At one time or another over last several years we have all heard someone reference the Trueblood case (Trueblood v. DSHS, 101 F. Supp. 3d 1010 (W.D. Wash. 2015). In Washington state, there is what many are referring to as a mental health crisis. The demand for mental health services is much greater than what is available in the community – and that includes a shortage of competency evaluation and restoration services.

Why would someone need a competency evaluation or restoration services? 

Individuals charged with crimes have a constitutional right to assist in their own defense. However, if a court believes that the individual will be unable to assist in his or her own defense because of a mental disability, the court will place a hold on the criminal case while an evaluation is completed to determine the individual’s competency.

If the individual is found competent pursuant to the evaluation, he or she is returned to stand trial. But, if the individual is found not competent, the court will order the defendant to receive mental health treatment to restore competency.

What is bringing this to the forefront?

In 2014 the state was sued in federal district court in the Trueblood case and in April 2015, a federal court found that the Department of Social and Health Services (DSHS) was liable for imposing excessive wait times on in-custody defendants who were ordered to receive competency evaluation and restoration services.

The court ordered the State to provide court-ordered competency evaluations within 14 days and move individuals into treatment facilities within seven days. In 2017 the court found the State in contempt for continued noncompliance (continually taking too long to provide competency evaluation and restoration services) and assessed over $83 million in fines before the State reached a settlement with the plaintiffs which was ultimately approved in December 2018.

What does the settlement say?

The Trueblood settlement requires the State to take numerous actions that are expected to speed up the delivery of competency evaluation and restoration services. For the 2019 legislative session specifically, the settlement obligates the State to reduce the number of people ordered to receive competency evaluation and restoration services. (The wait times as of January 31, 2019 for in-custody defendants is 13 days for competency evaluations in jail, 28.5 days for transportation to facilities for competency evaluations, and 42.8 days for transportation to a facility to obtain competency restoration.)

What is the 2019 legislature doing?

The legislature has introduced companion bills, SB 5444 and HB 1513, that attempt to address the Trueblood settlement agreement. 2SSB 5444, which passed out of the Senate on March 7th, does several things. It establishes forensic navigators who are employed or contracted by DSHS to assist individuals referred for competency evaluations to navigate the forensic process and provide information to the court to support diversion or placement in outpatient competency restoration.

They may also help coordinate community services for those ordered to receive outpatient competency restoration. The bill also expands police authority to divert individuals to treatment, rather than criminal prosecution, to include those believed to have committed any crime, subject to law enforcement guidelines.

It provides guidelines and restrictions pertaining to outpatient competency restoration. It also restricts competency restoration for misdemeanants to circumstances in which the prosecutor proactively moves for competency restoration and proves by a preponderance of the evidence that there is a compelling state interest to restore the individual’s competence.

How will this be rolled out? According to the State, this bill will be rolled out in phases. The first phase will provide funding for and apply to Pierce, Spokane, Clark, Lewis, Okanogan, Adams, Stevens, Ferry, Pend Oreille, and Lincoln counties. The second phase applies solely to King County. The third, and final phase would apply to the remaining counties if there is money remaining or funding provided.


October 19, 2017 –

August 15, 2016 –

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April 2, 2015 –

September 12, 2014 –


Seattle Times: After paying $83million in fines, Washington settles jail mental-health lawsuit. (December 12, 2018)

The Olympian: With $50M in fines piled up over help for mentally ill, that state is seeking a settlement. (February 19, 2018)

The News Tribune: Contempt order and more fines for state agency slow to provide mental-health evaluations (October 26, 2017)

The Seattle Times: Judge holds Washington state mental-health agency in contempt, orders fines. (October 25, 2017)

The Spokesman: Judge holds Washington state mental health agency in contempt, orders fines. (October 25, 2017)

The Spokesman: Federal judge scolds state for treatment of mentally ill. (February 17, 2017)

The Lewiston Tribune: State accrues $7.5M in contempt fines. (Decemeber 22, 2016)

The Seattle PI: State pays thousands in fines as jailed patients wait in limbo (Decemeber 16, 2016)

The Spokesman: Judge gives Washington mental hospitals more time to fix programs (February 9, 2016)