During his campaign, Gov. Bob Ferguson promised to spend a week working at Western State Hospital to better understand the challenges facing the state’s largest psychiatric facility.
Following a four-day stint at the facility in Lakewood, Pierce County, this week, where he talked to staff daily and toured the construction site for a new state hospital, Ferguson said a few things have become clear.
He’s encouraged by the state’s progress on major mental health goals, such as starting construction on a new hospital and reducing wait times for patients sitting in jail awaiting treatment.
But maintaining some of those gains, he warned at a Thursday news conference, will be a challenge amid the state’s budget crunch.
As he prepares to release his supplemental budget in the coming weeks, Ferguson said a top concern is ensuring the state can keep up with 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 said. “This is something we need to be looking to the future to make sure we’re anticipating.”
A key test will be maintaining the state’s compliance with the “Trueblood” settlement — where a federal judge fined the state tens of millions of dollars over its long-term failure to quickly admit patients from jail to the state hospital for mental health evaluations and treatment. In the past two years, the state has cut wait times and come into compliance, a transformation Ferguson called “remarkable.”
Still, he’s concerned about staying ahead of rising demand. State data projects that the number of people referred to the state hospital will grow 8% per year.
Ferguson stopped short of saying he will propose the state add more beds, but said his team is “looking very closely” at what that would cost.
He didn’t address Thursday whether the state is exploring ways to reduce the number of people being referred to the hospital in the first place. Angela Ramirez, the new secretary of the Department of Social and Health Services, said they discussed how patients enter the system and the types of patients DSHS serves in both residential facilities and the state hospital.
Ferguson also said he’s asked his staff to determine the cost of replacing the hospital’s documentation system with an electronic one. The facility still relies on paper records.
“Talking to workers, that came through loud and clear that they are looking for a change,” he said. “That also takes resources, but that’s going to be important when the new facility comes online.”
Digitizing the documentation system, along with other updates at the new state hospital facility, scheduled to open in August 2028, will likely make a difference as the state seeks federal certification again, he said.
Western State Hospital lost its funding from the Centers for Medicare and Medicaid in 2018 due to safety violations.
Ferguson and DSHS staff also discussed efforts to improve safety including reducing assaults on staff.
Charles Sutherland and Mark Thompson, who respectively oversee the civil and forensic wards at the hospital, said while zero assaults is always the goal, it’s unlikely given that many patients are admitted after being charged with violent crimes. Still, they said violent assaults are decreasing.
The hospital has a psychiatric emergency response team, which Thompson said can intervene before situations escalate, as well as on-campus security staff.
They said they hope the new hospital’s design will further reduce assaults, with more single-patient rooms and other features meant to be more therapeutic.
“We’re designing our way out of violence with the new state hospital,” said Sean Murphy, an 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. It overshadows five courtyards. No more fences, now you have buildings and aesthetically pleasing designs around those things.”
Ferguson said he knows safety will be an “ongoing challenge” at the state hospital but was encouraged to see it being discussed openly. “From workers to leadership, across the board, that was a regular topic of conversation.”
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