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22 Washington counties sue state for 'refusing' to provide mental health services

A circle of people watch as a man in a grey suit talks in a classroom.
Scott Greenstone
King County Executive Dow Constantine, third from left, visits a recovery school in Seattle for teens struggling with substance use disorder, on August 23, 2023. During the tour, news broke that King County and 21 other counties are suing the state for underfunding mental health. The federal government funds the school; Dr. Rahul Gupta, right, is the director for the White House's Office of National Drug Control Policy.

The majority of Washington’s counties, including Snohomish, King and Pierce counties, are suing the state government for underfunding mental and behavioral health, according to a King County press release.

The state of Washington has "refused" to provide necessary behavioral health treatment to people in jails and courts, according to the lawsuit 22 counties announced on Wednesday that they'd filed in Pierce County Superior Court.

The lawsuit stems from a recent $100 million fine a federal court imposed on the state, for letting mentally ill people wait too long for treatment.

A spokesperson for Gov. Jay Inslee said that ruling limited the state's ability to treat and care for those patients, but that the governor's office is committed to its legal obligations.

Earlier this month the state Department of Social and Health Services said there are nearly 200 people in Washington jails who a judge found unable to stand trial. They’re waiting for psychiatric evaluation and help.

It’s a rare move motivated by desperation, county leaders say. They claim the state’s behavioral health system is “crumbling” from decades of underfunding.

"It makes it very difficult for local government, which does not have the tools to make up for the job that the state is supposed to be doing by court order and statute," said David Hackett, general counsel for Constantine.

"DSHS now claims that its refusal to follow state law with conversion patients is the fault of the federal court," the county press release said. "However there is nothing in the court’s orders that interferes with DSHS’s obligation or ability to provide evaluations and restorative services."

DSHS disputed that characterization in a statement, and said they're working as quickly as possible to put up new beds.

When the news broke that county government is suing the state, King County Executive Dow Constantine was at a tour of a local recovery school for teens struggling with addiction and mental illness, alongside state officials and the White House's head of national drug control policy.

Constantine has tried to plug holes in the last year as behavioral health hospitals and treatment centers shut down, and the system staggers after decades of underfunding from the state. Earlier this month, the state bought a shut-down behavioral health hospital in Tukwila to treat people taking up beds in Western State psychiatric hospital.

Constantine declined to talk about the lawsuit in person.

But in the release, he wrote: "For the benefit of the patient and the public, DSHS has a basic legal obligation to provide behavioral health treatment to those involved in the legal system. The reality is that people in these circumstances are often failed by multiple systems that, rather than offering hope and restoration, leave them untreated and at risk of reoffending. It is the state's responsibility in these circumstances to provide people treatment and a chance to recover."

Dr. Umair Shah, the state’s Department of Health head, was also on the tour. He said he thinks the state has done a "tremendous job" of investing in behavioral and mental health.

“Both Governor Inslee and legislature this last session have have put a number of initiatives in place," Shah said. "Now, obviously, it's gonna take some time before all those dollars flow out to different programs and different activities. But we believe there's a lot more that we can do, because we always have more than we can do.”

A spokesperson for DSHS pointed out in an email that requests for evaluations and treatment in the criminal legal system have shot up 145% in the last nine years.

"With the imploding demand for behavioral health services rising tremendously, the Department of Social and Health Services and dedicated staff continue to care for the state’s most complex patients when others are unwilling or unable to provide such care," Tyler Hemstreet wrote in an email.

Updated: August 23, 2023 at 5:40 PM PDT
Added comments from governor's office and Department of Social and Health Services.
Updated: August 23, 2023 at 3:18 PM PDT
Added details from county leaders and quote from David Hackett.
Scott Greenstone is a former KNKX reporter. His reporting focused on under-covered communities, and spotlighting the powerful people making decisions that affect all of us throughout Western Washington.