Governor Jay Inslee’s office has notified the Washington State Hospital Association and the Washington State Medical Association that the state will temporarily continue to allow the detention of patients experiencing a mental health crisis, confirming hospitals will not be required to discharge patients.
In the wake of Thursday’s Supreme Court ruling that ended the practice of psychiatric boarding – holding patients in hospital emergency rooms without therapeutic psychiatric care – there was confusion about how to care for patients who met the criteria for involuntary treatment, but could not be immediately transferred to an Evaluation and Treatment facility.
Supreme Court rules allow 20 days before a ruling goes into effect. Agencies do not have to petition for the 20 days; the allowed delay is automatic, with the count starting immediately after the ruling is filed.
On Friday afternoon, the Governor’s office confirmed to the two associations that single-bed certifications based on no beds being available may continue, and the state will take advantage of the 20-day delay. This will ensure that patients who are a danger to themselves or others will not be immediately discharged. Earlier, there had been conflicting direction that suggested that patients could be discharged with no plans in place to care for them. The hospital association and medical association strongly supported the end to the practice of psychiatric boarding, but urged the state to take advantage of the allowed delay to ensure patient safety.
Beginning early next week, state and local agencies and health care organizations will begin developing a plan to care for patients who would otherwise have been boarded. The hospital and medical associations will be very involved in seeking new solutions.
On Thursday, August 7, the state Supreme Court issued a ruling that puts an end to psychiatric boarding in Washington (In re the Detention of D.W. et. al). Supreme Court rules (Rule of Appellate Procedure 12.5(c)) allow 20 days after a ruling is issued before it takes effect. This time will give the state and health care providers time to begin establishing new processes for patients who urgently need psychiatric services.
For more information about the case, visit:
August 7: WSHA response on Supreme Court ruling