Increased caseloads plague a court designed to help the mentally ill
Kirkland ReporterNov 24, 2017
"I know this is a difficult day for you, but can I ask you a few questions?" Judge
After responding in the affirmative, the patient is asked, "What do you like to do for fun?"
After a long silence, she responds in a quiet voice, "Crafts."
This isn't a criminal proceeding. This is
The court is the product of the Involuntary Treatment Act, which was enacted in
A recent spike in caseloads, however, has
"These are people who are mentally ill [and] are not getting the legal assistance that they need to get the services that they need," said King County Councilmember Kathy Lambert, who has been an advocate of the court since joining the council in 2001.
That story starts somewhere around 2011 when Chandler was first introduced to ITA Court after he and his son got into a violent fight.
"He doesn't remember this. He'd defend my life with his if he were in a normal state," Chandler told
The process to civilly commit someone often begins with a call to the authorities, who then contact a Designated Mental Health Professional (DMHP), a state employee who evaluates whether or not someone should be involuntarily committed. The threshold for commitment is high. According to the Involuntary Treatment Act, a person has to threaten to harm themselves or others, substantially damage someone's property, or be unable to take care of themselves—usually, this means they're not sleeping or eating.
If imminent danger exists, the person will be immediately detained, picked up by an ambulance, and taken to an Evaluation and Treatment facility. In
"I can't imagine it happening. People come and grab you, and you don't know what's going on," said Chandler. Chandler estimates that's happened to his son seven times, three in the past year.
After initial detention, a person is held for observation. The Involuntary Treatment Act stipulates a person can be held up to 72 hours, excluding weekends, before they must have a hearing to determine whether they will be civilly committed another 14 days. In
"I think that we have a system in crisis,"
The court calls these delayed cases "bubble cases." They occur when both the hospital and the patient are ready for a hearing but because of time constraints the hearing doesn't happen. In 2014, there were 113 "bubble cases." So far in 2017, there have been 935, an eightfold increase and the year isn't even over.
These numbers include cases mentioned above, where a patient has a right to a hearing in 72 hours but also includes civil commitment extension hearings where the court has more time, 30 days, to hold a hearing.
"People are being detained an extra day because of bubbling, and that is terrible," said
For the patients, this means another day confined in a hospital, another day without freedom. But for the families, too, it can cause difficulty.
"You take a day off work. You drive in there. It's frustrating," said Chandler about his experience showing up to testify for a scheduled hearing, only to be turned away. "But it's sort of okay because then he's not going to get released and I get to sleep for another day, and he's safe for another day."
To Chandler, the real problem is that ITA Court is ineffective. He calls the court a "waste" and "a complete mess."
Chandler says the court has had three outcomes for his son. One, a hearing is held and a judge decides to civilly commit his son for 14 or in some cases 90 days. But during that commitment a deal is made called a "least restrictive order," allowing his son to be released as long as he promises to meet certain conditions like taking his medication.
"Then he doesn't take his meds, and we're right back where we were, except he doesn't trust anybody," said Chandler.
The second outcome is that a civil commitment hearing is held but by that time his son is medicated. The judge determines that he's fine and releases him. But to Chandler this isn't a solution; his son is only temporarily well.
Chandler says the other outcome is even worse. He says that's when you never get a hearing in ITA Court at all. A person is detained, but for whatever reason, the case is dismissed and the person is released.
According to the court, those types of situations accounted for a quarter of the initial detentions in 2012. But that number is rising. Last year, one-third of cases were dismissed before a hearing. Chandler says this statistic shows the court is not taking initial detentions and the recommendations of DMHPs seriously.
"These people [DMHPs] are determining whether these people are a danger to themselves and others and then we have a bunch of lawyers deciding they're not," said Chandler of the prosecuting and defense attorneys in the court. While a judge is responsible for deciding a patient's fate, deals are often made for a patient's release prior to a hearing.
But
But to Chandler "every one of those [patients] is going to be back, so that's not any kind of victory. That's a disaster." Chandler says that in his experience the ITA Court process doesn't treat the problem; it just runs the patients through the system over and over again.
"You're asking me what I make of all that, and the answer is, 'I'm not sure,' " said
The one area that appears overtaxed to some officials is the prosecuting arm of the ITA Court.
"We want to have the resources to make sure their case can be heard," said prosecuting attorney supervisor Mizuta. "It is a priority for everyone to get [their cases heard], but that does not always happen."
Currently, there are five full-time and one part-time prosecuting trial attorneys in ITA Court. According to Mizuta, those attorneys handle 15 cases a day. Compare that to the 18 public defenders working in the court who handle 25 to 30 cases per month.
While the disparity seems stark, no one, not even the court's prosecuting attorney's office, is advocating for an equal ratio. The main reason for this is the nature of the public defenders' work.
Still, the workload of prosecuting attorneys recently caught the attention of County Councilmember Lambert. Last month she introduced an amendment to the supplemental county budget to fund two more full-time ITA Court prosecuting attorneys.
"The problem is only going to get worse guys, and this is the tip of the iceberg, and I'm trying to get ahead of the iceberg so that it doesn't hurt people that are mentally ill," Lambert said at a
"I think that actually this is something that we have been needing for quite a while and it will definitely help," said Mizuta, but she admits the funding is a band-aid, not the solution to all the court's problems.
That's because money allocated for the new attorneys does not come from the budget for the
"We've been very cautious to not want to use that money unnecessarily for legal purposes when patients in the community could really use this for treatment," said Mizuta.
To Chandler "there's not a budget problem here at all" because the court is a "joke" that doesn't help the people it serves. Chandler said while he doesn't know every family that goes through ITA Court, in his mental health support groups, the opinion is universal that the court system "is the worst."
Chandler said he's often called by families with a mentally ill relative seeking advice about the ITA Court system. His advice to them: "if you're in danger, call the police, but don't [call the authorities] otherwise because you're just going to end up with a mess and it's not going to do you any good."
"We have created an emergency situation by failing to do anything at the onset," said Khandelwal. "It impacts the people, the clients who are forced into the system. It impacts their families that are forced to watch them suffer, and ultimately it impacts us as a community because we're spending all this money in a system that is just not that effective and we could be spending our money more wisely and having better outcomes for folks."
"It's a first step," said
"The reality is we have created a system where we can't do our best for these patients, and I find that very concerning," said
Attorneys on both sides agree it's not the quality of the staff but the system that's broken.
"At the core, we have a shared caring for these individuals being forced into this system, but right now are not serving them in a meaningful way," said Khandelwal.
Chandler agrees that compassion exists, from initial detentions to release, among
"[The court] wrecks all sorts of lives: mine, his mother's, his siblings', his friends," said Chandler. "It's darkening. I thought we had a benevolent society."
As for Chandler's son, at the time of the interview he was in jail for missing a meeting the court demanded. Chandler said he believes that if his son would have received beneficial treatment just one of the seven times he visited ITA Court, he wouldn't be behind bars right now.