Assessing the Risk of Criminal Offense for Washington's Involuntary Treatment and Forensic Commitment Populations (Archived)

The 2013 Washington State Legislature directed WSIPP to develop a risk assessment for patients in the state’s involuntary mental health treatment system.

In Washington State, formal risk assessments have been used to predict the risk of criminal recidivism among juvenile and adult offenders. This report finds that the existing Static Risk Assessment (SRA), used by courts and corrections in Washington for criminal populations, can also serve as a valid tool for determining the level of risk for adults with involuntary civil commitments and forensic competency evaluations. Results indicate that the adapted SRA described in this report has reasonable predictive accuracy for both the civil and forensic populations.

Can Drug Courts Save Money for Washington State Taxpayers? (Archived)

In the late 1980s, with the number of drug-related cases on the rise, several courts in the United States began to experiment with new ways to process defendants charged with drug-related offenses.  A key innovation was the “drug court.”  Due to the more intensive monitoring by the court, as well as the provision of drug treatment, drug courts are more expensive than regular court processing.  A typical program costs about $2,000 more per participant.  Are drug courts worth this extra cost?  Do participants commit fewer subsequent crimes and thereby reduce future costs to taxpayers and crime victims?  In short, what is the bottom line? 

Involuntary Treatment Act for Substance Use Disorders in Washington State: First Preliminary Report (Archived)

Before 2016, two separate systems existed for involuntary commitment of individuals in crisis due to mental health or substance use disorders. The 2016 Legislature passed E3SHB 1713—called Ricky's Law—to integrate both conditions into a statewide behavioral health system within Washington’s Involuntary Treatment Act (ITA). WSIPP is required to “evaluate the effect of the integration of the involuntary treatment systems for substance use disorders and mental health.”

In this initial report, we examine the broad changes to Washington’s ITA for substance use disorders that resulted from Ricky’s Law. We provide background on Washington’s behavioral health context and examine the main components of Ricky’s Law. Then, we outline our basic research strategy to examine the effectiveness of this multi-component law.

Our second and third reports are due in June 2021 and 2023. We will examine the impact of Ricky's Law on (1) client outcomes (e.g., substance use, overdose, death, employment, housing, and mental health services); (2) system outcomes; and (3) cost-effectiveness and efficiency of the integrated involuntary behavioral health treatment system.

Providing Evidence-Based Programs With Fidelity in Washington State Juvenile Courts: Cost Analysis (Archived)

The Washington State Legislature has been funding evidence-based programs in the Washington State juvenile courts since 1999. In 2009, the Legislature directed the Institute to “conduct an analysis of the costs per participant of evidence-based programs by the juvenile courts.” This report provides estimated costs per participant for these evidence-based programs:

• Aggression Replacement Training (ART)
• Coordination of Services (COS)
• Functional Family Therapy (FFT)
• Family Integrated Transitions (FIT)
• Multi-Systemic Therapy (MST)

The statewide average costs can be used to estimate the number of youth who can be served by these programs for a given amount of funding.

Purchasing State Employee Health Benefits: An Overview and Options for Change (Archived)

This report examines the bidding process used by the Public Employee Benefits Board to purchase state employee health benefits from managed care organizations. Three options having the potential to improve decision-making and reduce costs are identified: 1) requiring the bidding process to occur before the biennial budget is passed; 2) limiting the number of accepted bids in a geographic area; and 3) requesting annual and multi-year bids.

Inpatient Psychiatric Capacity in Washington State: Assessing Future Needs and Impacts (Part Two) (Archived)

In 2012, recent amendments to Washington State’s Involuntary Treatment Act (ITA) will take effect. New legal guidelines will allow a designated investigator to more fully consider information from both credible witnesses and historical records when making commitment decisions. The 2010 Legislature directed the Washington State Institute for Public Policy (Institute) to estimate the number of additional psychiatric admissions that may occur as a result of this law and examine how many inpatient psychiatric beds may be necessary to accommodate this increase. These estimates were presented in a companion to this report (completed in July 2011).

