The state of Washington is scrambling to find beds for an estimated 200 mental health patients by August 27. That's when the state must comply with a Washington Supreme Court ruling that said detaining psychiatric patients in emergency room beds is unlawful.
It's known as “boarding.” The state has been sending involuntarily committed mental health patients to regular hospitals and acute care centers – sometimes for up to two weeks. The reason was that certified psychiatric treatment centers simply don't have the space.
But now Washington will have to find it somewhere, by court order.
Andi Smith, the governor's senior policy adviser on health and human services, said the state has been able to find some space at residential facilities, private psychiatric centers, and at Eastern State Hospital.
“We will work as hard at implementation as we possibly can,” she said. “But the problem will not be solved by Day 1.”
Smith said optimistically, they may have 50 more beds by the time the Supreme Court's ruling takes effect. That's far short.
The governor's office is working on a budget request for the next legislative session. Another short-term option he’s weighing is to ask the court for more time.
The governor's office estimates the cost of complying with the ruling to be in the tens of millions of dollars.
Patients and mental health advocates have complained that hospital emergency rooms and acute care centers aren’t equipped to provide adequate mental health treatment.
On August 7, the Washington Supreme Court agreed, ruling that “boarding” patients because there's not space at specifically certified psychiatric centers is illegal under the state's Involuntary Treatment Act.
“Patients may not be warehoused without treatment because of lack of funds,” wrote Justice Steven Gonzalez. The act says patients may only be sent to hospital beds when there’s a secondary medical need.
Public health officials say eventually, the state may need to consider building new wards at the state psychiatric hospitals, as well as funding more preventive care and low-income housing support.
The practice of boarding patients has been on the rise in recent years, as the state has scaled back spending.