Criminal Commitment to Inpatient Services

A judge can order a 15-day evaluation to determine if a suspect was sane at the time of a crime. The evaluation also helps to determine if the suspect is competent enough to participate in his or her trial.

Suspects found not competent to stand trial by hospital psychiatrists and psychologists can be ordered by the court to remain at the state hospital to receive medication and therapy that may help restore their competency to face their criminal charges. If the hospital treatment restores a suspect's competence, prosecutors can re-file criminal charges and the judicial process resumes.

Suspects found to be mentally competent are released to stand trial. Judges may dismiss charges and order continued hospitalization for suspects who are unlikely to become competent.

Patients found competent for trial continue through the court process. After, or even during a trial, judges and juries may find defendants not guilty by reason of insanity. Normally a judge orders continued inpatient psychiatric treatment for persons acquitted because of insanity.
Suspects being evaluated for competency and defendants found to be not guilty due to insanity are held in the forensic facilities at Western and Eastern State hospitals.

Western State Hospital in Lakewood has a new, modern Center for Forensic Services (CFS) where criminal suspects from 19 western Washington counties are evaluated and treated. Approximately 240 of the hospital's 883 patients have been committed by the criminal courts to the CFS.

Eastern State Hospital, in Spokane County's Medical Lake, has an 83-bed Forensic Services Unit (FSU). The FSU was remodeled in 2000 with state-of-the-art security construction.

Hospital patients are treated and supported by physicians, nurses, rehabilitation experts, social workers, psychiatric security attendants and other specialists. Patients living in the hospitals' forensic facilities are not "inmates" nor are they "sentenced" to the hospitals. However, forensic residents live in a locked, controlled buildings with security fences. Normally, they only leave the building/grounds (with a security escort) for medical appointments and other services available only off the campuses.

It is important to know that while some patients have had a history of criminal or sexual offenses they may reach a level in their recovery to become eligible for judges to consider them for community placement with court-imposed conditions, or final discharges. Patients eventually earn privileges which progress to independent trips off their wards and sometimes into the community. These privileges always are approved by the treatment teams and are under doctors' orders. The doctors will not allow patients to leave the hospital without a security escort if they are an imminent danger to themselves or to the community.