This report outlines various approaches for addressing the projected increase in psychiatric admissions. First, we discuss options for developing additional capacity within the state’s inpatient psychiatric system. Next, we highlight both programmatic and statutory alternatives that may help prevent (or divert) future psychiatric admissions. This section also summarizes laws from four different states that provide for alternatives to involuntary inpatient admissions. Finally, this report examines the relationship between ITA-related psychiatric admissions and utilization of both county jails and hospital emergency departments.

After Hendricks: Defining Constitutional Treatment for Washington State's Civil Commitment Program (Archived)

Washington State's law for sexually violent predators was enacted in 1990; since then, 14 other states have passed similar laws authorizing civil commitment for dangerous sexual offenders following their prison terms. Although the law has survived constitutional challenges at both the state and in the U.S. Supreme Court, a related set of court actions has addressed whether the treatment program is adequate. In 1994, the federal district court placed Washington's program under injunction and appointed a special master to ensure that the state improve deficiencies in the program. As of 2003, the federal court continues to oversee the state's program, with a threat of fines totaling several million dollars if the injunction terms are not met. Over an eight-year period, the special master delivered 19 reports to the court, documenting the program's deficiencies as well as its successes in meeting the court's orders. This article reviews these reports and court orders, detailing the court's requirements for an adequate treatment program.

Designated Crisis Responders and Ricky's Law: Involuntary Treatment Investigation, Decision, and Placement (Archived)

Before 2016, two separate systems existed for the involuntary commitment of individuals in crisis due to mental health (MH) or substance use disorders (SUD). The 2016 Legislature passed E3SHB 1713—called “Ricky's Law”—to integrate both conditions into Washington’s existing Involuntary Treatment Act (ITA). The legislation required the Washington State Institute for Public Policy (WSIPP) to evaluate the changes resulting from Ricky’s Law.

As part of the integration, Ricky’s Law (1) created the designated crisis responders (DCRs)—a single professional designation responsible for conducting all ITA investigations, both MH and SUD, and (2) established Secure Withdrawal Management and Stabilization (SWMS) facilities. WSIPP interviewed DCRs from across the state to learn about their experience when determining whether to detain people under Ricky’s Law and whether to place people in SWMS facilities.

This report—the second in a series of three— provides an in-depth look at the integrated ITA detention and placement processes from the DCR perspective. We present themes from interviews conducted with DCR managers and DCRs throughout Washington. The interviews provide an understanding of the mechanisms that may affect outcomes, provide an on-the-ground perspective of the implementation and ongoing application of Ricky’s Law, and inform our approach for the third report.

Changes to Washington State's Juvenile Court and Juvenile Rehabilitation Jurisdiction: A Preliminary Analysis of "JR to 25"

Starting in 2018, the Washington State Legislature made reforms colloquially referred to as “JR to 25.” This legislation, in part, modified the jurisdiction of courts and correctional facilities for juveniles who commit serious violent offenses in Washington State. The JR to 25 bills also directed WSIPP to examine the impacts of the legislative changes. This study serves as a preliminary report.

In this report, we summarize the policy changes resulting from JR to 25; describe changes in the population housed in juvenile facilities before and after the legislation took effect; provide a preliminary descriptive analysis of individuals’ participation in programming and behavior while in confinement; and estimate the fiscal impacts of the legislation.

First, we see slight changes in the demographic makeup of JR facilities following the legislative changes, with the population skewing slightly older and being more likely to come in based on a felony, person-based offense. We find that individuals are engaged in more rehabilitative programming after the JR to 25 policy changes took effect. We also find an increase in reports signaling misbehavior, the issuing of incident reports and associated room confinement or isolation events after the policy changes. Across all our findings in this preliminary report, we cannot say whether observed differences before and after the legislative changes are due to JR to 25 or other factors.

A final evaluation is due to the legislature in December 2031.

Six-Year Follow-Up of 135 Released Sex Offenders Recommended for Commitment Under Washington’s Sexually Violent Predator Law, Where No Petition Was Filed (Archived)

Washington’s Sexually Violent Predator (SVP) statute permits the involuntary commitment of persons found by a jury to meet the statutory definition of a sexually violent predator. In a previous report, the Institute examined the recidivism of 89 released sex offenders referred by the Department of Corrections (DOC) as meeting the filing standards for civil commitment petitions, but for whom no petitions were filed.

This report extends the results of the previous study by adding 46 individuals who were referred by sources other than the DOC.