During his campaign, Governor Bob Ferguson pledged to gain firsthand experience of the challenges at Western State Hospital, Washington’s largest psychiatric facility. After a four-day visit to the facility in Lakewood, Pierce County, Ferguson expressed mixed feelings about the state’s progress in mental health care. While he noted advancements such as the initiation of a new hospital’s construction and reduced wait times for individuals awaiting treatment, he warned of potential strains on the system due to budget limitations.
Budget Constraints and Growing Demand
At a press conference on October 12, 2023, Ferguson highlighted that maintaining improvements in mental health services will be particularly challenging in light of the state’s current budgetary constraints. He is preparing to release a supplemental budget in the coming weeks, focusing on the growing demand for psychiatric beds and court-ordered treatment.
“It’s not a static number of people who are here and once you meet that need, you’re good,” he stated. “This is something we need to be looking to the future to make sure we’re anticipating.”
A critical issue facing the state is compliance with the Trueblood settlement, which resulted from a federal court ruling that fined Washington tens of millions of dollars due to delays in admitting patients from jails to hospitals for mental health evaluations. Ferguson commended the recent improvements in reducing wait times and achieving compliance, describing the transformation as “remarkable.” However, he remains concerned as state data anticipates an 8% annual increase in referrals to the state hospital.
Future Changes and Safety Improvements
While Ferguson refrained from guaranteeing additional psychiatric beds, he mentioned that his administration is “looking very closely” at the associated costs. He also did not address whether measures are being considered to decrease the number of individuals referred to the hospital.
Newly appointed Angela Ramirez, secretary of the Department of Social and Health Services (DSHS), joined Ferguson in discussions about patient entry into the system and the profiles of those served in both residential facilities and the state hospital.
Ferguson additionally revealed plans to potentially replace the hospital’s outdated documentation system with an electronic one, as current operations still rely on paper records. “Talking to workers, that came through loud and clear that they are looking for a change,” he noted. He emphasized that upgrading this system is vital, especially as the new facility is projected to open in August 2028.
The new state hospital is set to enhance safety and therapeutic environments, following the loss of federal funding from the Centers for Medicare and Medicaid in 2018 due to safety violations. Ferguson and DSHS staff explored ongoing efforts to improve safety measures, including reducing incidents of violence against staff members. Both Charles Sutherland and Mark Thompson, who oversee civil and forensic wards, acknowledged that while a goal of zero assaults is ideal, it is challenging given the nature of many patients’ backgrounds. Yet, they noted that violent incidents are decreasing.
The hospital has implemented a psychiatric emergency response team to intervene in escalating situations, along with on-campus security staff. The new design of the hospital aims to further mitigate violence, featuring more single-patient rooms and therapeutic spaces. “We’re designing our way out of violence with the new state hospital,” stated Sean Murphy, assistant DSHS secretary. “They’ve made this a very environmentally friendly place. You see elevated walkways that lead from patient care areas to a very therapeutic setting.”
Despite acknowledging safety as an “ongoing challenge,” Ferguson expressed optimism that addressing these concerns is becoming a priority among staff and leadership alike. “From workers to leadership, across the board, that was a regular topic of conversation,” he concluded.
