Regular, but fewer, walkaways at Western State

More than two decades have passed since a Western State Hospital patient walked into Sam Hunter’s Lakewood house uninvited.

Hunter’s wife deduced the big man’s origins from his tennis shoes. His name was written on them.

“He told her, ‘I’m just a gentle giant who’s never grown up,’ ” said Hunter, a retired dentist. Authorities picked up the man without incident.

These days, patients regularly go missing from the Lakewood psychiatric hospital: 81 times last year.

As high as that might sound, it’s less than half of the 181 who went missing in 2014.

Disappearances are on track to drop much further this year after the hospital fenced off an interior section of the campus. March was the first month in at least a couple of years with no reported “unauthorized leave” incidents.

That short streak ended this month. On April 6 alone, three patients slipped away.

One left through an exit door at a clothing shop on the hospital’s campus. The disappearance might not have come to public attention if not for the other two missing patients: men with violent histories who escaped through a window and put the hospital on high alert. A reverse 911 call went out to about 5,400 Lakewood and Steilacoom residents and cab, bus and train agencies.

Both high-profile escapees were captured, but not before one made it 300 miles away to the Spokane area.

Such escapes, and the manhunts they prompted, are the anomaly. Most unauthorized leaves are patients who aren’t considered high risk. Although the patient who slipped away from the clothing shop April 6 is still missing, people who leave without authorization typically return on their own, according to state records from November to March. Most from that period were gone less than a day.

“The hospital has been here for many, many years. We’ve had a very open, porous campus for the majority of that time,” said Victoria Roberts, a deputy assistant secretary at the state Department of Social and Health Services, which runs the hospital. “There is not a history of adverse events happening as a result of grounds privileges.”

NEIGHBORS NOT TOO WORRIED

Residents of the nearby Lakewood neighborhood of Oakbrook contacted by a reporter weren’t particularly worried about patients who wander off.

Michelle Byrnes feels safe after a year and a half living there. And Don MacSparren isn’t bothered after 26 years.

“It’s not a daily fear,” Melanie Wallschlaeger said while walking her dog in Oakbrook. Still, she suspects a man who made inappropriate comments to her at the park and another person who followed one of her children may have had ties to Western State.

Patients gradually win more privileges as they progress through treatment. They might first be allowed outside their ward in the newly fenced quadrangle, then outside the quad for 15 minutes, then a half-hour, Roberts said.

They might be allowed to go to a nearby bus stop or grocery store.

Roberts said it’s a critical part of treatment to “be around people, understand that people aren’t going to look at them differently, get over the stigma of having been in the hospital and feel that they can make those steps.”

They might start out escorted and graduate to unescorted walks. Eventually, they might be allowed authorized leave with family or to check out potential housing.

When they don’t come back from walks or trips, it’s considered unauthorized leave.

A DSHS spokeswoman said all unauthorized leaves are reported to Lakewood Police Department. Prosecutors are notified if they have asked for updates on a particular patient.

Lakewood police use the reports to add missing patients to a national database of missing people.

Most aren’t publicized.

“It is the law enforcement agency that currently does those notifications,” DSHS acting secretary Pat Lashway said at a recent news conference.

An officer checks on the patient’s criminal history to determine if there’s a danger to the public, assistant Lakewood police chief John Unfred said.

“If we yell every time somebody walks away,” Unfred said, “when we yell when a dangerous person escapes, nobody’s going to pay attention.”

TIGHTER SECURITY, WITH LIMITS

Following the April 6 escape, the hospital is reviewing security with help from state officials who have experience in the prison system.

Many doors and windows open onto the unfenced campus. Roberts said staff are being trained to lock doors behind them. She said alarms are being considered for some of the doors.

Some places where patients work or congregate are entirely outside the interior quad that was fenced this winter, including a laundry, coffee stand, arts-and-crafts center, greenhouse and chapel, she said.

So is the “fashion center,” where patients can replace hospital gowns with street clothes. The patient who walked away this month on the same day as the escapes was on a supervised group outing to the fashion center.

Roberts said the hospital is considering how to bring some of those programs inside the fenced area. It will take money. So will proposed improvements to the fenced area to turn what is partly former parking lots into a more park-like setting.

No fence is likely to encircle the campus.

Newer psychiatric hospital campuses tend to be enclosed, Ron Adler told the Lakewood City Council on April 11, a day before he was fired as CEO of the hospital. But Western dates to 1871, and Adler said people look at the historic grounds every day, he said.

“For someone who doesn’t know it’s Western State Hospital when you drive through, quite frankly you’d think you’re back in New England at an Ivy League school. It’s just beautiful there,” he said.

“This isn’t the border between Texas and Mexico.”

And Lakewood Mayor Don Anderson said making the hospital look like a prison compound would be a bad idea for patients’ therapy as well as for aesthetic reasons.

As with neighbors, Anderson hasn’t heard of major problems involving patients on unauthorized leave.

“It hasn’t been frequent enough or dramatic enough to create alarm,” Anderson said.

The Hunters lock their doors these days. But Sam Hunter said: “Living next door probably is pretty safe, in my mind, because they’re heading out.”

WHAT TO DO WITH DANGEROUS PATIENTS

Rather than close off the campus, Anderson would like to see some of the more dangerous patients at Western moved somewhere else. He’s concerned patients with violent histories are being kept in the general population instead of the secure forensic section of the hospital reserved for referrals from the criminal courts.

The patients who escaped were former forensic patients who were no longer eligible for that status because they were found incompetent to stand trial for violent crimes. They continued to be detained under authority of a recent law.

Those patients, as well as current forensic patients, need a public-safety review panel’s approval or a court order to win grounds privileges or authorized leave.

In ramping up privileges for those potentially dangerous patients, DSHS gets pressure from two sides.

A member of the public-safety panel, David Hackett, said the state goes too fast.

“We want to see a patient succeed for at least a couple months with staff escorts and go to the next level of escorts and kind of incrementally bring that system about ... ,” Hackett said. “That approach has been very much resisted by DSHS.”

But a lawsuit by patients says the state is too restrictive in giving forensic patients access to fresh air, exercise and trips into the outside world to apply and practice the skills they have learned in treatment.

“If the goal of hospitalization is treatment, reintegration should occur as soon as recovery is achieved,” a complaint in the lawsuit states.

A March 31 court filing says attorneys for the state and patients are close to a settlement of that case.

This story was originally published April 25, 2016 at 7:42 AM with the headline "Regular, but fewer, walkaways at Western State."