22 counties take on Washington state over mental health crisis, plans to release patients

TACOMA, Wash. - In a rare move 22 counties across Washington state banded together to sue Washington’s Department of Social and Health Services (DSHS) over mental health services, or a lack thereof.

The court filing, filed on Wednesday in Pierce County Superior Court, accuses DSHS of refusing to offer services ordered by courts.

David Hackett, the general counsel to King County’s executive, said there are two instances where the state is failing.

The state isn’t giving mental health evaluations to individuals that are not competent to stand trial, but have been ordered through the court to undergo a mental health evaluation.
DSHS has failed to give full details to law enforcement and prosecutors about plans to release people from state mental health hospitals, noting it wasn't following "routine notification process" until it could get into compliance following a separate court order.

"When you have a legal obligation, a court order, staring you in the face you can’t say: ‘It’s just too difficult, I’m not going to do it,’" said Hackett.

According to Hackett, the concern is both over public safety and the mental health of the people at state facilities. He explained that with the current situation unfolding, it’d be possible for a stalking victim’s perpetrator to be released from a state facility without notice the way things are currently unfolding.

Eric Johnson, head of the Washington state Association of Counties, said that there are an estimated 200 people on a list ready to be released. That includes people accused of violent felonies, which typically would be released following a process of planning and preparation with local law enforcement.

The lawsuit came together quickly, in part, because the letters DSHS began sending out in early August that indicated a number of patients would be released from state mental hospitals on September 7th.

A section of the letter reads: "By this letter DSHS is providing notice of pending discharge for the patients in your jurisdiction. However, at this point, many discharge plans, including locations, remains undetermined."

It’s no secret that the state is facing major issues keeping up with the demands. It previously closed beds in the Western State Hospital, only to watch a backlog grow. In January, 2023 FOX 13 reported that the waitlist had reached 850 patients.

Eventually, a judge held the state of Washington in contempt for not providing services to mentally ill people in jails. The federal judge ordered the state to pay more than $100 million in fines, for forcing people to wait weeks or months for treatment.

In early August, Governor Inslee announced that the state would acquire the psychiatric hospital formerly owned by Cascade Behavioral Health to add roughly 100 beds to the state’s struggling mental health system.

While the move is being cheered, it will take time before the facility is online. In the meantime, people are being turned away from services.

"These are people that often have serious mental health conditions, or co-occurring substance abuse conditions," said Isabel Jones, with King County Dept. of Community and Human Services. "These are disproportionately people of color, and people who have cycled in and out of multiple systems; in many cases over the course of a number of years."

The two sides are miles apart. The state, telling FOX 13 that it is following a federal court order known as the "Trueblood Order." While the counties argue the order they’re referring to has nothing to do with the moves they’re making.

According to the state, in order to comply with a federal court ruling it must open more beds for incarcerated individuals waiting for competency evaluations and restoration services. To clear those beds, it plans to discharge patients that are not being held under a violent felony civil commitment.

The counties have argued that the "Trueblood Order" had nothing to do with short-term evaluation admissions, and that the state has began citing the court order as a reason to decline mental health evaluations as ordered by courts.

"This new bout of litigation brough forward today by the counties is in direct conflict with the federal court’s order," a statement from DSHS read. "The challenge of tackling this multi-tiered problem does not become easier when counties demand the state and the superior court ignore a federal court order."

The state legislature has committed an additional $2 billion in funding for construction of a new hospital, but that facility is years away from opening. In the meantime, the demand for beds continues to rise.

DSHS stated that in nine years service requests have increased by roughly 145-percent.

However, as the state declines to offer services counties are now left to fill gaps – counties that have already warned they’re overburdened with their own mental health needs. King County voters recently approved a $1.2 billion crisis care center levy to increase its own number of treatment beds.

Jones warned that of the estimated 200 people that are set to be released from state mental hospitals, roughly 20 were "nowhere near ready" to be released.

"We do already know of some cases where we haven’t been able to locate a placement yet, and Western State Hospital has released the individual – I believe in at least one case, to a shelter," said Jones.

The counties are now asking for a preliminary injunction by September 8th in Pierce County Superior Court. It’s unclear how many patients in state facilities will be released by that date.

COMPLETE STATEMENT FROM DSHS:

"With the imploding demand for behavioral health services rising tremendously, the Department of Social and Health Services and dedicated staff continue to care for the state’s most complex patients when others are unwilling or unable to provide such care.

"This new bout of litigation brought forward today by the counties is in direct conflict with the federal court’s order. The challenge of tackling this multi-tiered problem does not become easier when counties demand the state and the superior court ignore a federal court order.

"Over the past nine fiscal years, requests for DSHS to provide inpatient evaluations and competency restoration services have increased by roughly 145%. These large and unpredicted increases in the number of county criminal court orders have exceeded the large number of beds already added to the forensic system. We are working as quickly and efficiently as possible to bring treatment beds for civil conversion patients online, including at the former Cascade Behavioral Health facility in Tukwila, which we acquired earlier this month. The department does not have the authority to build beds outside its own facilities.

"We are grateful for the more than $2 billion in funding the Legislature has already approved for construction of the new forensic hospital and other facilities scheduled to go online in the next few years pending county permitting and other construction dilemmas. We will continue to push forward with multiple new facilities, but the demand for beds is only increasing."