Trueblood et al v. Washington State DSHS

Trueblood Task Force

  • Trueblood Frequently Asked Questions
  • On June 27, 2019, the state of Washington submitted the final Trueblood Implementation Plan to the Court. This plan is high-level view on how the state will successfully implement what is in the agreed settlement within the Phase 1 regions.

    If you have any questions or concerns, please email

  • Update 6/17/2019 - In December 2018, the U.S. District Court of Washington approved a contempt settlement agreement (Trueblood Settlement Agreement) in the Trueblood as Next Friend of AB et al. v Washington State Department of Social and Health Services lawsuit. As part of that agreement, the two interim competency restoration programs located at both the Maple Lane facility and within the Yakima Department of Corrections facility will close. See letter for more information.
  • 12/12/2018 - At a fairness hearing on Dec. 11 2018, Federal Court Judge, Marsha Pechman, granted final approval of the settlement of contempt agreement between DSHS and Disability Rights Washington. The final approved settlement of contempt agreement can be viewed here.
  • 11/19/2018 - Trueblood Information and Training on Proposed Settlement of Contempt – learn how to comment on the proposed preliminary agreement related to the Trueblood lawsuit and how to get involved by watching this video. For more information, contact Disability Rights Washington at; (206) 324-1521 or toll free (800) 562-2702. Please note DRW accepts collect calls from jails.

You can also visit the DRW website at

  • Update 11/1/2018 - The Department of Social and Health Services and plaintiffs have received preliminary approval for the amended proposed Trueblood settlement of contempt from the court.

    The next step is for the parties to issue a class-action notification and attend fairness hearing (scheduled Dec. 11, 2018).

    Any class members with questions should reach out to Disability Rights Washington at any of the contacts listed below.

    By mail: Disability Rights Washington, 315 5th Ave. S., Seattle, WA 98104

    By email:

    By phone: (206) 324-1521, toll free (800) 562-2702. DRW accepts collect calls from jails.

    Trueblood website:

    More information will be available after the December hearing.

  • Trueblood Update – 10/26/2018

    On Oct. 25, 2018, an amended preliminary approval of a settlement of contempt agreement was filed in Federal Court with regard to the Trueblood et al., v. DSHS, et all. The original agreement was filed in August 2018.

    This amended proposed settlement of contempt is now before Western District Court of Washington Judge Marsha Pechman, who will decide whether to preliminarily approve it.

    If approved, the settlement of contempt will be disseminated to class members (individuals with mental illness waiting in jail for competency evaluation and restoration services) with an opportunity for them to provide feedback. The Court will review feedback during a hearing this fall and grant final approval if it determines the proposed agreement meets class members’ needs. 

    All parties expect that this multi-year, multi-phase plan would resolve the issues in this case and bring the state into compliance with the Court’s orders. The ultimate goal of the plan is to reduce the number of people who become or remain class members, timely serve those who cannot be diverted from becoming or remaining class members, and focus on effective outcomes and successes of existing programs in Washington.

    We will provide updates as more information becomes available. The proposed agreement, along with other information related to this case, can be found here. If you have questions, please email the Trueblood taskforce at

  • Trueblood update 8/17/18
  • Trueblood update 2/6/18
  • Key Principles

Background on Trueblood

All criminal defendants have the constitutional right to assist in their own defense. If a court believes a mental disability may prevent a defendant from assisting in their own defense, the court puts the criminal case on hold while an evaluation is completed to determine the defendant’s competency.

If the evaluation finds the defendant competent, they are returned to stand trial. However, if the court finds the evaluation shows the person is not competent, the court will then order the defendant to receive mental health treatment to restore competency. 

In April 2015, a federal court found that the Department of Social and Health Services was taking too long to provide these competency evaluation and restoration services.

Trueblood v DSHS (Trueblood) is a case challenging unconstitutional delays in competency evaluation and restoration services. As a result of this case, the state has been ordered to provide court-ordered competency evaluations within 14 days and competency restoration services within seven days. Trueblood helps individuals who are detained in city and county jails awaiting a competency evaluation or restoration services and individuals who have previously received competency evaluation and restoration services, who are released and at risk for re-arrest or re-institutionalization.

A Trueblood taskforce is a collaboration between class counsel, DSHS, the Attorney General’s Office, and the Governor’s Office. This taskforce was created as part of the ongoing work to enforce the Federal Court’s order under Trueblood and can be contacted at

Where we are today

There is a mental health crisis in our state. The demand for all forms of mental health services far outweighs what is currently available including competency evaluation and restoration services.

Many of the problems with untimely competency evaluations can be prevented if fewer people with mental illness enter the criminal court system. When people are able to get the treatment they need when they need it, they are more likely to avoid becoming entwined in the criminal court system. They are also less likely to place strains on the civil inpatient system. We intend to explore opportunities to provide access to appropriate behavioral health services which are designed to dramatically reduce the number of individuals entering the criminal court system – enabling the state to meet the constitutional competency evaluation and restoration services timelines.

To the extent that forensic services are delayed, the delay is due to factors outside the department’s control, including dramatic increases in overall referrals for competency restoration services. Over the past seven fiscal years, there has been an 87 percent increase for inpatient evaluations and competency restoration services. Further, there was a 25 percent increase in inpatient referrals in the course of a single fiscal year, from 2015 to 2016, and another 33 percent increase from fiscal year 2016 to 2017. The table below provides number of referrals statewide and the annual percentage change from fiscal year 2013 through fiscal year 2020.

Data Notes:
1) Count does not include individuals on personal recognizance.
2) Includes non-competency evaluation orders for Eastern State Hospital.

The chart below demonstrates the increase in referrals the department has experienced at the same time it has been adding both evaluator and bed capacity. This increase in referrals exceeds any historical peak, and greatly exceeds the previously calculated 5-8 percent expected annual rise in referrals prior to 2012.

The goal of the Trueblood Taskforce is to craft a bold solution to the problems in Washington state’s forensic mental health system. Our current system must deliver the right service to the right population, and at the right time. Fixing this necessitates many players and systems working together. The Trueblood Taskforce would like to see mental health services provided in the community whenever possible and appropriate. We want the care system to more appropriately assess the level of care needed by a consumer and be able to provide variable levels of care to prevent overuse of the highest and most intensive level of care. The current care system is disparate and siloed. This presents challenges in establishing continuity and coordination of care and in creating long-term and sustainable solutions.

Task Force Materials

Building 27 Project

Groundswell Reports

Monthly Progress Report for Court Monitor