Washington Elder Law Practice Report (#20) / Obtaining mental health services for seniors

August 13, 2014

health-care-lawThis is #20 in a continuing series of Elder Law Practice Reports.

A recent ruling by the Washington State Supreme Court has illustrated the difficulties that may be experienced by an attorney in obtaining care for a senior client or family member, when active intervention by the mental health system is required. (In The Matter of the Detention of….versus The Department of Social and Health Services (DSHS)…., Opinion No. 90110-4, August 7, 2014).

Elder Law attorneys may sometimes find that a client or family member with mental incapacity or disability requires intervention assistance from medical health professionals.

This situation can arise when a senior actively resists assistance, is disruptive in a care setting, or is a potential threat to self or others.

In some situations, cooperative solutions are possible.

In other situations, professional help is required.

Sometimes, appropriate medical care can improve the senior’s quality of life. It may turn out that impairment is being caused by medicines, diet, or other factors and may be reversible to some degree.

In all cases, a detailed medical evaluation and appropriate treatment are essential.

However, throughout Washington, there is a lack of adequate access to mental health care.

In the referenced opinion, the Court found that Washington State’s involuntary treatment act (ITA)…authorizes counties to briefly detain those who, “as the result of a mental disorder,” present an imminent risk of harm to themselves or others, or are gravely disabled….”

“However, (there is often inadequate)…space in certified evaluation and treatment facilities for all those…(detained) under the ITA….”

The solution is often “psychiatric boarding” in other settings, where no appropriate evaluation and treatment is available.

In a news release of August 7, DSHS noted that, following this ruling, “mental health patients can no longer be held in emergency rooms or general hospitals simply because there are no appropriate settings available to serve them and meet their needs….”

“This latest decision by the Court means people in need of treatment cannot be detained and may end up on the streets….”

Thus, attorneys may find it difficult—or impossible—to help obtain appropriate care for a client or family member, or to obtain appropriate evaluation or treatment. Dealing with individuals who have been released back to the community may present numerous challenges.

The problem is that more certified settings require more funding at the county level, state level, or both, at a time when there are competing needs for all funds.

This problem has been going on for years, but has now reached a new crisis stage.

There is a growing need for more resources to be made available for all long-term care needs, but little support for the needed funding. Those requiring long-term care and their families—and attorneys—are likely to face more difficult situations for the foreseeable future.

More on Elder Law in Washington may be found in the “Elder Law” volumes of Washington Practice by Cheryl and Ferd Mitchell: Washington Elder Law and Practice (Vol. 26), the associated Elder Law Handbook (Vol. 26A), and the Washington Probate volume (Vol. 26B). These materials are available at www.legalsolutions.thomsonreuters.com under the tag Mitchell and Mitchell elder law. Additional updates may also be found on this blog under the tag Washington Elder Law Practice Reports.