More than half of WA counties have filed suit against the state for behavioral health failures

Twenty-two of the state’s 39 counties have joined a lawsuit filed Wednesday in Pierce County Superior Court against the Department of Social and Health Services, claiming that the state has failed in its obligations surrounding mental health care, particularly in regards to “civil conversion” patients.

“By ignoring the dictates of the legislative and judicial branches, DSHS is depriving a particularly at-risk population of the opportunity for necessary mental health treatment to the detriment of both patient well-being and community safety,” the lawsuit said. “In the face of DSHS’s continuing contempt for both legislative and judicial authority, Washington’s counties have joined in an unprecedented coalition to enforce DSHS’s legal obligations.”

King, Pierce, Thurston, Whatcom and Lewis counties are among those that have signed on to the lawsuit, as well as the Washington State Association of Counties, a nonprofit that represents all 39 counties in Washington.

“When the mental competency of a criminal defendant cannot be restored, county superior courts dismiss the defendant’s charges without prejudice and must commit the former defendant to DSHS custody to evaluate the patient for potential civil commitment,” the lawsuit says. “Because the dismissal of criminal charges ‘converts’ these patients from a criminal hold to a civil commitment hold, they are referred to as ‘civil conversion patients.’”

Instead, the lawsuit alleged that DSHS has not only “selectively refused” admission for patients since December 2022, but that it also hasn’t admitted any patients for evaluations required by state law since July.

The lawsuit also alleges that the agency is required by law to notify law enforcement agencies, victims and other interested parties when certain civil conversion patients are released after treatment, but that DSHS has “recently stated” their intention not to do so.

Not only are patients denied necessary treatments, public safety is impeded, the lawsuit continues.

The plaintiffs are seeking a declaratory judgment from the court that shows DSHS is required to accept civil conversion patients for evaluations, and that DSHS is required to comply with state law when releasing patients back into their communities. The plaintiffs claim that they “will suffer immediate damage and harm” if violations are not declared under the law.

Additionally, the plaintiffs are seeking injunctive relief that would require DSHS to accept patients for evaluations and to follow state law when releasing civil conversion patients. As an alternative to an injunction, a writ of mandamus, a type of court order, was requested that would compel DSHS to do its duties under the law.

Plaintiffs are also seeking attorney’s fees in the lawsuit.

“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,” Tyler Hemstreet, the media relations manager for DSHS, told McClatchy in an email. “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.”

In early July, that Judge Marsha J. Pechman of the U.S. Western District of Washington issued a scathing decision, finding DSHS in breach of a settlement agreement known as Trueblood that established time frames for people in jail to get services at state psychiatric facilities.

As part of the judge’s ruling, The Seattle Times reported that DSHS officials have to comply with 10 key changes, most notably ceasing admission of civil conversion patients to state hospitals. The judge said these civil conversion patients have been taking valuable bed space needed for people receiving competency services.

Under Pechman’s order, DSHS must transfer or discharge these patients within 60 days, unless they were held on previous violent felony charges. At the time of the ruling, it was not clear how many of those patients there are or where they will go, the Times reported.

Hemstreet noted that over the past nine years, there has been a 145% increase in requests for DSHS to provide evaluations and competency restoration services and that “the 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,” Hemstreet continued.

DSHS does not have authority to build beds outside of the agency’s 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,” Hemstreet added. “We will continue to push forward with multiple new facilities, but the demand for beds is only increasing.”