Changes to Washington state’s Involuntary Treatment Act were signed into law last year, strengthening legal protections and expanding treatment options for those experiencing severe mental health and addiction crises.
Senate Bill 5745 is intended to clarify how appointed counsel services work when someone is facing involuntary commitment. At the same time, ongoing reforms to assisted outpatient-based treatment provide court-ordered, community-based care as an alternative to being hospitalized.
These changes build upon years of existing modifications to Washington’s civil commitment system, addressing gaps in due process protections and creating new avenues to less-restrictive treatment.
To help you better understand changes to Washington state’s Involuntary Treatment Act, this blog will discuss:
- What the Involuntary Treatment Act in Washington state does
- If Washington allows involuntary treatment for substance use disorders and addiction crises
- Recent legal reforms, including Senate Bill 5745
- How assisted outpatient treatment works as a less-restrictive option
- People’s rights under an involuntary commitment
Founded in 2010, A Mission For Michael (AMFM) offers specialized mental health care across California, Minnesota, and Virginia. Our accredited facilities provide residential and outpatient programs, utilizing evidence-based therapies such as CBT, DBT, and EMDR.
Our dedicated team of licensed professionals ensures every client receives the best care possible, supported by accreditation from The Joint Commission. We are committed to safety and personalized treatment plans.
Washington’s Involuntary Treatment Act
The Washington Involuntary Treatment Act establishes the legal framework for court-ordered behavioral health treatment when someone can’t make safe decisions due to mental illness or substance use.1
Originally passed as part of Washington’s civil commitment law, the ITA allows for designated crisis responders and courts to intervene in mental health crises. This may be the case if someone is presenting with a likelihood of serious harm to themselves or others, is gravely disabled, or meets the criteria for assisted outpatient-based treatment.
The process itself is civil and not criminal. A designated crisis responder – a specially-trained and county-designated mental health professional authorized to perform an evaluation – assesses the person to determine whether they meet the legal criteria for detention.
If the criteria are met, the person can then be detained for up to 120 hours (excluding weekends and holidays) at a facility for stabilization.
After the initial detention period, the facility is able to petition the court for an extended commitment, and the court can order additional treatment ranging from 14 to 180 days. The length of treatment depends on the person’s circumstances.
Further, the law requires that people subject to involuntary treatment receive a court-appointed attorney if needed and have the right to challenge their detention in a court hearing.
Does WA Also Allow For Detainment Based on Substance Use?
Yes, the ITA covers both mental health and substance use-based conditions. The state expanded the laws to include substance use crisis detention following the passage of “Ricky’s Law.” This law recognizes that severe addiction can also impair someone’s ability to keep themselves safe, just as mental illness can.2
The process and requirements largely remain the same: the person must be a danger to themselves or others, or be presenting with a grave disability due to substance use. However, if someone is detained for a substance use issue, they are sent to a secure withdrawal management and stabilization facility. This is instead of one that specializes in evaluation and treatment for mental health-based issues.
Recent Legal Reforms to Washington’s Involuntary Treatment Laws
Washington’s mental health and substance use involuntary treatment laws underwent major updates and reforms in 2024 and 2025 to improve legal protections and clarify responsibilities across the civil commitment system. Let’s take a look at what these updates and reforms involve.
Senate Bill 5745
Senate Bill 5745 brought ITA legal representation changes across the state, clarifying how Washington counties provide appointed legal counsel to people detained under the Involuntary Treatment Act.3
Signed into law in May of 2025, the bill makes the county where a person is detained responsible for administering the appointed attorney services. This is regardless of the person’s county of origin.
The legislation came about after King County faced challenges providing defense counsel for patients at the University of Washington’s Behavioral Health and Learning Center. Admissions had to be briefly paused in the fall of 2024 when public defenders weren’t available.
SB 5745 provides legal clarity to prevent similar disruptions in the future, with counties able to either provide the legal support directly or contract for these services. This move helps address workforce and capacity issues that could prevent patients from experiencing a bottleneck during the ITA process.4
Tribal Inclusions
Legislation passed in 2024 mandated that tribes, Indian healthcare providers, and tribal entities be included at every step of the involuntary treatment proceedings. The law requires the creation of stateword forms for use by tribal Designed Crisis Responders and requires that courts accept these forms when filed.5
As a result, tribes can now seek reimbursement from the state Health Care Authority for judicial costs associated with ITA hearings. Courts must provide copies of orders necessary for tribal notification of relevant proceedings, working to ensure culturally appropriate crisis response for Native community members in Washington.
Expanding Assisted Outpatient Treatment Options
Reform of involuntary treatment laws in recent years has also expanded criteria and procedures for assisted outpatient treatment. Assisted-outpatient treatment is a level of care that provides court-ordered behavioral health treatment in a community setting instead of in hospitals or residential care.6
The burden of proof for these petitions has been lowered to a new standard, making it easier to establish the need for community-based treatment as an alternative.
The law also clarifies that, when a less restrictive alternative order is revoked, and someone is detained for two weeks of inpatient-based treatment, they must then be returned to the least restrictive alternative at the end of that period. This is unless a new petition for continued hospitalization is filed.
How Does Assisted Outpatient Treatment Work?
