More Than $1.7B Needed to Remake Western State Hospital, New Plan Says


Plans to remake the state psychiatric hospital in Lakewood have become more clear, as has the price tag: Upwards of $1.86 billion.

The Department of Social and Health Services submitted plans last year to build a 350-bed forensic psychiatric hospital, an 18-bed residential cottage for the child treatment center and potentially a 48-bed residential treatment facility on the grounds of Western State Hospital by 2031.

Included in the renovations, the state has added security features like additional cameras, 24/7 locked buildings and walls for the psychiatric hospital. The master plan has been amended during a year-long public comment, which ended recently.

Washington is expected to pay between $1.76 billion and $1.86 billion for renovations in property, facilities and programs, according to the newly amended master plan. The master plan does not discuss how that money would be raised.

Over the next decade, the total bed count at the campus would decline from 922 to 906. Sixteen buildings would be demolished due to age. Currently, Western State employs 2,800 staff. After the build-out, staffing is expected to reach 3,035.

The plan is part of Gov. Jay Inslee's five-year policy to move nearly all mental health patients who are admitted to the big state hospitals through civil commitments into smaller facilities around the state, allowing those patients to be closer to family and community support.

Lakewood Mayor Don Anderson told The News Tribune last year at the beginning of the public comment period he questioned if patients will be relocated out of the city.

"Too many of those folks have been released into the community without adequate care," he said in June 2020.

For years, Western State Hospital struggled to upgrade aging facilities, to reduce physical assaults on patients and staff, and to address long wait times for admission and discharge, patient escapes and staffing shortages. In 2018, the federal government pulled funding after the hospital failed a safety inspection. Since then, the state has overhauled spending to increase staffing and to make the facility safer.

The plan emphasizes that design of the security features would be more "inviting, aesthetically appealing, and safe."

"Features like open, well-lit spaces will allow in daylight while using window features that are resistant to breakage," the plan said.

The new facility would use key cards and magnetic locks, more fences, walls and additional cameras.

The Child Study & Treatment Center's residential cottage is intended to provide "culturally competent care to children and youth with severe psychiatric, emotional, and behavioral disorders complicated by medical, social, legal, and developmental issues." Children aged 5-17 can be committed, according to the master plan.

The children's facility is not fenced but continuously locked. There are expected to be security checks completed by staff every 30 minutes. In community outings, the staff would have contingency plans.

"Staff members are trained to observe for signs of behavioral escalation and intervene when necessary, both verbally and physically as a last resort," the plan said.

The new forensic psychiatric hospital would admit patients who have been accused of a crime and deemed by a court to need mental or behavioral services.

During prosecution, a court may commit someone to Western State for an evaluation to determine whether they are competent to stand trial. If found competent, those people are returned to jail to stand trial. If found not, they stay in the hospital until competency is restored or further court order.

The existing facilities are expected to house patients found not guilty by reason of insanity, the amended master plan said.

"All facilities for forensic patients are secured at the building perimeter with controlled locked perimeter doors, with vestibules and internal compartmentalization of sub-areas," the state said.

Scores of comments have been submitted to Lakewood. Some have said they are thankful for the resources allocated toward mental health services, but most are concerned about an expansion of the hospital, specifically the higher number of "forensic" beds.

The hospital was established for those with mental illness in 1871, 18 years before Washington became a state.

Lakewood is the lead agency on the project and will determine whether DSHS gets a permit.