State ‘totally disregarded’ involuntary treatment law, held people too long, high court rules

In a pair of 5-4 decisions the Washington state Supreme Court clarified when people detained in crisis must be released.

By: - July 27, 2023 6:45 pm

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Washington authorities failed to follow a state law that allows for people to be temporarily detained against their will for mental health treatment, the state Supreme Court ruled Thursday.

In two 5-4 decisions, the court ruled that the state “totally disregarded” the requirements of the Involuntary Treatment Act for three individuals held for behavioral health treatment. Justice Helen Whitener wrote in one of the opinions that the violations were “not a mere oversight” but rather “a complete failure to treat the ITA with respect or attention.”

The Involuntary Treatment Act allows a person who is experiencing a mental health or substance abuse crisis to be detained involuntarily. 

Initial detentions can’t be more than 120 hours, according to the law. 

If the individual does not stabilize within the initial detention, authorities can ask a court to approve a 14-day commitment for additional treatment. After 14 days, authorities can petition that court for a 90-day commitment for the person at a long-term facility, or a 180-day commitment, if the person is a physical threat to themselves or others.

In 2021, more than 15,200 people received initial detentions under the law and more than 3,200 had orders for subsequent 14-day commitments, according to the state Health Care Authority.

The act is designed for situations when a person is in crisis and effective alternatives do not exist, Chief Justice Steven González wrote in the other decision. 

Involuntary detention is “a profound deprivation of liberty,” González wrote, and therefore, must be done following highly specific restrictions. 

During the time they are detained, for example, a person must be promptly provided a lawyer and brought before a judge, and if the state wants to keep holding them longer, it must present “clear, cogent and convincing evidence” in court justifying the decision to do so.

Civil rights advocates applauded the rulings. Jazmyn Clark, director of the American Civil Liberties of Washington Smart Justice Policy Program, said the ACLU, which filed friend-of-the-court briefs in the cases, was “thrilled” with the decisions. 

They ensure that people cannot be held against their will longer than what is allowed by law, Clark said, noting also that the law has had disproportionate effects on people of color.

The two separate cases before the court hinged on similar questions. One: What amounts to “total disregard” by the state in following the law? Another: When the state exhibits total disregard, should petitions allowing someone to be held be dismissed and the person released?

In both cases, the court found the law’s requirements were “totally disregarded,” which the majority defined as “involuntarily detained without legal authority under the act.” 

Further, the court ruled, when the state totally disregards the law’s requirements, petitions must then be dismissed.

Marcus Jay Miller, who heads the Civil Commitment Unit of the Pierce County Prosecuting Attorney’s Office, said Thursday’s rulings brought clarity to the process. His office defended the entities in both cases. 

“We never had a working definition of ‘total disregard.’ We wanted the court to weigh in,” he said. What the majority of justices delivered was “pretty much a bright line rule. Now it’s clear.”

With the ruling, he explained, a person needs to be released when the clock runs out on the petition for their involuntary hold, even if those providing treatment believe the person may still be in need of care. 

As for what that means in practice: “I don’t know how it is going to play out,” Miller said.

In the first case, two people – identified as NG and CM  – were confined at Western State Hospital for more than a month after their six-month civil commitment orders expired.

Hospital staff continued to hold them involuntarily, even after learning of the expired documents. Instead, staff decided to file new petitions to keep them detained longer. 

In the other case, a person identified as DH was referred for evaluation by his mother who was concerned about his delusions, paranoia, and vague threats against his family, according to court documents. DH was detained and brought to a hospital under a 72-hour hold for involuntary treatment.

He was subsequently transferred to the nonprofit Wellfound Behavioral Health Hospital in Tacoma but was not released at the end of the 72-hour window. A day after that timeframe lapsed, a designated crisis responder evaluated DH and concluded he met the criteria for another 72-hour hold and filed a new one. Officials next filed a petition for a 14-day involuntary stretch of treatment. DH filed a motion to have the petition dismissed. But, 20 days after he was initially detained, a court denied it.

Here, the Supreme Court found that a trial court abused its discretion when it allowed the 14-day petition to stand because it was filed after the initial 72-hour hold had expired.

The court reached a similar conclusion in the other case, ruling that the individuals should have been released before officials started new petitions to keep them detained for a longer period of time. 

Four justices – Barbara Madsen, Charles Johnson, Susan Owens and Debra Stephens – disagreed with the majority’s decision. Madsen wrote both dissenting opinions.

She wrote that if a person currently receiving treatment still needs further care, it could be appropriate in some cases to keep them committed even if the order allowing for that has lapsed.

“‘Total disregard’ must mean something other than violations of the timelines,” Madsen wrote. She added that commencing a new petition while an individual is detained does not undermine the law’s goal of preventing indefinite commitments and pointed to safeguards surrounding the process.

Madsen also said the court should think about public policy for treating mental health and substance abuse disorders when it thinks about the definition of “total disregard,” adding that continued detention should be an option when “persons are in obvious need of behavioral health services and pose serious risks of harm to themselves or others.”

Standard reporters Jerry Cornfield and Grace Deng contributed to this report.

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Laurel Demkovich
Laurel Demkovich

Laurel joined States Newsroom in 2023 after almost three years as a statehouse reporter for the Spokesman-Review. She covers state government, the Legislature and all other Olympia news.