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Washington's mental health services backlog is costing time and money

FILE - In this Oct. 8, 2005, file photo, a sign that reads "now hiring" is shown at Western State Hospital in Lakewood, Wash. The nurse who was brutally attacked at Washington state's troubled psychiatric hospital Sunday, Aug. 26, 2018 was only one in a series of assaults that have staff so on edge that they're holding a rally on Thursday, Aug., to demand changes to the way officials assign dangerous patients to wards. (AP Photo/Ted S. Warren, file)
Ted S. Warren
FILE - In this Oct. 8, 2005, file photo, a sign that reads "now hiring" is shown at Western State Hospital in Lakewood, Wash. An ongoing mental health services backlog meant individuals like Joshua Marsh are spending months in jail before receiving competency evaluations or restoration treatment – often provided at hospitals like Western Sate – before they can go to trial.

When police arrest someone who's experiencing a mental health crisis, what happens next? How long does it take for that person to get the help they may need? It's supposed to be within two weeks, but for many, the answer to that question is turning out to be months.

According to Seattle Times reporter Esmy Jimenez nearly 900 people in Washington state are awaiting either a competency evaluation or restoration treatment, which is needed before they can go to trial. Restoration treatment can often involve medication, classes or therapy.

"Many of them have a history of severe mental illness, substance use and sometimes even an intellectual or developmental disability on top of that,” said Jimenez, who covers mental health for The Seattle Times.

The other thing that stood out in her recent reporting was the amount of money the state of Washington is being fined – between $500 and $1,500 a day when mental health services are delayed, the result of a class action lawsuit.

So far that's amounted to $98 million since 2018 for failure to actually get people services,” said Jimenez.

Listen to KNKX All Things Consider host Emil Moffat's conversation with Jimenez above, or read selected quotes below.

Key takeaways:

You recently profiled one individual who is living this reality. Tell us a little bit about Joshua Marsh.

JIMENEZ: Joshua Marsh is a 40-year-old man from Grays Harbor County. I first learned about him because there was an incident that I found in police records. Essentially what happened in January, he was found outside of a local grocery store. He wasn't wearing shoes and he didn't have a coat, even though it was the middle of winter. And the grocery store officials asked him to leave. He didn't leave. Police were called twice and they ended up arresting him. He was also resisting arrest and ultimately charged with assaulting police officers. But what was also interesting to me is that he ended up waiting altogether eight months at the Grays Harbor County jail to get these mental health services.

Why are these wait times going on for so long and what's being done to help these people get services?

JIMENEZ: One of the things that's happening is that there's just so many people trying to get through the system at once. There are only so many beds that are physically available at each of these hospitals for someone. It's causing this huge backup and it's just a jam. And what's happening is officials are having to triage. They’re saying, okay, 'who is the most sick or most acute that are people waiting in jail? Let's get those people in first.' In Joshua Marsh's case. He wasn't nearly as sick as some other defendants. So it did mean that he waited much, much longer. The Department of Social and Health Services adds they're also experiencing a staff shortage. They've had to bring in travel nurses at the state hospitals to maintain staffing ratios. The jails say they also have issues with keeping their staff. And then, of course, the COVID-19 virus partially has contributed to all of this as well.

This has become a source of frustration, not only for those experiencing crises, but also for lawyers and judges, too, right?

JIMENEZ: Last month, I sat in at the King County Superior Court, and I listened in to Judge Johanna Bender. She was so frustrated with DSHS officials. You could really tell because judges are tasked with finding the balance between this really difficult thing, which is maintaining public safety and then not releasing people who have a high risk of re-offending, while also being very mindful that these defendants have not been found guilty, right? There hasn't even been a trial, in which case that amounts to unlawful detention, which is the issue that has been litigated in the past here.

Emil Moffatt joined KNKX in October 2022 as All Things Considered host/reporter. He came to the Puget Sound area from Atlanta where he covered the state legislature, the 2021 World Series and most recently, business and technology as a reporter for WABE. Contact him at