Assisted outpatient treatment provides court-mandated mental health care in a community setting, rather than in a hospital. A court can order AOT as a form of less restrictive alternative treatment either instead of involuntary inpatient commitment or at discharge from an inpatient stay.
The order can last for up to 18 months, with the courts supervising the person through periodic reviews. During these reviews, the person must appear in court to demonstrate compliance with their treatment plan.
Assisted outpatient-based treatment still involves mandatory participation in things like therapy and medication management while the person maintains their housing in the community.
Several people can file an AOT petition, including hospital directors, mental health professionals involved in treatment, the county-designated crisis responders, release planners from jails and prisons, or emergency room doctors.
People under this type of order cannot be placed directly into involuntary, inpatient-based treatment. They would have to be referred to the county DCR for assessment first to have the court decide whether continued inpatient care is necessary.
What Rights Do People Have Under WA’s ITA Process?
Anyone facing involuntary commitment under Washington’s ITA maintains their legal protections and rights, even during a crisis hold. This means that every person subject to civil commitment has the right to an attorney to challenge the detention, cross-examine any witnesses, and present their own evidence at a hearing.
People are also entitled to receive individualized treatment during their care (as opposed to one-size-fits-all approaches). Further, they can refuse psychiatric medications unless the court stipulates it after determining they lack the capacity to make treatment decisions.
Courts themselves must also hold hearings within specific timeframes to review the necessity of ongoing detention. These protections are intended to support the ITA process as being a last resort when someone truly cannot help themselves to stay safe. They are not a shortcut to avoid voluntary treatment.
Access the Right Care for Your Needs at AMFM
A Mission For Michael’s treatment approach focuses on helping you or your loved one build the motivation and momentum to get the most out of treatment. We also aim to assist you with maintaining stability after discharge, which can help prevent future crises that could lead to ITA involvement.
Seeking out care is a true sign of strength, and our clinical team utilizes evidence-based therapies to address mental health conditions that can escalate without the appropriate care.
AMFM also accepts most major insurance plans and can verify your benefits quickly. Contact us today to learn how our residential program can provide the support you need to turn the page and start the healing process.
Frequently Asked Questions About Washington’s ITA Laws and Process
If you or a loved one is experiencing a mental health crisis in Washington, you may have some ongoing concerns about changes to the state’s Involuntary Treatment Act. We’ve provided the following answers to commonly asked questions to help alleviate these.
How Long Does an Involuntary Commitment Last in Washington?
The length of involuntary commitment depends on court determinations and the person’s progress. Initial detention can last up to 120 hours (excluding weekends and holidays) for evaluation. If the facility petitions for extended treatment, courts can order commitment for 14 days, 90 days, or up to 180 days depending on the severity of the situation.
Assisted outpatient treatment orders can last up to 18 months with periodic court reviews. The person has the right to request earlier release if their condition improves, and courts must hold hearings to review the necessity of continued detention at specific intervals.
Who Can Initiate an Involuntary Treatment Petition in Washington?
Several people can start the involuntary treatment process in Washington. Family members, first responders, caregivers, medical providers, and mental health professionals can all contact a designated crisis responder to request an evaluation. The DCR then investigates and determines whether legal criteria for detention are met.
For assisted outpatient treatment specifically, petitions can be filed by hospital directors, treating mental health professionals, emergency room physicians, or release planners from correctional facilities. The petitioner must personally interview the person unless they refuse and must provide specific facts based on direct observation or evaluation.
What Happens After Someone Is Released From Involuntary Treatment?
Discharge planning begins before someone leaves involuntary treatment and must include consideration of whether assisted outpatient treatment would help maintain stability. The treatment facility works with the person to connect them to ongoing community services, outpatient therapy, medication management, and case management support.
For people committed for 90 or 180 days at state hospitals, individualized discharge plans specifically evaluate whether an AOT petition should be filed to ensure continued engagement in treatment.
References
- Washington State Health Care Authority (n.d). Involuntary treatment act (ITA) Program overview. https://www.hca.wa.gov/assets/program/fact-sheet-involuntary-treatment-act.pdf
- Washington State Health Care Authority (n.d.). Ricky’s Law: Involuntary Treatment Act | Washington State Health Care Authority. Www.hca.wa.gov. https://www.hca.wa.gov/about-hca/programs-and-initiatives/behavioral-health-and-recovery/ricky-s-law-involuntary-treatment-act
- Washington State Legislature (2025). SB 5745 Washington State Legislature. Wa.gov. https://app.leg.wa.gov/billsummary?BillNumber=5745&Year=2025
- Ramakrishnan, J. (2025, February 26). Beds are sitting empty at a new UW behavioral health facility. That could change. The Seattle Times. https://www.seattletimes.com/seattle-news/mental-health/new-plans-will-provide-lawyers-for-uw-mental-health-patients/
- Senate Bill Report (2024). 1877-S2 SBR WM TA 24. Wa.gov. https://lawfilesext.leg.wa.gov/biennium/2023-24/Htm/Bill%20Reports/Senate/1877-S2%20SBR%20WM%20TA%2024.htm
- Senate Bill Report (2026). SENATE BILL REPORT SB 6296 Title: An act relating to involuntary treatment. https://lawfilesext.leg.wa.gov/biennium/2025-26/Pdf/Bill%20Reports/Senate/6296%20SBA%20LAW%2026.pdf?q=20260204124309
