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Involuntary treatment hearings

Learn more about Involuntary Treatment Act (ITA) Court hearings in King County, and the role of the prosecutor in these hearings. The ITA Court handles petitions for court-ordered mental health or substance use disorder treatment that are not part of a criminal case.

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The Involuntary Treatment Act (ITA) Unit of the prosecutor’s office represents the facilities that are seeking to treat patients against their will. Patients are represented by public defenders. The set of laws that allows this process is called the Involuntary Treatment Act (RCW 71.05 and RCW 71.34).

Learn additional details about the ITA process in King County ITA Court in our Information for Witnesses in the Involuntary Treatment Act Court (290KB) 

The involuntary treatment process

  • Initial detention

    Involuntary Treatment Act cases are involuntary behavioral health commitment cases. Involuntary treatment of a patient must meet certain requirements. It is for those with a mental illness or substance use disorder who are at risk of harming themselves or others. The King County Designated Crisis Responders (DCRs) may detain a person for up to 120 hours. The patient is sent to a behavioral health facility for evaluation, treatment, and safety.

    King County facilities include:

    The King County substance use disorder facility is Recovery Place Kent.

    A patient held in the hospital against their wishes has a right to a court hearing. The hearing is scheduled within 120 hours of the DCR detaining the patient. This does not include weekends and holidays.

  • Petition and hearing for up to 14 days of treatment

    During the 120-hour initial detention, the facility can release a patient or can file a petition for up to 14 days of additional treatment. The scheduled court hearing addresses the 14 Day Petition.

    Many cases are resolved without a hearing if the patient and the hospital agree on a resolution. If that happens, no one testifies in court on the day of the hearing. If the patient and the hospital agree on a continuance, witnesses may be required to provide testimony on the new court date.

    If a resolution cannot be reached, the case may proceed to a hearing where a judge makes a decision about the patient’s treatment.

  • Witness testimony in court

    ITA court hearings occur between 9:30 am and 4:30 pm, Monday through Friday.

    If you received a subpoena to testify in a case, you have been asked to appear via video on the day of the scheduled hearing. Follow the instructions on your subpoena to call the witness coordinator check in line at 206-477-2714 between 10 am to 3 pm the business day before the hearing for further instruction.

    All parties (including the patient, attorneys, witnesses, and judge) will appear for the trial via video. If you are unable or unwilling to appear via video, the prosecutor may ask the judge to find good cause for you to testify via telephone instead. If the court does not allow telephonic testimony, you may be asked to appear in person at ITA Court at Harborview Medical Center.

    If a witness to certain facts is unwilling or unable to testify in court, the judge will not be able to consider those facts. The judge can only make a decision based on what is said in court and cannot rely on a person’s written statement as evidence.

    On the day of the hearing, there are many factors determining what time a case is called into court. Accordingly, you may have to wait for several hours before you testify. The prosecutor’s witness coordinator paralegal will be able to give you more specific information about when your case may be heard. If the hearing is continued, the subpoena remains in effect until either you testify or you are told your testimony is no longer needed. 

    How to successfully appear for court online

  • The hearing

    A Superior Court Judge or Commissioner presides over the hearing. A prosecutor represents the hospital and presents evidence that the patient meets the legal criteria for an involuntary commitment. A defense attorney represents the patients. These hearings take place via video. 

    The prosecutor

    An attorney from the King County Prosecuting Attorney's Office represents the hospitals. The prosecutor reviews the facts that led to the patient’s detention and talks to witnesses. They also speak with the behavioral health professional from the hospital who serves as the expert witness.

    The prosecutor must demonstrate all of the following:

    • The patient has a mental, emotional, or organic disorder.
    • This disorder directly led to the patient being gravely disabled or a risk of harm to self, others, or the property of others.
    • Involuntary treatment would be in the best interest of the patient and the community.

    If the prosecutor does not have sufficient evidence to prove the case, and all attempts of negotiation have been exhausted, the case is dismissed. The patient is then released from the hospital.

    The patient's defense

    A public defense attorney represents patients at no cost. They act on the patient’s wishes in court and defends the patient’s rights.

    The public defense attorney may file preliminary motions and argue against additional treatment in a hearing. They may also interview witnesses before a hearing. Witnesses can request that a prosecutor is present during a defense interview.

    Witness testimony

    The judge swears in witnesses before they testify.

    The prosecutor then asks questions, which may include: 

    • Events that led to the patient being detained.
    • How the patient functions when doing well.
    • Past difficulties the patient may have had with behavioral health in the past.
    • Resources the patient may have in the community for support, treatment, and housing.

    The defense attorney may ask additional questions.

    When testifying, do not speak directly to the patient. You must answer only the questions asked. Listen to each question and answer as directly, completely, and truthfully as you can. Do not volunteer any additional information. Only state what you saw or heard, not what you assume or have been told by someone other than the patient.

    If during your testimony either attorney says, “Objection” or “I object,” please stop talking and wait until the judge rules on the objection or an attorney asks you another question.

    When both attorneys have finished questioning you, the judge will excuse you. This ends your court appearance.

    If the judge allows, you may either watch the remainder of the hearing via video or leave the courtroom.

  • Hearing outcome

    After the judge hears all of the testimony, they decide if the patient needs to:

    • Stay in the hospital for involuntary treatment.
    • Be released into the community under a court order for outpatient behavioral health treatment.
    • Be released with no conditions for treatment.
  • If the patient is ordered to 14 days of additional care

    The hospital providers will release the patient within 14 days if they feel the patient no longer requires in-patient care. This discharge might include a court order for outpatient behavioral health treatment.

    If necessary, the hospital can petition for longer term treatment of the patient. If so, another hearing will be scheduled to review this request.

Community resources

  • If a patient is released and you feel their behavior is dangerous and need immediate help, call 911 for assistance.
  • If a patient’s behavior causes you concern for the safety of the patient or others, but the situation is not urgent, call Crisis and Commitment Services (CCS) at 206-263-9200.
  • If you are the family member of a patient who is going through the ITA process, the prosecutor family advocate is available to provide information, resources, and support through the court process by calling 206-477-8517.