Audit: King County Jail delays psych care, often missing patients before release
(The Center Square) – A new audit of King County Jail Health Services revealed that the department had gaps in services, leaving some patients with no access to psychiatric care.
The King County Governing Accountability and Oversight Committee was briefed on the audit on Tuesday, with findings revealing that Jail Health Services treats patients with acute symptoms quickly – within 24 hours – but those with less obvious symptoms have to wait over a month for health services. Oftentimes, they are released from jail before they can see a health provider.
In 2023, more than 2,500 patients at the jail in downtown Seattle were provided behavioral health medication.
The audit revealed that many patients see longer wait times for clinic appointments with psychiatric providers to get restarted on medication, with many of these appointments not occurring before a patient is released. In 2023, 60% of psychiatric clinic appointments ordered through Jail Health Services were canceled on a patient’s release date. Only 20% of orders were completed.
Of the completed appointments, about 34% were completed within Jail Health Services’ goal of 30 days after an order was placed. Most were completed within 60 days. King County Auditor Basil Hariri noted that the results are influenced by stays at the jail being frequently short and some patients being sent to psychiatric housing and being seen through different avenues.
Jail Health Services has taken steps to reduce wait times, but the audit argues that the department does not have a formal understanding of its psychiatric care capacity.
Two-thirds of behavioral health medications were ordered within two days of a patient’s booking and most patients received their order within 24 hours. However, about 5% of medications take 30 days or more. The audit found that 20% of patients received their prescription at release in 2023. The audit notes that many Jail Health Services patients only receive behavioral health care at the jail.
The department is actively considering efforts to increase the supply in the future.
During the committee meeting, King County Councilmembers Teresa Mosqueda and Sarah Perry inquired on the importance of the budget implications of the audit report in order to make informed decisions later in the year, as the county works to handle a $150 million budget gap.
Jail Health Services Division Director Danotra McBride said the department will need to do a more broad-scale analysis of audit report recommendations to see how the draft 2026-2027 county budget can address the flagged issues. McBride mentioned an analysis of staffing size needed to provide sufficient service levels at the jail.
The audit recommends Jail Health Services implement a plan to reduce psychiatric clinic wait times for patients in the general population by updating its behavioral health staffing plan and its standards for psychiatric wait times.
When it comes to patient access to medications at release, auditors recommend improving communication with patients and developing more pathways that don’t rely on patients to have to proactively advocate for themselves, as patients interviewed by auditors said they were unaware of opportunities to request medications.
Jail Health Services concurred with all 12 of the auditor’s recommendations.
