MCNEIL ISLAND, Wash. » The college campus-styled facility tucked inside razor-wire-laced electric fences on a restricted and tightly guarded island in Puget Sound houses some of the most dangerous and feared criminals in Washington state: sexually violent predators.
The 252 Special Commitment Center residents have completed their prison sentences but were sent to the McNeil Island facility after a judge ruled they would likely hurt someone again. To hold them under Washington’s sexual-predator civil commitment law, officials must provide sex offender treatment.
The therapy offered most residents, many mental health experts and residents’ lawyers say, is inadequate and the "programming" for those with mental illnesses or brain injuries ranges from "negligent" to "malpractice."
An independent inspection team that, under state law produces annual reports on the center, has repeatedly said some units provide "no obvious treatment" and one unit was "more reminiscent of a correctional setting than a treatment facility."
Disability Rights Washington, an advocacy group, has drafted a federal lawsuit claiming the mistreatment of some residents has left them languishing in the center for years, or decades, without a realistic chance of being released, violating their constitutional rights.
Mark Strong, the center’s CEO, said they’ve taken steps to correct some of the problems, but they’re constrained by a lack of resources. The Rehabilitation Administration, the agency that oversees the facility, acknowledged the center’s shortcomings in its supplemental budget request, which seeks an additional $4.1 million over the next two years. The money would pay for the extra staff needed to change its focus from "safety and security" to individualized treatment and rehabilitation.
They face a tough battle in getting those funds. The state is under a contempt order for failing to adequately fund education and is under a federal injunction for not providing timely competency services for mentally ill defendants.
Rep. Laurie Jinkins, D-Tacoma, said the state is only now seeing the impacts of cuts to mental health made in 2009 to 2011. Although lawmakers added $100 million to the state’s mental health system last year, more may be needed.
"I would say, for myself, I don’t ever want to be violating anyone’s constitutional rights," she said. "Those are really high-priority issues."
Finding staff also poses a challenge. The center has been without a psychiatrist and medical director since August; it only has two psychologists; and had 33 vacant positions in mid-October. Like prison guards, workers are sometimes verbally and physically assaulted; handle residents who expose themselves or try to touch inappropriately or cover themselves with feces.
The facility’s location, the "island factor" is part of the problem, Strong said. Workers must take a 20-minute ferry ride across Puget Sound twice a day.
Washington is among 21 states that have some variation of the sexual predator law and most have faced legal challenges.
On Thursday, a federal judge in Minnesota ordered state officials to conduct risk assessments for all sex offenders held in the state’s civil confinement program, after ruling earlier this year that the indefinite detentions were unconstitutional. A federal judge in Washington state issued an injunction against the center in 1994 after a jury found the treatment was inadequate. The state responded with changes.
But the center may yet again be headed to court.
Rachael Seevers, with Disability Rights Washington, said the issues the group identified in its months-long investigation are wide-ranging, and while the budget requests are a promising first step, "we believe that more comprehensive reform is needed."
The center’s buildings ring a large green lawn, where residents stroll, socialize and smoke cigarettes in the shadow of tall pines. The dining hall, medical center and recreation center, complete with woodshop and library, line one side of the ring of buildings, while housing units sit opposite.
Residents in the less-restricted Redwood units cook meals and chat freely on telephones. They have a lot of time on their hands, since treatment, consisting of group meetings, only takes up about three hours each week. There are no individual therapy sessions. The clinical program requires at least five hours of weekly treatment, but the facility has not met that standard because of the vacant clinical positions, inspectors said.
Across the lawn in the Alder and Cedar units, residents pace behind locked doors and glass walls. They speak to staff through intercoms and get meals in their rooms.
"In Alder, it’s very clear you are a prisoner," said Virginia Faller, a recently retired public defender who handled many of the center’s cases and is critical of the treatment plan.
As punishment for infractions, some residents are locked in their rooms for weeks or months, a practice experts say causes long-term mental health damage. Inspectors have repeatedly said isolating residents and using restraints is counter-therapeutic and doing so for long periods is "virtually unheard of in modern psychiatric settings."
Dr. Alan Abrams, a San Diego-based psychiatrist who evaluated one resident for his court case, said in a deposition that the man, who has a brain injury, "has been significantly damaged by the malpractice" at the center. The man was assaulted by several residents and has spent months at a time isolated in his room.
The psychiatric treatment he received "is far below the standard of care" and the use of seclusion to punish him violates the facility’s own policies, which say "seclusion shall not be used as a means of discipline," Abrams wrote.