SEATTLE — A yearslong effort to examine Washington’s involuntary treatment court system has produced a set of recommendations aimed at improving how people in behavioral health crisis are evaluated, treated, and supported after they leave the system.
King County Prosecuting Attorney Leesa Manion said the work began as an unfunded two-plus-year project, and she credited those involved for staying committed.
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“The goal is to improve our state involuntary treatment court system. We know the system is failing individuals; we know that the system is not serving our community in the way we would hope.”
Manion said the project included a “listening tour” that gathered statewide input from people with lived experience, families, designated crisis responders, psychiatrists, treatment providers, prosecutors, defense attorneys, judges, law enforcement, and first responders.
That feedback was compiled into a report.
When asked the report’s biggest takeaway, Manion said, “Our involuntary treatment at court needs improvement.”
While she admitted that it “doesn’t sound revolutionary,” she said it confirmed what she believed when she started the project in 2023, after first raising the issue on the campaign trail in 2022 in King County.
Manion described the current process as adversarial and said she wants a system that is more therapeutic and collaborative.
“I had this notion: if we could build a system that was more therapeutic, more collaborative, could we get people in crisis the help they need in the least restrictive means possible, as quickly as possible before they become victims or perpetrators of harm,” she explained.
In an ideal system, Manion said people would receive services earlier so they do not have to enter the involuntary treatment court process.
The report also urges that available treatment options be dictated by individual patient needs, not by health complexity, geography, or insurance status.
Manion said the system is overburdened and not producing the results communities want. She emphasized there are steps that could be taken now.
One recommendation is to improve data collection statewide. According to Manion, there is currently no statewide database to track how often someone enters the involuntary treatment court system, what treatment they might have received, or what happens after they exit.
“We don’t have the data,” she said, adding lawmakers should fund the creation of a database.
“Once we have the data, we can start to really look at the types of care that are effective, what is needed to keep people well and keep them from returning to the system,” she added.
Another recommendation calls for creating a pilot site focused on continuity of care for people leaving the system, so they are released to care “instead of being released to nothing.”
Manion described what she said is a common pattern: “You take individuals in crisis, you stabilize them, then release them to nothing, and we somehow magically expect them to stay out of our system.”
Manion believes a pilot program should be designed to track outcomes and be scalable. “So let’s invest in a pilot site and let’s do this work in a way that is meaningful and track the results so we can replicate that across the state,” she said.
Manion said her office sees significant demand, with about 200 new involuntary treatment court petitions each week.
She said she has been in discussions with state lawmakers and, with the right investment, a pilot site could launch in 2027. She said the effort would require partnership with people already working in the system, including providers and experts who regularly interact with individuals in crisis.
Improvements and investments are needed, Manion said, “so we can have better outcomes for individuals, for families, for our community.”