WSH -- Center for Forensic Services
The Center for Forensic Services (CFS) serves clients who have been committed to the hospital under the Revised Code of Washington Law (RCW) 10.77. These include defendants who are undergoing an inpatient evaluation for competency to stand trial and/or mental state at the time of the criminal offense. CFS also provides competency restoration treatment and treatment for clients who have been found Not Guilty by Reason of Insanity (NGRI). CFS contains four wards which primarily house clients undergoing forensic evaluation/competency restoration and four wards which house NGRI clients. The forensic Community Program is located on an additional ward in CFS and serves NGRI clients who are ready for or have already received a Conditional Release. Additionally, Community Program staff provide treatment and case management services for a number of NGRI clients who are living in the community after being Conditionally Released.
In additional to providing inpatient forensic evaluations, CFS staff are located in two satellite offices (one on hospital grounds and one located in Seattle) which provide forensic evaluations to defendants in Western Washington jails and those who are residing in the community on Personal Recognizance (PR).
The majority of CFS wards house only male clients, although there are three wards which are co-ed. Most wards contain 30-31 clients. CFS is a highly secured environment with procedures/processes unique to that center. All patients in CFS participate in daily active psychiatric treatment which is ordered by a physician and individualized to clients’ particular treatment needs and reasons for admission. Group treatments, competency restoration classes, and recreational activities are offered in the Treatment and Recovery Center (TRC).
Benefits and Outcomes
The goal of CFS, like the rest of the hospital, is to promote recovery and well-being in partnership with the people we serve. However, CFS does provide forensic evaluations to defendants who may or may not require mental health treatment. Each client works closely with a multidisciplinary treatment team that includes staff from Psychiatry, Medicine, Nursing, Rehabilitation, and Social Work. For CFS clients undergoing a forensic evaluation or competency evaluation, an additional team member includes a forensic evaluator (usually psychologist or psychiatrist) who provides a formal report to the Court upon completion of the client’s evaluation or competency restoration treatment.
NGRI clients wishing to be conditionally released or receive final discharge are reviewed by the CFS Risk Review Board (RRB). The RRB makes recommendations to the Court, and a judge makes the final decision as to whether and under what conditions an NGRI client may leave WSH.
CFS staff participate in the hospital’s Continuous Improvement Process and are constantly striving to better meet the needs of the patients served in this Center. Many CFS clients have significant criminal and violence histories. Although the primary focus is on patient recovery, CFS strives constantly to improve its security and safety. Ongoing improvement projects include increasing physical plant security, improving treatment planning, offering therapeutic interventions which are based on best psychiatric practices, and increasing active treatment.
Treatment and Therapy
The CFS TRC offers offer a wide range of group treatments many of which are evidenced-based practices, such as Cognitive Behavioral Therapy, the Competency Restoration Kit, and Dialectical Behavioral Therapy. Additionally, the TRC offers groups to increase leisure skills, vocational opportunities, and help clients better manage mental illness symptoms. Each NGRI client has a primary therapist who works 1:1 with the client to lessen the client’s risk of reoffending.
CFS clients progress through a level privilege system which offers them greater responsibility. (Unless conditionally released by a judge, CFS clients do not leave the CFS building unsupervised by staff.) However, as they advance in the CFS level privilege system, they are able to earn increased opportunities to have more personal items and greater unsupervised walks within CFS.
Clients whose medical needs require additional care beyond the hospital are served in local medical hospitals and clinics. The hospital works closely with the local courts and the Criminal Justice System to provide forensic evaluations throughout Western Washington. Community Program staff also work with Regional Support Networks (RSNs) in every county to ensure that CFS clients receive adequate outpatient treatments and housing upon their discharge from WSH.
It is important to remember that CFS has unique rules and procedures which closely resembles a forensic setting. These include, but are not limited to, specific visitation hours and procedures, mail limitations, and restrictions on personal items allowed in the secure forensic building. Families are especially encouraged to call ahead and speak with their loved one’s primary therapist and/or other treatment staff if they have questions. Additionally, clinical supervisors in CFS are always willing to speak directly with clients and their families about a clinical concern.
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