The WA State Supreme Court released a decision this morning on psychiatric boarding in hospitals that basically prohibits the state from doing this. Judge Gonzales’ summary is quite pithy.
GONZALEZ, I.-Washington State’s involuntary treatment act (ITA), chapter 71.05 RCW, authorizes counties to briefly detain those who, “as the result of a mental disorder,” present an imminent risk of harm to themselves or others, or are gravely disabled. RCW 71.05.153(1), .230. The initial brief detention is for the limited purpose of evaluation, stabilization, and treatment, and once someone is detained under the IT A, he or she is entitled to individualized treatment. RCW 71.05.153, .230, .360(2). Pierce County frequently lacks sufficient space in certified evaluation and treatment facilities for all those it involuntarily detains under the ITA. It regularly resorts to temporarily placing those it involuntarily detains in emergency rooms and acute care centers via “single bed certifications” to avoid overcrowding certified facilities. Such overcrowding-driven detentions are often described as “psychiatric boarding.” Patients psychiatrically boarded in single bed certifications generally receive only emergent care. After 10 involuntarily detained patients moved to dismiss the county’s ITA petitions, a trial judge found that psychiatric boarding is unlawful. We agree and affirm. (http://www.courts.wa.gov/opinions/pdf/901104.pdf)
There are hundreds of patients in this category statewide and we are going to have to take action to resolve the situation or the courts will release the involuntary commitment petitions on these folks. In general, people in this situation need immediate treatment. Not providing treatment, but keeping them strapped down on gurneys in the hallways of hospitals has always been inhumane, now it is clearly illegal.
During the recession the state budget made significant reductions in mental health spending. We are starting to see the outcomes of this. Yet another category where we most certainly cannot take reductions in order to fund other more visible state services.
Continue reading “No More Boarding the Mentally Ill in Emergency Rooms”