Politics & Government

Doctor shortage keeps Western State Hospital from taking detained patients

Western State Hospital has been closed for weeks to 90-day involuntary commitments, one of its two main types of admissions, worsening one choke point in a mental-health system full of them.

The state psychiatric hospital in Lakewood hopes to resume accepting detained patients Wednesday but has taken none since Feb. 19.

A struggle to hire and retain psychiatrists is to blame, according to the Department of Social and Health Services. Nine of 45 positions are vacant or about to be vacant at the hospital.

“There is a tremendous shortage of psychiatrists, not only in this state but across the country. It’s just not a specialty that physicians are going into anymore,” said Victoria Roberts, a DSHS deputy assistant secretary, who added that the U.S. Department of Veterans Affairs has “been recruiting our doctors very, very hard” with salaries as high as $250,000.

State psychiatrists are paid as much as $164,000, Roberts said, but the state has negotiated with doctors to raise their salaries by 15 percent. Lawmakers approved money for the raises last month.

The state also won agreement to hire contract doctors, while some staff doctors have agreed to work extra shifts.

That should allow the hospital to once again accept patients on 90-day involuntary commitments. That kind of detention is ordered by a court when a patient continues to need treatment for a dangerous or disabling mental illness after the clock runs out on a shorter detention in a local facility.

A wait list stood Friday at 41 people, Roberts said, about double of what’s normal.

Of the hospital’s 557 beds for involuntary commitment, 528 are full, she said.

Local facilities can keep patients for longer stays. But that takes up space meant for short-term detentions that then must be handled by local hospitals – in what may or may not be the proper environment for mental recovery.

“Currently over 40 percent of our beds are filled with people waiting to get into Western,” said Ian Harrel, director of crisis services for Behavioral Health Resources in Olympia, whose facility has space for 15 patients. “That’s a substantial backup.”

The Legislature last month approved spending $459,000 on the 15 percent pay raises for psychiatrists at both Western State Hospital and Eastern State Hospital near Spokane.

“I think it’s awful that we are not compensating psychiatrists well enough to keep our hospital adequately staffed,” Rep. Laurie Jinkins, D-Tacoma, said Monday.

The money came in a supplemental budget that also spent more than $13 million on space at local hospitals, facilities and Western State Hospital to comply with a state Supreme Court order to stop detaining people without treatment.

Doctor turnover has also played a role in backups in another division of Western State, where there are long waits for jail inmates needing psychiatric evaluations or needing to be restored to competency to stand trial. The halt in admissions does not apply to inmates.

  Comments