Under the order by Judge Michael Schwartz, DSHS is immediately obligated to fulfill its statutory duty to assess all new conversion patients (those individuals for whom criminal charges were dismissed due to their inability to be restored to competency). Additionally, DSHS is now mandated to provide adequate notice when releasing existing conversion patients, a critical measure for both patient well-being and community safety.
The coalition includes Asotin, Cowlitz, Douglas, Grant, Grays Harbor, Island, Jefferson, King, Kitsap, Klickitat, Lewis, Lincoln, Pacific, Pierce, Skagit, Skamania, Snohomish, Spokane, Thurston, Whatcom, and Yakima Counties. The plaintiff counties represent over seven million Washington residents.
The ruling follows a separate judgment in July, when a federal judge determined that the state had failed to provide timely care to those with mental illnesses in Washington jails.
King County Executive Dow Constantine said, “Today’s ruling affirms the state’s basic obligation to evaluate the behavioral health needs of people in the legal system who cannot be tried because they lack the ability to aid in their own defense and to give them an opportunity for meaningful treatment. It does not, of course, solve the very real capacity problems in the behavioral health system born of long-term funding and workforce shortages.”
When a person with a serious mental health condition has their charges dismissed because they are unable to understand the charges, DSHS is ordered by the court to provide effective behavioral health treatment. This system, called a civil conversion commitment, focuses on people with severe behavioral health conditions who have not been adequately served by the crisis and outpatient behavioral health system.
Despite court orders and state laws requiring them to do so, DSHS has asserted that it is no longer obligated to treat patients whose criminal charges are dismissed, citing a federal judge’s orders in a separate case. To date, the agency has repeatedly argued that it will not follow court-ordered legal requirements, leaving hundreds of individuals losing their chance for mental health treatment that might otherwise break the cycle of re-offense.
Charges are dropped against individuals when they are determined not to be competent to stand trial. The individuals are then released back into the community without facing justice nor receiving the treatment courts have ordered. When DSHS fails to provide restoration services, individuals are referred back to their home counties to designated crisis responders, placing the burden of care on counties, despite state law requiring the state to do so. These releases further a harmful cycle where the state does not meet its responsibility of care and leaves individuals at risk of re-offending, repeating the legal process without any care and treatment.
In the Trueblood case, after failing to follow its legal obligations, DSHS was held in contempt, and the federal court imposed a $100 million fine. DSHS now claims that its refusal to follow state law with conversion patients is the fault of the federal court. However, there is nothing in the court’s orders that interferes with DSHS’s obligation or ability to provide restorative services.
While the state has recently purchased a former behavioral health hospital in Tukwila to address a shortage of capacity, the department has refused to provide the care ordered by courts and required by state law.
The case is known as Pierce County vs. Washington State Department of Social and Health Services. ◆
