In a psychiatric emergency, the more you know about your state’s laws and treatment options, the better prepared you will be to respond in the most effective way possible. These resources will help. Like every state, Washington has civil commitment laws that establish criteria for determining when involuntary treatment is appropriate for individuals with severe mental illness who cannot seek care voluntarily. Washington’s laws allow for the use of court-ordered treatment in the community, known as assisted outpatient treatment (AOT).
Inpatient or Outpatient Commitment | Assisted Outpatient Behavioral Health Treatment
Link: REV. CODE WASH. § 71.05.230(4)(a)(i)
The petition must be signed by:
(A) One physician, physician assistant, or psychiatric advanced registered nurse practitioner; and
(B) One physician, physician assistant, psychiatric advanced registered nurse practitioner, or mental health professional.
Emergency Evaluation
Link: REV. CODE WASH. § 71.05.150(1)
When a designated crisis responder receives information alleging that a person, as a result of a mental disorder [meets the criteria for inpatient commitment], the designated crisis responder may, after investigation and evaluation of the specific facts alleged and of the reliability and credibility of any person providing information to initiate detention or involuntary outpatient treatment, if satisfied that the allegations are true and that the person will not voluntarily seek appropriate treatment, file a petition for initial detention under this section or a petition for involuntary outpatient behavioral health treatment. Before filing the petition, the designated crisis responder must personally interview the person, unless the person refuses an interview, and determine whether the person will voluntarily receive appropriate evaluation and treatment at an evaluation and treatment facility, crisis stabilization unit, triage facility, or approved substance use disorder treatment program.
Link: REV. CODE WASH. § 71.05.153(1)
When a designated crisis responder receives information alleging that a person [meets the criteria for emergency evaluation], after investigation and evaluation of the specific facts alleged and of the reliability and credibility of the person or persons providing the information if any, the designated crisis responder may take such person, or cause by oral or written order such person to be taken into emergency custody in an evaluation and treatment facility for not more Washington than seventy-two hours.
Link: REV. CODE WASH. § 71.05.153(2)(a)
A peace officer may take or cause such person to be taken into custody and immediately delivered to a triage facility, crisis stabilization unit, evaluation and treatment facility, or the emergency department of a local hospital under the following circumstances:
(i) Pursuant to subsection (1) … of this section; or
(ii) When he or she has reasonable cause to believe that such person [meets the criteria for emergency evaluation].
All WA State Mental Health Laws and Rules
Washington Administrative Code (WAC)
Chapter 388-855 – Liability for costs of care and hospitalization of the mentally ill.
Chapter 388-865 – Community Mental Health and Involuntary Treatment Programs
Chapter 388-875 – Criminally insane person committed to the care of the department of social and health services — Evaluation, placement, care and discharge.
Revised Code of Washington (RCW)
Chapter 10.77 RCW – Provides for the commitment of persons found incompetent to stand trial or acquitted of a crime by reason of insanity.
Chapter 71.05 RCW – Provides for persons suffering from mental disorders to be involuntarily committed for treatment and sets forth that procedures and services be integrated with Chapter 71.24 RCW.
Chapter 71.24 RCW – Establishes community mental health programs through county-based regional support networks that operate systems of care.
Chapter 71.32 RCW – Establishes that validly executed mental health advance directives are to be respected by agents, guardians, and other surrogate decision makers, health care providers, professional persons, and health care facilities.
Chapter 71.34 RCW – Establishes mental health services for minors, protects minors against needless hospitalization, enables treatment decisions to be made with sound professional judgment, and ensures minors’ parents/guardians are given an opportunity to participate in treatment decisions.
Chapter 72.23 RCW – Establishes Eastern and Western psychiatric state hospitals for the admission of voluntary patients.
Chapter 74.09 RCW – Establishes medical services, including behavioral health care, for recipients of federal Medicaid as well as general assistance and alcohol and drug addiction services.
Behavioral Health Agencies (BHA) Laws
Chapter 71.24 RCW Community Mental Health Services Act – This chapter grants Department of Health the authority to license behavioral health agencies and to certify behavioral health services (see RCW 71.24.037)
Chapter 71.05 RCW Mental Illness – This chapter contains requirements for services provided to adults under civil commitment (involuntary detention) for behavioral health conditions.
Chapter 71.34 RCW Mental Health Services for Minors – This chapter contains requirements for services provided to minors under civil commitment (involuntary detention) for behavioral health conditions.
Department of Health Rules
Chapter 246-341 WAC Behavioral Health Services Administrative Requirements – These rules describe the licensing and certification requirements for behavioral health agencies and the services they provide.
Health Care Authority Rules
The Health Care Authority has a behavioral health and recovery rulemaking website showing its rule-making activity related to behavioral health agencies and services.
Health Care Authority rules related to behavioral health and managed care are in title 182 WAC, under the following WAC chapters:
All WA State Mental Health Laws and Rules
Estimated Prevalence of Severe Mental Illness in Washington (2017)
- Total adult population: 5.8 million
- Individuals with schizophrenia: ~ 63,000
- Individuals with severe bipolar disorder: ~ 127,000
(SOURCE: NIMH and US BUREAU OF THE CENSUS, 2017)