SPOKANE - The state should consider moving all criminally insane mental patients to Western State Hospital in the wake of an escape from Eastern State earlier this year, a report released Thursday said.
Eastern State may be unable to safely deal with the most dangerous patients in its forensic unit, and consolidating people found not guilty by reason of insanity at Western State in Lakewood could save money, the report from the Washington State Psychiatric Hospital Safety Review Panel said.
“This approach would need to be weighed against the potential for an adverse impact on families,” the report said. “Local work force impacts would also need to be considered.”
Moving the criminally insane to Western State is just a recommendation at this point and requires much more study, Department of Social and Health Services Secretary spokesman John Wiley said.
There are an average of 67 patients at Eastern State, in Medical Lake, and 126 patients at Western State who have been judged not guilty by reason of insanity.
Pierce County Prosecuting Attorney Mark Lindquist said such a move would “negatively impact Pierce County and burden our services.
“Based on what I know at this time, I would vigorously oppose this idea,” Lindquist said. “Pierce County already has far more than our fair share of problems from around the state.”
The report was commissioned by Department of Social and Health Services Secretary Susan Dreyfus after the September escape of Phillip Paul during an outing to the Spokane County Interstate Fair. Paul was committed in 1987 for the slaying of a Sunnyside woman. He was recaptured without incident near Goldendale three days after escaping.
The department will immediately adopt new controls on how forensics patients – meaning those who enter mental hospitals as a result of being found innocent by reason of insanity in criminal trials – are selected for field trips off hospital grounds, Dreyfus said.
“Public safety should always be our top priority,” Dreyfus said. “These recommendations will help us ensure that.”
Under the new policies:
Only forensic patients who have been cleared for conditional release by the courts can go on field trips, which mental health experts say can be a useful tool in treatment.
Law enforcement agencies will be notified in advance of field trips.
Field trips will be limited to no more than four patients at a time. Paul was among 31 patients taken to the fair.
Mental hospitals will maintain up-to-date photo files of all forensic patients, with descriptions of clothing worn on the field trip.
Any escape from a field trip will be immediately reported to 911. Paul was gone for more than an hour before authorities were called.
The review panel found that Eastern State policies and procedures were out of date, that staff members were not documenting risk assessments and that the hospital in the Spokane suburb of Medical Lake generally did not pay sufficient attention to safety and security issues.
“It appears that ESH Forensic unit staff had become too familiar with the patients, leading to insufficient attention to safety and security issues,” the report said.
Eastern also was ordered to stop mingling civil and forensic patients.
The panel did not endorse a legislative proposal to create a “guilty but mentally ill” verdict, which would treat such people as inmates rather than patients. But it did endorse creation of a Psychiatric Security Review Board like one that exists in Oregon. That board acts as a second layer of authority for decisions involving all forensic patients.
Security experts from the Department of Corrections still are visiting both Eastern and Western state hospital campuses to review security.
The panel did not recommend staff discipline at Eastern State Hospital, although chief executive officer Harold Wilson resigned after the escape. Dreyfus said the Washington State Patrol has been assigned to review staff roles during the escape.
Following the escape, all field trips were suspended at both hospitals. Dreyfus said field trips will be “carefully reinstated.”
Escapes from the state mental hospitals are extremely rare, according to DSHS. Since 1999, there have been only four escapes from Eastern State, and only one escape from Western State, the agency said.
Diagnosed as a paranoid schizophrenic, Paul was committed for the 1987 strangling and slashing of 78-year-old Ruth Mottley in Sunnyside. Paul told authorities that voices in his head told him Mottley was a witch who was casting spells on him.
News Tribune staff writer David Wickert contributed to this report.