Until 2019, Washington State incarcerated more youth for non-criminal status offenses, like truancy or running away from home, than any other state. In that year, Washington outlawed incarceration for status offenses while at the same time expanding the options for parents and guardians to admit their children to inpatient mental health treatment without their consent.

This Note asks whether these recent legislative changes will lead to a rise in inappropriate inpatient and residential treatment admissions, a form of transinstitutionalization. It argues that transinstitutionalization can be a harmful unintended consequence of decarceration, and extracts two lessons from the history of legislative change in Washington State for policymakers and advocates seeking to prevent unnecessary transinstitutionalization.
First, physical safety concerns are a significant stumbling block for advocates seeking to increase community-based alternatives to incarceration and institutionalization. Advocates must explicitly address stakeholder physical safety concerns by demonstrating that community-based treatment can increase young people’s long-term physical safety while effectively mitigating short-term safety risks. Litigation and pooling funding offer two strategies to expand the availability of high-quality community-based programming.

Second, empowering parents to unilaterally initiate inpatient mental health treatment deprives children of important procedural safeguards against inappropriate inpatient and residential treatment. Policymakers should build up procedural safeguards within the parent-initiated treatment process in order to limit inpatient treatment to cases in which a young person truly cannot remain at home safely.