March 2014 Bar Bulletin
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From the Desk of the Presiding Judge

Efficiencies Easing Load of Civil Commitment Cases

By Judge Susan Craighead


Lately we have been reading and hearing about the struggle to care for people with serious mental illness in King County. These are among the most vulnerable in our community and all of us should care about how they are treated. And yet, until one is thrust into the civil commitment system by tragedy, it remains a mystery. King County Superior Court is trying hard to improve the part of the mental health system that we control.

Since 2007, there has been nearly a 50 percent increase in the number of people referred to our Involuntary Treatment Act (ITA) Court for civil commitment. No one knows for certain why these numbers have skyrocketed. We speculate that during the recession people lost jobs and health insurance and began to fall through the cracks, while at the same time cutbacks to the public mental health system reduced services.

We expect another 15 percent increase in filings when a law relaxing some of the criteria for civil commitment goes into effect in July. As I write, the Legislature is considering another bill that would allow families to appeal to the court decisions not to detain their loved ones for civil commitment. This could greatly expand our workload.

Civil commitment begins with a call to a designated mental health professional (DMHP), each of whom is a highly trained social worker employed by the county. The call can come from anyone - family, the police, a landlord or the emergency room.

Only DMHPs have the authority to detain people to begin the civil commitment process after an evaluation in the field. Currently, they have to find that the person is an imminent risk of harm to themselves or others, or that they are so gravely disabled that they cannot fill their own basic needs - for example, they are not eating.

The DMHP detains a person for 72 hours awaiting a hearing before our ITA Court. If things go well, there is a bed at one of our evaluation and treatment facilities. Three of these facilities are designed to care for mentally ill patients exclusively. The others are wards geared to serve this population within a regular hospital, such as Harborview.

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