Authorities accused Anthony Garver of killing a woman by stabbing her in the chest 24 times and cutting her throat.
That’s the type of patient one might expect to find in the highly secure section of Western State Hospital reserved for referrals from the criminal courts. But Garver, 28, was housed elsewhere before his escape through a window Wednesday.
He was on ward C4, whose patients include 14 people who were charged with violent crimes but found incompetent to stand trial. Garver and fellow escapee Mark Alexander Adams, 58, fell into that category before their escape and eventual recapture, Alexander a day later in Des Moines and Garver on Friday 300 miles away in Spokane.
A patient deemed incompetent tends to be very different from a typical Western State patient, said Henry Richards, a forensic psychologist in private practice in Seattle who formerly led a panel reviewing potential releases from the state psychiatric hospitals. A 2014 report by the panel said the hospitals sometimes wrongly treat the two populations as similar.
These patients may be violent and calculating, even if they are not showing psychotic symptoms, Richards said.
“There’s a concern about how the staff can deal with that, given the nature of the facility,” he said.
The patients are under the authority of a 2013 law that made it easier to keep them locked up.
The poster child for House Bill 1114 was Jonathan Meline, a Tacoma man who was found incompetent to stand trial on an assault charge and was eventually released from Western State Hospital. Months later, he killed his sleeping father with a hatchet.
Garver was found incompetent to stand trial on a charge of first-degree murder.
There are 21 such patients under Western State’s jurisdiction because of HB 1114, according to the Department of Social and Health Services that runs the hospital.
Four of them have made enough progress in treatment to earn “community placements,” such as living on their own or with family. Unlike most patients discharged from the hospital to a community placement, the state pays for a place to live and checks in on them at 30-day intervals after discharge.
The rest are detained at the hospital. It’s not clear how many would be there without the law. Lawmakers added a layer of review and shifted the standard for keeping people detained, but they didn’t change the basics: Detentions last six months and can be renewed if the hospital asks and a judge approves.
A DSHS summary of the law says the new standard allows for a violent offender to potentially be committed permanently, a change that “is being reviewed by the Washington State Supreme Court and may be found unconstitutional.”
Prosecutors said at the time that the old standard wasn’t enough to keep people locked up. The solution worked, Pierce County Prosecuting Attorney Mark Lindquist says now.
“The Jonathan Melines of the world are being held in a locked facility rather than released in the community,” Lindquist said. “The good news is the law is working. The bad news is the locked facility wasn’t sufficiently secure, judging by what happened here.”
The most secure section of the hospital is the Center for Forensic Services, housing patients who have been charged with crimes. Some are undergoing treatment to be restored to competency to stand trial. Others have been deemed not guilty by reason of insanity.
Units there are called forensic wards. Entrances and exits to the center go through sally ports, sets of doors controlled by security officers.
But most of the hospital is dedicated to patients detained in civil court proceedings, usually because they pose a threat to themselves or others. The units are called civil wards. Patients such as Garver who begin their time at Western in the forensic ward might end up on the civil side if efforts to restore their competency to stand trial fail and they are deemed a threat.
Civil wards are locked, although not generally with the same kind of sally ports as forensic wards. Patients can earn privileges to go in and out of the wards.
Ward C4, where most of the House Bill 1114 patients live, is a civil ward. It’s more “hardened” than other civil wards, said Kathy Spears, a DSHS spokeswoman, with more “enhanced video security surveillance.”
“The physical ward is more difficult for escape and medical staff is trained to deal with more high-risk patients,” Spears said in an email.
She said those hardened safety features aren’t targeted to C4, but instead are being put in place around the hospital as money becomes available.
Records show C4 is considered a “high acuity” ward for the purposes of deciding which wards should be prioritized during short-staffing.
But Spears acknowledged there are some other wards where patients are checked every 15 minutes, more frequently than the once-an-hour checks done in C4.
As recently as 2014, according to court filings, there was a secure civil ward adjacent to the forensic center and accessed via sally port: ward E2, where some patients found incompetent to stand trial were housed. But court filings indicate that ward was later shifted to use for forensic patients. The state faces pressure from a federal judge to speed up its forensic treatment.
It wasn’t clear Friday how long C4 has housed incompetent and violent patients, but assaults in that ward increased from 2013 to early 2015.
C4 was the only ward that saw significant increases during that time in patients’ assaults on staff, patients’ assaults on each other and patients’ assault-related injuries, according to DSHS records.
Spokane County Sheriff Ozzie Knezovich had sharp words for state officials late Friday after a police dog found a hungry and dehydrated Garver hiding in trees above the Spokane-area home of his parents.
Knezovich was incredulous that Garver, who has a history of running from law enforcement, had been able to make another run for it.
“The state of Washington needs to get a clue,” the sheriff said. “This cannot happen again.”
DSHS said Saturday that Garver is now being held and treated at a state prison, Airway Heights Corrections Center. The agency said “immediate steps” would be taken to tighten security at Western State Hospital and retrain staff.
The Associated Press contributed to this report.