State officials are speeding up the time it takes to evaluate the mental state of a criminal defendant sitting in jail.
But when it comes to moving those inmates out of jail and into treatment to prepare them for trial, wait times remain persistently long.
“We’ve had people waiting in jail before they can proceed to trial, sometimes for weeks,” said Tim Hunter, a competency restoration specialist with the Department of Social and Health Services.
Hunter is among those working on the state’s stopgap solution: two new treatment facilities, one on each side of the Cascades, run by contractors.
Patients are trickling into the Eastern Washington unit, in an otherwise vacant jail in Yakima. Training classes for staff start Monday at the Western Washington facility, a former juvenile detention center in south Thurston County’s Grand Mound that closed during Great Recession-era state budget cuts.
12 Percent of patients in February who were admitted to the state hospitals for competency restoration within a court deadline of 7 days.
37.1 Average number of days waited.
Workers this week were putting finishing touches on renovations to Cascade Cottage on the campus of the former Maple Lane School.
To prepare the former youth lockup for adult patients, workers added cameras and redesigned a central control booth where video screens are monitored. They built a seclusion room where difficult patients can be confined alone or restrained and a small outside recreation area surrounded by a fence with webbing too tight to climb.
They covered grates on the backs of stairs that could have potentially allowed patients to hang themselves and areas above second-floor railings that would have allowed jumping.
“We tried to model it both structurally and clinically after the programs at the state hospitals,” Hunter said.
Maple Lane is supposed to avoid taking defendants with the most severe mental and physical illnesses and those most at risk for violence. State hospitals are to continue treating those patients. Men with histories of preying on women will not be admitted to Maple Lane, because women are expected to make up a fraction of its patients.
The site’s opening, once set for April 1, has been delayed and is at least three weeks away. About three-quarters of state employees and at least half of contract employees have been hired, Hunter said.
DSHS is spending $9 million at Maple Lane through June 2017, including $4.27 million to pay Correct Care Recovery Solutions to run the center. The for-profit company will handle treatment, while DSHS provides security, maintenance and oversight and brings in cooked meals from the nearby Green Hill School detention center.
The plan is for the satellite facilities to be temporary, with the treatment shifting back to state psychiatric hospitals, where it has historically been done. Expansions have been planned and funded at the state hospitals but have mostly stalled, in part because of safety problems at Western State Hospital in Lakewood.
Maple Lane might then become the home of a new state prison. The prison system is evaluating a possible 700-bed medium-security prison focused on adults with mental illness.
Pressure from a lawsuit is driving expansion of mental health beds.
U.S. District Judge Marsha Pechman, ruling in what’s known as the Trueblood case, demanded that the state take no more than seven days to evaluate a defendant’s competency to stand trial. Those deemed incompetent to stand trial must be admitted for treatment in no more than an additional seven days, Pechman ruled.
The treatment attempts to break down mental barriers to understanding court proceedings.
Until now, that treatment happened only at the Lakewood hospital for all Western Washington patients. All Eastern Washington patients went to Eastern State Hospital near Spokane.
42Percent of patients in February who were evaluated for competency to stand trial within a court deadline of 7 days.
11.2Average number of days waited.
If current plans hold up, as many as one in five beds for competency restoration will be located at the two satellite locations.
Geography will no longer limit where defendants go, although Hunter said keeping them close to home and family would be considered.
If sent across the mountains, patients appear more likely to go from west to east than the other direction. About 13 percent of defendants needing the treatment are from Eastern Washington, but the region will have 32 percent of beds.
Attorneys for criminal defendants have complained about the difficulty in communicating with their clients from across the state and the stress of repeated moves on someone with mental illness. The lawyers said DSHS has sought to move clients to Yakima who are already in Western State Hospital.
Their comments came in court filings supporting Trueblood plaintiffs’ request for Pechman to halt use of the Yakima jail. Keeping patients from languishing in jail is the very reason for the court order for faster treatment, so plaintiffs say they shouldn’t go to another correctional facility.
The plaintiffs have raised similar objections to Maple Lane, although they haven’t issued a request for a restraining order against its use.
DSHS replies that treatment style is more important that the historic use of a facility. The satellite locations will be completely devoted to treatment, unlike a jail that might hand out medication and provide some nominal level of therapy while primarily focusing on incarceration, Hunter said. They have to be licensed by the state Department of Health as treatment facilities, he said.
The need for the treatment has been rising. Western State Hospital admitted about 650 patients to restore their competency in 2013, nearly doubling its 2011 admissions, according to DSHS.
Wait times for restoration admissions at the two hospitals averaged between about three and seven weeks in each of the past 11 months, according to DSHS figures. In February, according to preliminary figures released Thursday, waits lasted an average of 37 days, and just 12 percent of patients were admitted by the seven-day deadline, a new low since the court ruling.
In-jail evaluations of competency, which precede restoration, have shown more improvement as the state has hired more evaluators. Wait times for evaluations have fallen in recent months, especially at Eastern State Hospital.
In February, waits for evaluations dipped below two weeks — to 11 days — for the first time since the court ruling. The same month, 42 percent of evaluations were done by the seven-day deadline, a new high.