Last month shined an unforgiving light on Washington’s mental health treatment practices. In case you missed it, here is the backstory.

At one time, Washington was ahead of the nation’s curve in the involuntary treatment of mental illness. 1973 saw the involuntary treatment law passed, which basically meant that when someone is a serious threat to themselves or others that “a designated mental health professional” may commit that person for up to 72 hours to either a “mental hospital or center for evaluation and treatment.”

That was a great start back in 1973, but times change and Washington now ranks near the bottom in the nation for psychiatric treatment beds per capita. How did we get there?

1. State lawmakers have made it easier over the years to commit Washingtonians.

2. The state has cut psychiatric treatment beds by more than one third and cut funding for the mental health system by over $90 million during the recession — dropping psychiatric treatment services acutely.

3. The state’s population continues to grow significantly.

4. Hospitals have decided there is not enough profit treating mental illness, so there is a shortage of psychiatric doctors and staff.

5. The Affordable Care Act made health insurance available to over 500,000 and, along with it, mental health coverage. Expanded Medicaid eligibility coverage was also an additional boost to those numbers.

All this adds up to the situation of not enough psychiatric caregivers or the funds to pay for the growing population of mental health patients.

Until there is a bed for boarded patients in a mental hospital where they may be provided proper treatment, these involuntary patients have had to stay in hospital emergency facilities, at times tied down to their beds. Sometimes the wait for a psychiatric treatment bed has been three days, sometimes the wait has been three months. Emergency doctors may have prescribed medications, but are not trained in psychiatric medications or dosages.

It’s easy to imagine the damages this practice has done to those patients and hospital emergency facilities and personnel. This practice, known as “psychiatric boarding,” has nearly become standard operating procedure. It has also been at the center of attention in Washington courts, the latest in our Supreme Court.

The state Supreme Court reached a unanimous decision that psychiatric boarding in facilities that provide no individual psychiatric treatment is unlawful, and so the court enforced the 1973 Involuntary Treatment Act. The state may no longer involuntarily detain without psychiatric treatment.

Health officials have until Aug. 27 to comply, however they’re asking for delay of a few more months.

The state’s position is that it’s better to have potentially violent psychiatric patients off the street. And because they’re warm and dry, the beds are better than nothing at all.

Gov. Jay Inslee indicates he may have to call the Legislature into a special session in order to come up with a supplemental budget for funds in order to obtain more beds. Funds for psychiatric beds will have a tough go, as they will compete with yet another court mandate to fund schools — actually, billions of dollars’ worth of competition.

Besides adding more beds in Western and Eastern state hospitals, Inslee is also being advised to try beds in community treatment facilities which would cost far less.

Lots of questions remain. One important one is what happens to those patients that will, in the meantime, be released from being held involuntarily.

We need to get our priorities in order and provide essential mental health care, which is vital for the state.

— Contact columnist Marylin Olds at marylin.olds@gmail.com.