Ross v. Inslee: Improving the Treatment and Release of NGRI Patients

Description of the action

In 2014, people found Not Guilty by Reason of Insanity (NGRI) and sent to the state psychiatric hospitals for treatment brought a lawsuit against the Department of Social and Health Services (DSHS). The case is called Ross v. Inslee, No. CV-14-00130-TOR (E.D. Wash., 2014). 

The named plaintiffs are six individual NGRI patients at Western State Hospital (WSH) and Eastern State Hospital (ESH) as well as DRW. The Complaint alleged, in part, that patients’ rights were being systematically violated due to inadequate treatment and release planning, and overly punitive and restrictive treatment that failed to follow clinical standards and recommendations.

This lawsuit resulted in a Settlement Agreement [PDF] between the plaintiffs and DSHS that calls for changes in the treatment and release of NGRI patients.


The Megaphone Effect: Reclaiming Recovery features plaintiffs, other patients, hospital staff and administrators, and a Washington State Representative who discuss how these punitive laws place barriers on the road to recovery. The short film was an official selection of the 2013 Tacoma Film Festival.

Case Documents

Summary of work: 

Milestone: February 2017

“Patients Not Prisoners: How the Ross settlement agreement seeks to improve treatment and release of patients adjudicated NGRI” [PDF] was co-authored by Andrew Biviano and DRW’s Emily Cooper in the Washington Criminal Defense Magazine.

Milestone: August 26, 2016

The U.S. District Court approved of the Settlement Agreement [PDF]. Plaintiffs’ counsel (Disability Rights Washington and Andrew Biviano) are collaborating with DSHS to fully implement the terms of the Settlement Agreement through changes in policies and practices. The parties jointly drafted a summary of DSHS’s commitments [PDF] and an implementation timeline [PDF] and are using these materials to educate patients and staff at both state hospitals. 

Most significantly, the Ross Settlement Agreement states that Conditional Release with community supervision should be prioritized over extended hospitalization when patients are ready. Similarly, patients who are no longer dangerous or who no longer require hospitalization will be prioritized in the discharge process. DSHS has agreed to provide patients with an individualized treatment plan upon admission, care in the least restrictive clinically appropriate setting, and to base care decisions exclusively on clinical judgment.

Milestone: April 1, 2015

The Court granted our joint motion to stay litigation [PDF] so that we can fully discuss whether we can reach a settlement agreement. The parties agreed that there are several steps DSHS can take to improve the treatment and release process and bring significant benefits to patients without having to involve the court. For example, it was agreed that treating clinicians are in the best position to make individualized treatment decisions.

Milestone: June 30, 2014

The State hired experts to perform a thorough review of Washington's forensic mental health system. In their report, The Groundswell Report [PDF], the State's experts made several recommendations including an overhaul of services for NGRI aquittees in Washington. One of the most notable findings was that NGRI patients were more likely to be released to the coronor's office, than to the community on conditional release (The Groundswell Report, page 44).

Milestone: May 7, 2014

Plaintiffs filed their lawsuit [PDF] challenging the constitutionality of treatment and release planning of patients adjudicated NGRI at the state psychiatric hospitals. The lawsuit focused on legal barriers and process improvements to make sure patients get the treatment they need to get better and be released back home when they are ready.