·  Legal News, Analysis, & Commentary

Opioid Drugs

Treatment Center Allows for Involuntary Admission of Minors

— July 14, 2020

Spokane’s Excelsior will treat minors for substance use disorder and mental illness under Ricky’s Law.

Spokane’s Excelsior Youth Center will now serve minors who have been placed in inpatient treatment involuntarily for behavioral health and addiction issues.  The organization is the only Safe Withdrawal Management and Stabilization facility in the state and stands ready to assist with involuntary treatment of patients under Washington’s Involuntary Treatment Act, also known as Ricky’s Law.

Ricky’s law amends a previous act to include substance use disorders to the reasons for placing someone in involuntary treatment.  The criteria for doing so includes “a health care professional finds that someone dealing with a substance use disorder or behavioral health issues is likely to harm themselves or others, or if substance use disorder causes the patient to be disabled.”

Excelsior CEO Andrew Hill said the organization “has eight beds designated for minors who are undergoing withdrawal from drugs or who are struggling with alcoholism or mental illness.  The beds are in Excelsior’s new Integrated Care Center.”  Construction of the $6.3 million building was finished in April.

Treatment Center Allows for Involuntary Admission of Minors
Photo by Levi Clancy on Unsplash

“It’s the first children’s inpatient facility that was designed using trauma-informed research and architectural design,” Hill explained. “The facility was designed to operate four different programs independently of each other, so that Excelsior can provide help for minors who are struggling with different problems under the same roof.”

Excelsior hired 45 full-time and about 30 part-time employees at the Integrated Care Center, according to Hill, including “doctors, registered nurses, an executive director, population-specific care coordinators and others.”  Treatment costs at Excelsior average about $500 a day, depending on insurance coverage and services provided.

“Having the opportunity to say, ‘We’ve got this, we can help,’ and not turning that parent and family away because we can’t provide an intervention is what really matters to us,” Hill said.

Washington state Rep. Lauren Davis (D-Lynnwood) helped create Ricky’s Law when she was 24 years old and returned from overseas to find that her best friend from high school, Ricky Garcia, addicted to opioids and alcohol.  She was severely disheartened by the fact that no one could force Garcia to seek treatment.

“We’re a big civil liberties state, so the threshold to meet in order to take away a person’s civil liberties is really high,” Davis said.  She became Garcia’s primary caregiver, and over the next two years, Garcia was in and out of the emergency room, intensive care unit, and psychiatric unit.

“The same psychiatrist who had treated him on previous visits sat across from Ricky and me in the discharge planning meeting, and looked at Ricky, and said to him, ‘If we were in another state and I could commit you involuntarily to addiction treatment, I would.  But my hands are tied in Washington,” Davis recalled. “State law provided for involuntary treatment for those suffering from mental illness, but substance use disorders were specifically excluded from the law.”  She added she is happy to report that Garcia, now age 33, has spent the last eight years in sobriety.

“What I came to find out was really tragic: Not only could you not commit an adult who was dying of their addiction, but you couldn’t commit a child, either,” she said “We had a process called Parent Initiated Treatment for adolescents ages 13 to 17, but only for mental health. Substance-use disorder had been left out.”

Under Ricky’s Law, a designated caregiver of an individual underage can opt for family-initiated treatment if the minor refuses voluntary treatment.  The patient is then taken to a withdrawal management and stabilization facility, such as Excelsior, for up to seventeen days.

“These young people or adults are so caught up in their active addiction that there is no pause button, there’s no respite, you won’t find any moment in a 24-hour period where they’re not high or drunk,” Davis said. “Prior to Ricky’s Law, the only forced pause was through the criminal justice system, which is not where we want to send people in acute behavioral health crisis.”  Passing of the law, she said, is “a philosophical recognition that these are young people in the depths of an extremely acute behavioral health crisis, they’re not criminals.”


Excelsior to treat unwilling patients under Ricky’s Law

Ricky’s Law: Involuntary Treatment Act

Join the conversation!