housed at state hospitals.

Local courts statewide have become increasingly frustrated with their inability to get people out of county jails and into mental health care. In the meantime, hundreds of people are waiting in legal limbo, their cases blocked as they wait in jail to be moved to state psychiatric hospitals. King County’s move could foreshadow additional efforts to force the state into finding a resolution or risking continued fines.

The county’s motions, filed on behalf of the King County Executive’s Office, were filed Tuesday in King County Superior Court in the criminal case of Jay Alexander, a Seattle man with a history of mental illness who assaulted two people and killed one this summer, as well as in the cases of six other defendants.

“Today we’re holding the state to account, and beginning to file contempt orders with the court to require the state to meet their constitutional obligations,” King County Executive Dow Constantine said in a statement.

“These cases are serious — alleged crimes like murder, assault, and rape. And delaying trials while defendants wait for their evaluations or restoration services creates enormous costs for local governments, potentially delays critical behavioral health care, and prevents justice.”

The county argues the state is violating a previous class action settlement known as Trueblood, which in 2018 laid out timelines for people in jail to receive basic mental health services. The settlement said that, with a judge’s order, people should receive evaluations to determine whether they’re competent to stand trial within 14 days, and restoration services at state psychiatric facilities like Western or Eastern State Hospital within seven days. State officials have struggled to meet those timelines and people often wait, stuck in jail, weeks or months past their allotted times.

In one Grays Harbor case, for example, Joshua Marsh spent eight months waiting for a competency evaluation and restoration treatment at Western State Hospital. His lawyer said that if he’d had the opportunity to plead guilty to his charges, he likely would have been released from jail sooner.

As of November, King County prosecutors estimate there are 350 felony cases in need of mental health services.

For prosecutors, that means deliberating over which cases to keep pursuing and which to dismiss. Likewise, judges must balance the long wait times and constitutional rights of people who have not yet been tried or convicted of a crime with public safety risks if the defendant were freed.

DSHS has already paid $98 million in taxpayer money since 2018 for this failure. That money is going toward diversion programs and other initiatives like a forensic navigator program where staff supports people as they transition from jails to state hospitals and back into the community. In some cases, money is also going to defendants for their prolonged wait times, but these sanctions vary county by county and judge to judge.

Still, long wait times persist at jails, courts and state hospitals. DSHS officials attribute the delays to struggles to hiring and retaining mental health professionals, a shortage of beds in the state, and a growing demand for mental health services, all exacerbated by COVID-19.

“The numbers (approx. 100 people on any given day) have become intolerable, our resources are stretched to the limit, and we have no sign that there is any resolution to the backlog coming from the state at this point,” said Chase Gallagher , a spokesperson with the Executive’s Office.

Other counties like Pierce and Grays Harbor have made similar attempts to repurpose sanctions that would go toward the cost of caring for people in local jails.

If a judge supports King County’s motions, state officials would pay an estimated $46,200 for every month the seven defendants don’t get services at a state facility. The full cost for the 100 people awaiting competency and restoration treatment at the King County Jail would be much higher — $660,000 a month.

A spokesperson with DSHS said the agency will oppose the motions.

“The hospitals are full, referrals are up 40% over the past year while we deal with acute staffing shortages which are affecting the entire nation,” read an emailed statement. “We are working to increase capacity and bring additional beds on line as quickly as possible. Our commitment remains to serve our clients.”

According to the most recent data from DSHS, ordered 536 people statewide to receive competency evaluations in September. About 70% received one on time. An additional 163 people were ordered to receive restoration treatment. Only 6% received that treatment on time.

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Get in touch with us at mentalhealth@seattletimes.com.

Seattle Times researcher Miyoko Wolf contributed to this reporting.

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