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Community Alternatives to Boarding Task Force

Community Alternatives to Boarding Task Force

The right care at the right time in the right place for people in crisis

Gov. Jay Inslee and Executive Dow announce recommendations made by the CABTF to address mental-health system

Washington Gov. Jay Inslee and King County Executive Dow Constantine announced recommendations made by the CABTF during a tour of the West Seattle campus of Navos Mental Health Solutions on July 20, 2016.

The Community Alternatives to Boarding Task Force is creating sustainable solutions to address involuntary treatment demand through increased prevention and intervention, community-based diversion and psychiatric hospital re-entry programs, and increased capacity for both community care and hospitalizations.

Gov. Inslee and Executive Constantine announce CABTF report

The problem

To address the serious shortage statewide of involuntary psychiatric treatment beds, in August 2014 Gov. Jay Inslee and King County Executive Dow Constantine jointly convened the Task Force made up of a broad range of high-level representatives from the legal, judicial, and treatment systems. The lack of treatment beds had created an increasing number of people detained for inpatient care in temporary settings, such as hospital emergency rooms, without adequate psychiatric care while they waited for a treatment bed to open – a process known as psychiatric boarding. A Washington State Supreme Court ruled against that practice effective December 2014.

Download the Task Force's full report

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See the executive summary of the final report.

See the summary of top priority recommendations.


  • Significantly increased immediate involuntary placement in appropriate facilities following the court ruling
  • Established coordinated guidelines to match patients with appropriate treatment settings
  • Removed patient placement delays by greatly expanding placement hours
  • Streamlined approval process at Western State Hospital that previously caused delays and secured legislation to eliminate key Western State Hospital bottleneck
  • Led effort to collaborate with local hospitals to care for involuntarily detained patients, even with stricter guidelines from the state
  • Developed innovative and visionary recommendations for future system improvements and targeted resources across the continuum of care

Prevention and early intervention

  • Expanded outreach and engagement services
  • Quick access to community-based treatment
  • Intensive case management to help prevent costly hospitalizations

Crisis diversion

  • Mobile crisis outreach teams
  • Crisis Solutions Center
  • Step-up services to help prevent hospitalization
  • More after-hours response

Community-based discharge options

Support psychiatric hospital discharge and re-entry programs to help people successfully return to the community with the services and supports they need to achieve and maintain stability on the road to recovery.

Supporting integrated care 

Advocating policy changes to improve the entire system of care by increasing capacity at all levels of care, and support the delivery of integrate care.

Read more detailed information about the Task Force recommendations. Additional context for these recommendations are presented as part of the Task Force’s final report.

NEW: The Task Force’s latest quarterly report updates key metrics and briefly describes progress and next steps toward implementation of its recommendations.

Document library and Task Force membership information

The CABTF is comprised of a broad range of high-level representatives from the legal, judicial, and treatment systems that impact individuals involved in the involuntary commitment process. Participating organizations include the state Division of Behavioral Health and Recovery (DBHR); Western State Hospital (WSH); the Washington State Hospital Association; evaluation and treatment (E&T) providers Harborview Medical Center and Navos; King County Department of Community and Human Services staff; King County’s Involuntary Treatment (ITA) Court; and senior policy advisors for the Governor and Executive.

A full list of CABTF members is here.

The documents above are filled with detail about the Task Force and its recommendations. Still have questions? Email us

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