Outrage aside, fair escape begs questions

Plenty of opinions have been heard around Spokane since Thursday, when a criminally insane patient of Eastern State Hospital walked away from an outing to the Spokane County Interstate Fair. More accurately, one opinion was heard, but it was heard plenty of times:

Outrageous.

Twenty-two years ago, Phillip A. Paul strangled a 78-year-old woman he mistook for a witch, but he was found innocent by reason of insanity so he was committed to ESH in Medical Lake.

Yet there he was on Thursday, along with about 30 other patients, mingling with fairgoers, including children. Most if not all of the patient group were said to be “forensic patients,” meaning they were committed to the hospital because of criminal behavior. They were under the supervision of 11 hospital personnel.

Somehow, Paul walked away.

The idea of a mentally ill killer on a field trip into a setting for family activities roils the emotions of parents and other community members, although chances are relatively low that Paul would have done severe harm if the voices that influence him had commanded some sort of mischief. Among the ESH personnel, the crowd at large and a number of nearby law enforcement officers on foot patrol, someone almost certainly would have intervened to deter him if not bring him under control.

The more troublesome consequence of the hospital’s questionable decision is the one the community faced after he took off. Paul has been on the lam, beyond the reach of his supervisors/caregivers and possibly in need of medication – although ESH officials said Friday he would be OK on that score for a couple of weeks. Wherever he intended to go, and that could be anywhere, people in his path were potentially in danger.

Hospital officials have downplayed the threat Paul represents, but that’s of little comfort since the law put him in their custody because he was deemed unsafe to be discharged. His record, in fact, includes evidence of ongoing problems.

Appropriately and predictably, the state Department of Social and Health Services will conduct an intense inquiry into what happened. Among the angles that demand close examination are the delay of more than two hours before Paul’s absence was reported to law enforcement authorities and the assertion by employee groups at the hospital that they previously protested the very outing policies that put Paul in a position to escape.

DSHS has much to study and is certain to ordain some policy adjustments once the review is complete. We in the community must recognize that complex questions of law and mental health treatment are involved, and that the first emotional reactions rendered, without benefit of all the facts, are often invalid.

If the agency must continue public outings for their therapeutic value, better controls should be established. Even if Paul was gone only a minute or two before his absence was noticed, it is self-evident that the supervision was inadequate. Whatever the answer – smaller groups, more supervisors, better coordination with fair officials and authorities – there can be no margin for error.