King County Prosecuting Attorney Leesa Manion says the system meant to help people in behavioral health crisis is instead stabilizing them and then releasing them with nothing — no care, no follow-up, no safety net. Her office now fields about 200 new involuntary treatment court petitions every week, and she says that volume is part of why she believes the system is overburdened and failing the very people it was built to serve.
A Two-Year Push Started on the Campaign Trail
Manion first raised concerns about Washington's Involuntary Treatment Act, or ITA, on the campaign trail in King County back in 2022, according to KOMO News. The following year she convened what became known as the Reimagining ITA Task Force, an effort that started as an unfunded project and has now stretched past two years, per the same report. The King County Prosecuting Attorney's Office says the task force developed a plan, purpose, goals and timeline for a forthcoming statewide listening tour that launched in May 2024.
That tour pulled in voices from across the system, not just prosecutors. KOMO's reporting describes input gathered from people with lived experience, families, designated crisis responders, psychiatrists, treatment providers, defense attorneys, judges, law enforcement and first responders. The Health & Justice Recovery Alliance, which is also involved in the reimagining effort, says a version of this listening tour facilitated conversations across Spokane, Adams, Ferry, Stevens, Lincoln and Pend Oreille counties, gathering experiences and ideas about the law's strengths, challenges and potential areas for reform.
Manion Calls the Current Process Adversarial
Manion describes the current involuntary treatment process as adversarial and says she wants to see something more therapeutic and collaborative take its place, according to KOMO. She has said people in crisis should get the help they need as quickly as possible and through the least restrictive means available, and that earlier intervention could keep some people out of involuntary treatment court altogether.
The feedback gathered through the listening tour was compiled into a report that urges treatment decisions be based on what an individual patient actually needs, rather than the complexity of their case, where they live, or their insurance status, per KOMO's reporting. Manion has said the system, as it stands, is not producing the results communities want.
No Statewide Tracking of What Happens Next
One gap Manion keeps returning to is data. Washington has no statewide database tracking when people enter involuntary treatment court, what treatment they receive, or what happens to them after they exit, KOMO reports. The Disability Rights Washington organization has separately said that a lack of publicly available data on ITA admissions and treatment outcomes is a significant barrier to assessing the system and figuring out what needs to improve.
Manion has said she wants state lawmakers to fund the creation of a statewide database, arguing it would let officials analyze what care actually works and how to keep people well instead of cycling back through the system. She has discussed the issue directly with state lawmakers, according to KOMO.
A Pilot Site Targeted for 2027
Manion has described a recurring pattern in which people in crisis are stabilized and then released without any care lined up for them. The report recommends a pilot site built around continuity of care, aiming to make sure people leaving the system are released to actual support rather than nothing at all, KOMO reports.
Getting a pilot off the ground would require partnership with providers and experts who regularly work with people in crisis, according to the report. Manion has said a pilot could launch as soon as 2027, and that she believes any program should be designed to track outcomes and scale up, with results potentially replicated statewide.
A System With a Documented History
The push for reform doesn't emerge from nothing. A 2022 Washington Law Review article by Hannah Garland cited a 2019 King County report finding that 57% of involuntary treatment court cases involved people who had already been through at least one prior ITA proceeding — a historical figure, not a current one. The same article reported that Black individuals accounted for 14.8% of King County ITA cases at a time when they made up roughly 7% of the county's population.
Those numbers are years old and the available evidence doesn't establish whether those rates persist today. But the Health & Justice Recovery Alliance says there is broad consensus across the state — including within justice and behavioral health systems — that the current ITA system fails patients and the public, a sentiment that echoes what Manion has been saying since 2022.
By the Numbers, Every Year
The scale of what King County's courts handle underscores why Manion sees urgency here. King County Superior Court receives roughly 4,000 involuntary commitment petitions each year, and by law, the Prosecuting Attorney's Office must represent the treatment facility seeking longer involuntary treatment in those cases. Manion has framed her recommendations and proposed investments as aimed at producing better outcomes for individuals, families and the broader community — whether or not lawmakers act on the database funding or the 2027 pilot timeline she's floated.
