EDITORIAL: State must rise to federal judge's rebuke on mental health system

April 09--The crime rate in Washington state plunged by about a quarter and criminal case filings also fell in the last decade. Yet the number of defendants who need mental health evaluations and treatment while in jail rose like a fever -- an increase of more than 80 percent.

Why the two trend lines diverge so starkly isn't entirely clear. But the consequences are clear: mentally ill defendants have been forced to sit in jails for weeks, even months, just to see if they are competent to stand trial, even if the charge is petty. Often, they wait in solitary cells, with inadequate treatment.

Last week, U.S. District Court Judge Marsha Pechman, hearing a class-action lawsuit brought on behalf of these defendants, gave the state a stinging rebuke for its shaky system to ensure timely mental health competency services.

She ruled that defendants must wait no longer than seven days for mental health competency evaluations and treatment. "Our jails are not suitable places for the mentally ill to be warehoused while they wait for services," she wrote.

Although this problem has grown for a decade, the Department of Social and Health Services, which coordinates competency services, has "failed to show the leadership and capacity for innovation that is required to address the crisis," Pechman wrote.

Pechman's ruling -- and the appointment of a federal monitor to ensure it is followed -- hands the state Legislature another eight-figure bill. Anticipating this ruling, lawmakers earlier this session set a looser -- and less expensive -- two-week evaluation deadline. It now must revisit the issue.

The state will need cooperation from labor unions representing mental health staff at state psychiatric hospitals. The state has struggled to recruit and hire enough psychologists to conduct evaluations, in part because its pay scale has not kept pace with the private sector. Expanding the type of professionals who can perform evaluations also would help.

The Legislature also should view Pechman's ruling more broadly. It is a twin with the state Supreme Court "psychiatric boarding" ruling last year, which found similar waiting lists in community psychiatric hospitals unconstitutional.

Both address bottlenecks for inpatient care, but leave unsaid the fact that hospitalization -- and arrest -- for people with serious mental illness can be avoided with a more coherent network of preventive care.

That type of care was severely cut in the Great Recession. But in the past three years, the state has committed to an $800 million increase in mental health spending.

That enormous investment must yield results, including an end to stinging management rebukes by federal judges.

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