A new Western State Hospital breaks ground, and a promise is kept
On Thursday morning, state leaders gathered in Lakewood to break ground on a new hospital to be built on the Western State Hospital campus. The hospital will be a secure facility with 350 beds to serve forensic patients (those accused of a crime and ordered by a court to receive treatment before trial).
Construction of the new Forensic Center of Excellence will complete by 2029.
This project turns a page in state history. Washington state is a different place than it used to be. Western State Hospital is a different place than it used to be. And under the direction of Gov. Jay Inslee, the state’s approach to behavioral health care is different than it used to be.
It’s all change for the better.
Coming full-circle
From the front steps of Western State Hospital in 2018, Gov. Jay Inslee stood with leaders and legislators to announce a new course for the state’s behavioral health system. Thursday’s groundbreaking on the new hospital brought that moment full-circle.
The 2018 announcement detailed an ambitious five-year plan to create more community-based care settings that could treat civil patients, and to limit institutionalization at the state’s two psychiatric hospitals for forensic patients.
“Governor Inslee has a compassionate and grounded vision of how treating mental illness can be done right,” said then-CEO of Western State Hospital Cheryl Strange. “We must remember that mental illness is treatable. Ensuring that people get the right care at the right time and, most importantly, in the right place — where they are supported by loved ones, friends and their community — is the right thing to do.”
At the time, Western State Hospital was aging. Its outdated design was making it difficult to address urgent safety issues and provide adequate care and therapy. In addition, state facilities were strained for capacity. Court orders for competency restoration had leapt by nearly 60% in the four years prior. Over the next four years, they would jump another 60%. A 2015 decision in Trueblood v. DSHS mounted pressure on the state to manage the growing number of patients with even greater urgency.
As of this summer, after opening hundreds of new beds, the state successfully shortened wait times from months to days. Defendants were receiving competency restoration services within Trueblood’s timelines.
Recent sentencing reforms, new diversion programs, and new bed capacity are paying off. The state even snap-purchased a private hospital last year in its urgency to open more space. And now, construction of the state’s Forensic Center of Excellence marks another important step forward in the transition of how Washington state delivers behavioral health care.
A new building, and a new chapter
The new facility will reflect a modern patient-centric approach. Bricks and bars will be replaced by glass and daylight. Nature-inspired design reinforces the hospital’s therapeutic environment. Much like the recently-opened Civil Center for Behavioral Health at Maple Lane, a warm and pleasant environment will surround patients.
While Washington state is advancing a new system of behavioral health care, Inslee and state leaders are quick to reiterate the need for continued investments in the facilities and workforce necessary to provide the specific care people need when and where they need it.
“Opening a new institution with locking doors is not the end goal,” says Amber Leaders, Inslee’s senior policy advisor on behavioral health. “We have to build a system to responds to behavioral health issues long before people reach the criminal justice system. This hospital is necessary. It is important. But we remain focused on addressing mental health before people reach a jail cell or emergency room.”
To that end, the state has tackled improvements to behavioral health care and crisis response on multiple fronts.
- The state now operates a comprehensive 9–8–8 lifeline, offering callers in crisis a sympathetic ear and avenues to immediate care.
- Mobile crisis response teams are operating in dozens of Washington counties, with hundreds more long-term beds opening up.
- A newly-opened teaching hospital at the University of Washington will serve hundreds of patients.
- New wards are opening at Western State Hospital, Maple Lane, and elsewhere.
- Diversion programs are helping defendants with disabilities avoid stints in jail without access to services.
- Inslee and the Legislature have invested record sums towards supportive housing and emergency shelter to bring people inside from homelessness and connect them to treatment.
- In 2024, Inslee signed a slate of legislation fighting the opioid epidemic, a significant contributor to the state’s behavioral health crisis.
“Today is a groundbreaking for this facility, but in a sense it’s a groundbreaking for how we provide mental health services,” said Inslee. “It is part and parcel of our efforts to care for our family members, our community members, who run into mental health challenges — this is a very Washingtonian thing to do.”
Overcoming a heart-breaking past
The construction of the new hospital concludes a long and challenging legacy of the facility it replaces.
Western State Hospital began as the Insane Asylum of Washington Territory in 1871 with 21 patients. At the time, mental illness was deeply stigmatized and its treatments hardly scrutinized. Husbands could send their wives away for treatment, or undesirable family members could be abandoned and forgotten at asylums (1).
By 1953, more than 3,000 forgotten patients (2) were buried anonymously at the Western State Hospital Memorial Cemetery. Another 1,600 were buried anonymously on the campus of Northern State Hospital in Sedro-Wooley (5).
Starting in the 1940s, experimental psychiatric treatments came in vogue. Patients would be subjected to ‘hydrotherapy,’ or alternating baths in hot and cold water4. ‘Fever therapy’ involved elevating the patient’s body temperature to kill bacteria believed to be at fault for psychosis (3). ‘Insulin treatment’ involved inducing a hypoglycemic coma to calm the patient. The infamous Dr. Walter Freeman popularized brutal lobotomies during the 1940s and 1950s.
Over his career, Freeman would lobotomize 2,500 patients across 23 states — including patients at Western State Hospital. (4)
Those days are long gone. Western State Hospital patients are treated with evidence-based methods by expert psychiatric professionals. Layers of oversight protect patient wellbeing and treatment efficacy. Patients and their families have recourse to file complaints, request independent intervention, and even seek legal counsel.
“Patient rights are at the forefront here. Historically, they might not have been thought of as important to the treatment process. But it’s our job now to make sure patient voices are heard and acknowledged,” said Emily Dodsworth, the hospital’s civil center patient rights investigator.
Western State Hospital’s past is important to leave behind, but important to learn from. The state is doing both.
Citations
- Johnson, Eric. 2022. “Eric’s Heroes: The Anonymous Graves of Western State Hospital.” KOMO. 2022. https://komonews.com/news/erics-heroes/erics-heroes-the-anonymous-graves-of-western-state-hospital.
- Jimenez, Esmy. 2021. “Asylums, ‘Fever Therapy’ and a Big Rethinking: How Washington Has Wrestled with Mental Health Care.” The Seattle Times. December 15, 2021. https://www.seattletimes.com/seattle-news/mental-health/how-did-we-get-here-a-brief-history-of-mental-health-care-in-washington/.
- Cook, James. 2021. “Western State Hospital History with James Cook.” YouTube. August 23, 2021. https://www.youtube.com/watch?v=oieEWJaqvWQ.
- “My Lobotomy — StoryCorps.” StoryCorps, 16 Nov. 2005, storycorps.org/stories/my-lobotomy/. Accessed 16 Oct. 2024.
- “The Lost Patients of WA’s Abandoned Psychiatric Hospital.” The Seattle Times, 2023, projects.seattletimes.com/2023/local/lost-patients-WA-abandoned-psychiatric-hospital/. Accessed 17 Oct. 2024.
