A patient is civilly committed when the court agrees with a county-designated mental health professional’s clinical assessment that a person is an imminent risk to themselves, and/or others, or they are deemed gravely disabled due to a mental illness. The criteria for civil commitment is based on at least one of these three factors. Washington state RCW 71.05 provides the legal framework for civilly committed patients in our state.
A civilly committed patient is typically held 72 hours for observation. If they continue to meet the criteria for involuntary commitment, they will remain under a commitment order for another two weeks. The court reviews the recommendations of our providers to determine the status of the patient.
If the court finds the patient is still a potential threat to others or themselves, the court has the authority to order involuntary treatment for 90 to 180 days for a treatment team to work with the patient to help them improve their mental health with the goal of discharging them safely back into the community.
Civil conversion patients
Civil conversion patients are people who have undergone competency restoration and were found not competent to stand trial for their criminal charges. At the time that the criminal charges are dismissed, a judge may order the individual to undergo a civil commitment evaluation to determine if they meet criteria for 90 or 180 days of involuntary treatment.
Habilitative mental health patients
Habilitative mental health patients live with developmental/intellectual disabilities and mental health conditions, and have specialized treatment needs that could not be adequately addressed or supported in a community setting.
Special finding of violent felony patients
These patients make up a small number of civil conversion patients who have been civilly committed following a finding of incompetence to stand trial for a felony classified as violent under RCW 9.94A.030.
People who have been determined to have committed a violent felony offense may be civilly committed under additional grounds pursuant to RCW 71.05.280.
For these patients, the court has found that their mental illness or developmental disability contributed to violent acts. Their civil commitment may be extended based on evidence the person continues to suffer from a mental health disorder or developmental disability that results in a substantial likelihood of committing acts similar to the charged behavior.
Discharge process for civil patients
Discharge planning begins at admission with the clinical treatment team evaluating the individual’s needs and working with them throughout the course of treatment to determine what services and supports they would most benefit from when they are ready to transition into the community. Discharge focus areas include applying for independent and structured housing options, enrollment in community behavioral health programs, and the establishment of public assistance benefits such as Medicaid and supplemental security income.
When and individual has been determined to no longer require active psychiatric treatment at an inpatient facility and is safe to transition into the community, they will be discharged at the end of their civil commitment order where they can engage in ongoing outpatient services and supports in the community. Some individuals may discharge prior to the end of their civil commitment period under a conditional release, which will require that the individual participates in established follow up care requirements for the remaining duration of their civil commitment order. The court can also order that an individual will participate in up to one year of outpatient services and supports under a less restrictive order.
People who are civilly committed after found incompetent for a violent felony offense are required that their discharge plan is reviewed by the Public Safety Review Panel. The panel is tasked with assessing potential public safety risk and providing written recommendations to the secretary of DSHS and to the courts.