Authorities ‘plainly violated’ state law in psychiatric care, Washington Supreme Court rules

By Ellen Dennis / The Spokesman-Review

In 2021, an average of 41 people were detained daily for mental health crises in Washington. Authorities “totally disregarded” the law by holding some people in psychiatric hospitals too long, the state Supreme Court ruled Thursday.

The Involuntary Treatment Act allows authorities to detain a person undergoing a mental health or substance abuse crisis for up to 120 hours, or five days. That person must have a hearing before a judge or commissioner within that time.

In a pair of 5-4 decisions, the court ruled the state failed to follow requirements of the Involuntary Treatment Act by holding three people in behavioral health treatment facilities beyond the time permitted under the act.

Civil rights activists in the state welcomed news of the decisions with strong support, including the American Civil Liberties Union of Washington, which penned a brief urging the court to reverse the Court of Appeals decision and find authorities did not follow the law.

Prolonged detention can result in a “plethora” of repercussions, said Jazmyn Clark, director of the state ACLU Smart Justice Policy Program. “These include loss of housing, loss of employment, and loss of the custody of children. It can have incredibly detrimental effects on every aspect of a person’s life.”

Black people, Indigenous people and people of color are more likely to be detained through the state’s Involuntary Treatment Act, Clark said.

In 2021, 15,208 people were involuntarily detained in Washington, according to the state Health Care Authority. That same year, the program cost more than $123 million to fund.

If a doctor or other petitioner does not believe it is safe to release the person, they must demonstrate during the 120 hours that the person being detained is “gravely disabled,” or a threat to themselves, to others or to property. If a judge rules in favor of the petition, the person may be hospitalized for up to 14 more days or placed on a 90-day restrictive order, which means they are not hospitalized but are required to comply with conditions and subject to court surveillance.

In one of the two cases from the ruling, a person identified as DH in court documents was  taken to a hospital for a 72-hour mental health hold. DH was not released at the end of that time, and instead a hospital worker filed another 72-hour hold for DH the next day. After that second three-day stretch, officials filed a petition to detain DH for another two weeks. DH unsuccessfully tried to appeal the 14-day hold in court.

“We cannot allow the State to hold people without authority of law and avoid repercussions simply by starting a new case,” Justice Helen Whitener wrote in the majority opinion for the case.

In the other cases, two people, identified as CM and NG in court records, were held at Western State Hospital in Lakewood for more than a month longer than court orders authorized.

The two people had their rights under the Involuntary Commitment Act “plainly violated,” Chief Justice Steven González wrote in the majority opinion.

“Involuntary detention, even when done for the person’s own good, is a profound deprivation of liberty that the State may not impose without due process of law,” González wrote.

González’s majority opinion was joined by justices Mary Yu, Helen Whitener, Raquel Montoya-Lewis and Sheryl Gordon McCloud.

Justice Barbara Madsen, in the minority decision, acknowledged that Western State Hospital had shown “mismanagement” of CM’s case, but said that didn’t rise to the level of “total disregard” of the Involuntary Treatment Act.

“The record shows that CM has schizoaffective bipolar disorder, required two-to-one staff monitoring, and was described as one of the most assaultive patients at Western State Hospital. During CM’s commitment, CM was continuously assaultive, except for a six-month period from 2019 to 2020. The assaults were apparently ‘indiscriminate’ and occurred with and without provocation,” Madsen’s opinion said. “…Releasing CM in light of the violent and assaultive behaviors posed a risk of danger to public safety.”

Madsen was joined by justices Charles Johnson, Susan Owens and Debra Stephens.

Srikanth Naidu, a Snohomish County defense attorney who works in the mental health and involuntary treatment unit, said the court’s decision helped clarify the law and put up safeguards for people who might face involuntary commitment at some point in their lives.

“It also helps eliminate the argument that something is a harmless error — or an inadvertent mistake — when it comes to timelines,” Naidu said. “Matters involving liberty are at stake. It’s very important to ensure those constitutional rights and those due process rights are protected.”