ton state chapter. “These are not those sick people. These people are us.”
LOCKED UP
Emily Cooper, an attorney with the nonprofit Disability Rights Washington, says she knows of one case in which a s Tammy struggled to defendant has spent 111 days in jail, without trial or convicfind care for Alecia, tion, awaiting a mental health competency evaluation. she sought help from A state psychiatric hospital simply has been unable to Passages Family Support, a local schedule a visit from a licensed evaluator. agency that pairs people who “You just have an overly burdened system,” Cooper have a mental illness or who says. “The time people with disabilities spend in jail awaithave children with mental illness ing treatment is still growing.” with other people or parents. In 2012, Washington lawmakers tightened evaluation Passages is part of a growing deadlines to try to reduce the ever-growing backlog of peer-support movement that’s stalled trials and stranded inmates awaiting evaluations. hoping to give people friendly Those rules required defendants in jail to be evaluated access to care and to fill in some within seven days. Almost two of the gaps in the larger mental years later, a new audit shows wait health care system. times for local jail inmates seeking Generally speaking, most evaluations through Eastern State people with mental illness Hospital still average 33 days. receive outpatient care, like DSHS officials have cited a counseling or prescription drugs. shortage of local evaluators and Those with more severe or space limitations on admission long-term needs may seek care at community facilities like those Amanda Cook wards as significant challenges. They also blame some delays on run by Frontier Behavior Health external complications such as surges in referrals, attorney in Spokane or at state psychiatschedule conflicts and jail facility limitations. ric hospitals like Eastern State Independent financial reports have shown that delayHospital in Medical Lake. But ing the evaluations costs county jails millions of dollars without access to care, some in each year. Jail officials report inmates with mental health crisis end up in hospital emerissues often cost double that of other inmates after coungency rooms, where beds are seling and psychotropic medication expenses. limited. Complicating matters Much more important than any dollar value, Cooper are rapid changes in insurance says, are the “human costs” of locking people in jails with and Medicare and Medicaid unreasonable wait times for treatment. People with mencoverage. tal health issues may be victimized by other inmates or Today’s community-based their conditions may deteriorate. The seven-day deadline system has not always been the was established for a reason, Cooper says. A 2003 Ninth model. America’s early history Circuit decision found delays in treatment violated due is littered with stories of dank process rights. asylums and questionable treat“The [state psychiatric] hospitals at this point are ments: lobotomies, malaria injecrunning a very big risk,” she says. “They’re asking for a tions and insulin-induced comas. potential lawsuit.” Between 1955 and 1980, during Faster evaluations also could potentially save lives, a movement known as “deinstiCooper says, like that of 25-year-old Amanda Cook, who tutionalization,” the population killed herself in December after spending weeks in the in mental institutions across the Spokane County Jail awaiting a delayed competency country fell from 559,000 to evaluation. 154,000. Drugs were developed — JACOB JONES to treat symptoms, making it feasible for more people with mental illness to live in their communities. dren with mental illness. That prompted Slowly, states began moving people out plans for a significant overhaul of mental of their institutions and into nursing homes health care for young people in Washingand other facilities, but it wasn’t until 1993 ton. A bill passed last year in Olympia that they were actually spending more mandated that the Legislature create a task on community services than on state-run force to study possible reforms of the adult institutions. Patient advocacy groups like system. A report to the governor is due by NAMI say the system is still catching up. the end of this year. In Idaho, the governor In Washington and Idaho, some have has proposed funding for new “behavioral pushed for change. A 2009 lawsuit alleged health crisis centers” across the state. that the state of Washington was failing its ...continued on page 19 youngest and most vulnerable citizens: chil-
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