Not Guilty by Reason of Insanity Residents

NGRI Units

Units that serve not guilty by reason of insanity (NGRI) residents include Columbia Unit and Cascade Unit at Maple Lane Campus.

Not Guilty by Reason of Insanity

A defendant is found not guilty by reason of insanity and acquitted of the charge(s) against them when the court determines the person was not able to tell right from wrong due to their mental state at the time of the offense. 

These types of forensic patients typically experienced severe symptoms of mental illness at the time of the offense, which gravely impaired their capacity to perceive reality or think clearly.  

For example, they might describe suffering from delusions or hallucinations that directly led them to commit the offense.  If the court finds the person NGRI, the person is committed to the custody of DSHS and is usually admitted to a DSHS facility that provides treatment to those found NGRI, including Eastern State Hospital, Western State Hospital, or Maple Lane Campus – Columbia Unit or Cascade Unit. Length of inpatient commitment varies, depending on progress toward mitigating risk factors to ensure safe return to community living.   

 Learn more about NGRI patients.

Our Residents

Our mission is to treat people in need of inpatient psychiatric care who have been found not guilty by reason of insanity and have made substantial progress in their treatment. Behavioral Health and Treatment Centers help provide a therapeutic pathway for residents to further progress in their treatment.

Our Program

NGRI units are highly secured environments with procedures/processes unique to each facility. All residents will participate in daily active psychiatric treatment which is ordered by a physician and individualized to clients’ particular treatment needs and reasons for admission. Each resident works closely with a multidisciplinary treatment team that includes staff from psychiatry, pharmacy, psychology, nursing, rehabilitation, and social work. 

Each unit offers a wide range of group treatments, many of which are evidenced-based practices. Additionally, units offer groups to help increase residents’ mental illness symptom management, vocational opportunities, and recreation. 

Residents progress through a privilege system that offers them greater responsibility as they advance in their treatment. However, as they advance in the privilege system, they will be able to earn increased unsupervised walks within secure campus areas. Residents are regularly being assessed for safety before exercising ground or on-campus privileges.

FAQs

Q. What does it mean to be not guilty by reason of insanity?

A.  A defendant is found not guilty by reason of insanity (NGRI) when the defendant was either not able to perceive the nature and quality of the act or not able to tell right from wrong concerning the particular act in which they are charged. People found NGRI are typically people who were experiencing severe symptoms of mental illness at the time of the offense, gravely impairing their capacity to perceive reality or think coherently. For example, the defendant might describe suffering from delusions or hallucinations that directly led them to commit the alleged crime. If the court finds the person NGRI, then the person is either remanded to the custody of DSHS or released to the community. Persons remanded to DSHS custody, will be admitted to an NGRI treatment program. 

Learn more about patients found not guilty by reason of insanity.

 Q. Are residents able to leave the unit?

Most residents will have at least escorted grounds privileges by the time they reach Maple Lane grounds, meaning they will be able to access certain areas on campus grounds, accompanied by staff, and with time limitations.

Q. Can NGRI residents go into the local community on escorted day trips?  

A. Some NGRI residents will have staff-escorted community outings, or SECO, privileges. SECOs are trips to the community for therapeutic, recreational, and community reintegration purposes. The goal of SECOs is to continue to prepare residents to return to their community. Under the watchful eye of skilled staff members, residents can experience their feelings of excitement, normalcy, or practice coping skills while in a public community setting. SECOs are typically treatment or recovery focused, such as sober supports in the community, and include activities that are recreational and help with community reintegration, such as shopping, restaurants, getting familiar with public transportation, outdoors activities, and various community errands.

How does a resident qualify for SECOs?

This privilege would be granted by court following a four-step review process. After the resident advocates for their privilege increase, or upon determination by the treatment team of potential readiness, the review process for privileges includes a review by the treatment team, the Risk Review Board, the Public Safety Review Panel and DSHS secretary’s designee.  Court then determines whether to grant the increase in privileges via a court order.

Q. What policies and laws govern the treatment of NGRI residents?

A. The NGRI process is outlined in RCW 10.77.

In 2010, a series of new state laws added restrictions to the release process for NGRI patients. The new laws generally required the NGRI patients to obtain a court order to leave the hospital, including for family visits or taking a walk off of hospital grounds, even if doctors recommend this for treatment and recovery. These laws also created the Public Safety Review Panel, an advisory panel composed of a psychiatrist, a psychologist, a prosecutor, a law enforcement representative, a consumer and family advocate representative, and a public defender. This panel provides an additional layer of review before NGRI patients are permitted to leave the secure areas of the state psychiatric hospitals.

Because the changes in the law delayed the treatment and recovery process, plaintiffs brought a lawsuit against DSHS in an effort to ensure timely clinical decision-making while respecting the safety of patients and the public. The plaintiffs alleged that patients’ rights were being violated due to inadequate treatment and release planning.  This suit led to the Ross Settlement.

Although a federal court since dismissed the case after DSHS greatly improved its policies, the Ross settlement resulted in both state psychiatric hospitals having either updated or created new policies that address multiple areas to include individualized treatment plans, reinstating ground privileges, and a privilege system. Those new policies have carried over to the units on Maple Lane Campus that serve NGRI residents.

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