The message behind a recent federal court order from U.S. District Judge Marsha Pechman is clear: Jail is no place for those suffering from mental illness, and by forcing them to wait weeks or months for court-ordered services, the state of Washington is damaging their mental health and violating their constitutional rights.
“It was a very strong statement by the judge,” said Doug Honig, spokesperson for the American Civil Liberties Union of Washington (ACLU). “It’s one of the strongest-worded opinions you’ll see.”
The Department of Social and Health Services (DSHS) is responsible for court-ordered evaluations to determine the competency of jailed defendants, as well as mental health treatment, so they can stand trial — called restoration services.
The court ruled in a recent class-action lawsuit that DSHS has consistently failed to provide these services within reasonable time, allowing those with mental illness to languish in jail — sometimes more than 120 days. In the remedy phase of the lawsuit, on April 2, Pechman issued a permanent injunction requiring DSHS to provide competency services within seven days of a judge’s order.
For those suffering from mental illness, jail can exacerbate an already dire situation. Often, they end up in isolation for 23 hours a day due to their symptoms. In one example, a detainee waited 35 days for a competency evaluation while in solitary confinement or suicide watch after repeating that she wanted to die. Another woman committed suicide in jail while waiting for services in the month before the trial.
“Our jails are not suitable places for the mentally ill to be warehoused while they wait for services,” Pechman said in the order. “Jails are not hospitals, they are not designed as therapeutic environments and they are not equipped to manage mental illness or keep those with mental illness from being victimized by the general population of inmates.”
DSHS now has nine months to comply with the judge’s ruling and a court monitor will be appointed to track its progress.
The order also requires DSHS to establish a long-term plan to address an expected growth of 10 percent annually in demand for competency services.
Throughout the case, DSHS cited insufficient funds for hospital beds and staff. While acknowledging that DSHS has been hampered by a lack of resources, the judge said the state has failed to plan ahead or adequately change its procedures.
“ … the constitution is a guarantee to all people, and is not dependent upon a price tag,” the order reads.
Jane Beyer, assistant secretary for the DSHS Behavioral Health and Service Integration Administration, issued a statement that agreed “a radical improvement is required.”
At the same time, the statement pushed back against the seven-day deadline established by the court.
In March, the state legislature enacted a bill that had set a maximum of 14 days. Beyer expressed a clear preference for the legislature’s time frame, saying a shorter one could undermine the quality of evaluations, and that “our major concern with the seven-day decision is that it could result in inferior care for our clients.”
Honig said the judge already took the state’s concerns into account.
“The judge looked carefully at all the state’s considerations during the trial, and made a strong and clear ruling in favor of this seven-day period,” he said.
Chris Carney, of plaintiff Carney
Gillespie Isitt PLLP, emphasized that the issue of competency services ties into the root problem: an insufficient infrastructure for mental illness in Washington, largely a result of slashes in funding during the recession. Washington ranks in the bottom five states for access to services in relation to mental illness prevalence.
“[The ruling] is an important first step, I would say,” Carney said. “It’s going to be a long road for the state to figure out how to fix this problem they’ve created by failing to allocate sufficient resources.”
Carney said he hopes the court ruling inspires the state to think big-picture and build a better system for preventing those with mental illness from ending up in jail in the first place.
“It’s so much more expensive in money and in human cost to try to treat a person once they’ve reached a mental health crisis and are suffering behind bars, than to give them the support in the community that they need to prevent reaching that crisis,” Carney said.