Jailing a hospital administrator for treating the sickest

June 16, 2016

Newly-appointed Western State Hospital CEO Cheryl Strange is facing possible jail time for refusing to comply with a court order to admit a particular patient currently being served through single bed certification at a WSHA member hospital. Strange said she wouldn’t override the hospital’s waiting list, where other patients who are sicker have priority.

This possibility of jail time is a serious issue: Incarcerating a hospital leader for having an entirely reasonable and ethically correct position of treating the sickest patients first is not a reasonable remedy. The issue facing Western State is a problem of system capacity; jailing her is a distraction from a system in need of strong leadership.

The decisions Ms. Strange is making are the same ones hospital leaders and clinicians make all day, every day. And they should. Imagine if a patient with a broken leg were treated before a patient with a heart attack in an emergency room. That would be ethically untenable. Always, treat the sickest patient first.

This is not to say that Western State Hospital does not need attention. It does. It is also not to say that we need to find new ways to care for patients in mental health crises rather than relying on Western State as the sole solution. And the governor and the Department of Social and Health Services (DSHS) need to provide strong leadership. We absolutely share the court commissioner’s frustration with patients not being able to get beds or care. But jailing the CEO will not create a better hospital or fix the problem.

Encouragingly, the court commissioner who is threatening jail time has just scheduled a hearing to address issues in the mental health system. The hearing will happen on June 27 at the Western State Hospital courtroom. WSHA has been ordered to participate and plans to make full use of the opportunity. Issues on the table include the waiting list to get into Western State Hospital, the difficulty discharging patients from Western State due to a shortage of beds, the impact to local hospitals in having to detain psychiatric patients who are not admitted to Western State and the use of consecutive single bed certifications (where patients are held in local hospitals for treatment when beds in a psychiatric hospital are not available) for those not admitted to Western State. We look forward to being part of a solution to these serious issues.


Cassie Sauer
Executive Vice President


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