Her Hands Were Cuffed

My daughter, D, has a nine-year history of serious mental illness beginning at the age of eighteen. Over that time, she has received several diagnoses, including schizophrenia, bipolar I disorder with episodes of psychosis, depression, and PTSD. A neurological lack of insight, not believing she’s ill, often shattered her sense of reality. This is called anosognosia and resulted in her refusal of treatment. 

When her illness is controlled, D functions at a very high level. She has completed college courses, maintained employment, built friendships, played several musical instruments, and sustained meaningful relationships with her parents and family.

However, in the month preceding D’s arrest in January 2024, she had at least seven separate encounters with police in the southwest Washington area. During this time, she was in active psychosis and displayed increasingly intrusive behavior, including stepping into traffic, loitering, refusing to leave businesses, raging, and threatening people. Police provided hotel vouchers on multiple occasions, and we also paid for hotel rooms, but D would not stay longer than one night.

During that same month, D was placed on four involuntary holds ranging from 24 to 120 hours at three different area hospitals. Each time law enforcement brought her in, I advocated strongly for a continued civil commitment order. She was repeatedly discharged. There were no civil commitments pursued during this period. We were told there were no available beds in community mental health hospitals, and Washington state psychiatric hospitals were reportedly discharging civil patients to make room for individuals waiting in jail.

D was repeatedly discharged back to homelessness — without her ID, phone, money, credit or debit cards, glasses, and without any notification to, or coordination with, family. By failing to pursue involuntary treatment while she was hospitalized, multiple organizations and facilities failed D during the critical month before her arrest.

The cycle continued: police encounter, hospital evaluation, discharge — repeat. As her psychosis deteriorated further, she became increasingly confused, frustrated, and hostile while wandering the streets.

I placed at least three calls to the DSHS mental health crisis line (Clark County Crisis Services) and was told they would not send a designated crisis responder. I was told that when the situation became bad enough, I should “just call 911.”

One night at 2:00 a.m., PSU campus security called asking if we could come pick up D, who was hiding in the student union for shelter during an incoming ice storm. We brought her home. She surrendered a small pocket knife and marijuana she had somehow acquired while on the streets. Joe went to bed, but the following morning, D was in a raging psychotic state.

On the morning of January 10, 2024, D kicked holes in the walls, vandalized our home, threatened me, and ultimately assaulted me. She grabbed my throat. I immediately forced her hands off and was not physically injured, but locked myself in the bathroom and called 911.

The responding officers explained that under domestic violence protocols, they were required to make an arrest. Because a throat grab constitutes Assault II under Washington law, D was charged with a felony.

The civil mental health system requires that a person be a clear “danger to themselves or others” before intervention. But once that threshold is crossed, the response often becomes criminal rather than medical.

I advocated for D in court, submitting a Victim Impact Statement and requesting entry into the mental health court process. D could not obtain help through the civil system. She did not deserve a felony conviction, nor did she require a “not guilty by reason of insanity” defense. She needed treatment, a new caseworker, and stability so she could return to functioning in society.

D was in such a profound state of psychosis that she could not even be arraigned. She remained in Clark County Jail for over a month before being transferred to Western State Hospital for competency restoration. After ninety days in the state psychiatric hospital, she was returned to jail.

At that point, D was beginning to emerge from the fog of psychosis. From jail, she started arranging future services. Once she secured placement in a 30-day rehabilitation program, I paid a $500 bond to secure her release on $5,000 bail.

Upon release, D was unable to obtain her prescribed medication through the state system in a timely manner. We had to use our private family health insurance to ensure she received her urgently needed medication. Then, for her to qualify for the rehabilitation program — which accepted only Medicaid — we were required to remove her from our private insurance.

After a year of delays, waivers, and continuances with her public defender, D was finally admitted into the Clark County Mental Health Court process in the summer of 2025.
As part of that program, she was required to leave her halfway house — which she described as an “un-staffed insane asylum” — and move into a sober living house. There, she was accountable to chores, urine analysis testing, sobriety meetings, medication compliance, therapy, a caseworker, and weekly court appearances.

Reflect for a moment on the immense stress endured by D, the heartbreak experienced by our family, and the extraordinary financial cost to society for repeated police responses, multiple hospital evaluations, extended jail stays, a 90-day state psychiatric hospitalization for competency restoration, public defender services, prosecution, court proceedings, and the mental health court program itself.

All of this — the trauma, the criminal record, the enormous public expense — could have been avoided with timely, responsive civil commitment and access to stabilization when she first began decompensating.

Today, through medication, sobriety, improved sleep, and structured support, D has avoided relapse into psychosis for over two years. She has a job, a boyfriend, a supportive community, and is enjoying her life. She has successfully progressed through three phases of Mental Health Court and is entering the final fourth phase. Upon completion, her felony record will be expunged, allowing her to pursue better employment opportunities.
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We are hopeful for her future.​

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The financial cost of D’s untreated psychosis to the state of Washington has been substantial. Her repeated police encounters and emergency evaluations, extended jail stays, and a 90-day state psychiatric hospitalization add up quickly. Washington’s average daily jail cost is approximately $150–$200 per day; D spent over 30 days in Clark County Jail, costing an estimated $4,500–$6,000. Her 90-day stay at Western State Hospital, where competency restoration occurred, likely cost the state $72,000–$90,000. In addition, repeated short emergency holds, police responses, and associated hospital evaluations — which often exceed $1,000 per visit — add tens of thousands more. When public defense, prosecution, court proceedings, and mental health court oversight are included, the total fiscal impact to taxpayers easily approaches $150,000–$200,000 or more.
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And those figures do not capture the emotional cost to D or our family — the trauma, fear, and years of disruption that cannot be quantified in dollars. Early, effective civil intervention and access to stabilization when her symptoms first escalated would have cost far less, preserved her dignity, and prevented unnecessary harm. Treatment saves. Neglect costs — in human suffering and in taxpayer dollars.