Escapes raise questions about how state handles criminals with mental illness

DEPARTURE of the head of Eastern State Hospital is a critical start toward changing the way Washington state supervises patients committed as part of criminal proceedings.

Heads had to roll after last week's escape by two patients, one during an outing at a Spokane County fair, the other from Western State Hospital in Pierce County. Harold Wilson's resignation from Eastern acknowledges the buck stops at his office.

But responsibility begins at a lower level. Numerous staffers were involved in the decision to take 30 patients, including the one who escaped, Phillip Arnold Paul, to a community fair. He was committed after being found not guilty by reason of insanity in the 1987 slaying of an elderly woman.

Hospital staff members are required to keep patients within eyesight at all times. Yet Paul disappeared and his absence was not reported until two hours later. This is a serious breach of safety rules.

Two patients escaping in the same week is certainly a red flag. But the issue goes beyond potentially dangerous patients making a break for it to how well the state is handling its obligation to these patients and to the public.

The field trips have been defended by hospital doctors as therapeutic. But doctors must explain how a killer benefits from hanging out at the fairgrounds. Moreover, a public destination puts an unknowing public at risk. What's next, a trip to the public library during story time?

Susan Dreyfus, secretary of the state Department of Social and Health Services, has ordered the state's three mental institutions to halt these field trips. Good.

Gov. Chris Gregoire demanded a 30-day systemwide review of how the state oversees these patients. This is another important step.

The Legislature may have a role. Republican Sen. Mike Carrell of Lakewood wants to handle these patients differently. His proposal would require those found not guilty by reason of insanity to be placed under the control of the Department of Corrections and housed in a state mental institution until their mental condition is stabilized. That person would then be transferred to state prison to continue treatment.

Currently, such individuals are sent to either Eastern State Hospital or Western State Hospital. Carrell's effort in the 2009 Legislature was unsuccessful. Better to start with the review ordered by the governor.