Sex offense treatment limited at McNeil Island detention center
SEATTLE – The Department of Social and Health Services is providing just two hours of weekly group treatment for residents of a secure island facility used to detain and rehabilitate people with a history of sex crimes – a fraction of what state officials and national experts consider acceptable and of what was offered just nine months ago.
The drop comes amid a staff exodus that’s left half of all clinical positions vacant. Records reviewed by the Seattle Times show DSHS has infrequently met its own minimum treatment standards in 15 years.
Access to adequate mental health treatment is a constitutional mandate for the roughly 124 residents indefinitely held at the Special Commitment Center on McNeil Island. Most people are committed after completing criminal sentences, and because their confinement is civil, not criminal, it can’t function as punishment.
More than a dozen residents, attorneys and current and former employees interviewed by the Seattle Times say the access, quality and amount of treatment at the facility has been limited for years – and abysmal as of late.
The facility offered just 90 minutes of sex offense treatment weekly during this year’s first quarter, and groups were frequently canceled, according to documents reviewed by the Times and interviews with residents and staff. Beginning last month, DSHS has offered 30 more minutes weekly.
The island is missing a chief of resident treatment, and data as of April shows a 70% vacancy rate for psychologists (only two of seven positions filled) and nearly a third of all psychology associate jobs vacant – those charged with leading treatment groups. This is a significant drop from last year when there was an average 15% vacancy rate in clinicians.
Tyler Hemstreet, a spokesperson for the Special Commitment Center, said a staff shortage necessitated the drop in treatment hours.
“There is no defined minimum requirement of treatment,” he said by email, nor is there a “universal definition of treatment amongst the sex offender civil commitment programs.”
But Keith Devos, CEO of the Special Commitment Center, told the Times in an interview last year that the best practice would be 14 to 20 hours weekly.
The facility has long struggled to provide enough treatment and keep positions filled, even as the cost of the civil commitment has continued to soar. It’s one of the state’s most expensive institutional programs per person but receives no independent oversight and minimal scrutiny, Times investigations have found.
Residents are committed if a court finds that their history of sexual violence and underlying psychiatric conditions may make them 50% or more likely to reoffend in a predatory manner if not held in a secure setting.
Treatment is fundamentally tied to release, providing residents a way out of commitment and preparing them to be safer members of society. But while an increasing number have been released in the past decade, access to and quality of treatment have rarely improved.
A Times investigation in April found that half of residents granted conditional release to supervised homes are returned to the island by DSHS and the Department of Corrections for small and large violations. And while the state doesn’t track what happens to residents when they’re released from commitment, the Times revealed in an investigation last year that 1 in 4 have gone on to commit new crimes.
“There’s very little treatment given, and it’s few and far between and very haphazard,” said Jeffrey Jacobsen, a McNeil Island resident for 11 years after 25 years in prison.
Between January and early May, 20% of scheduled group treatment sessions were canceled, either for illness, for clinicians to catch up on work or for no stated reason, according to interviews and information reviewed by the Times.
Hemstreet said, “Due to vacancies, there is no coverage pool to pull from if a clinician takes time off,” but said cancellations are “not representative of the clinical program.”
DSHS officials have attributed staff shortages to the difficulty of the work and the commute, which includes a ferry and bus ride from the Steilacoom dock.
The “isolation of the work site has always presented a challenge with retention,” Hemstreet said, and other state agencies pay more. But he said DSHS is “actively working to hire and examine ways to increase retention.”
Recent budget cuts eliminated 36 positions. Hemstreet said most were achieved through attrition.
Current and former employees also point to deeper issues including burnout, a toxic culture and layoffs exacerbating already dangerously low staffing levels.
“The turnover rate is absolutely insane,” said a staff member who’s worked at the facility for over a year and asked not to be named for fear of retaliation. While there are some good clinical staff, they said, others “have really poor attitudes especially toward treatment and belief in the residents’ ability to change.”
DSHS’ inability to provide sufficient mental health treatment dates nearly to the inception of the law – the nation’s first – that created sexual civil commitment.
In multiple lawsuits, newly committed residents alleged Washington’s civil commitment program violated their civil rights. A 12-person jury agreed in 1994, finding the Special Commitment Center failed to provide constitutionally adequate mental health care. A U.S. district judge issued an injunction to bring the state into compliance, which required hiring and training competent therapists and developing individual treatment plans.
The injunction was in place for over a decade. By the early 2000s, Washington said it was complying, but plaintiffs alleged the state had already backslid on its promises to improve care, lying to the court about improvements at the institution.
“There is no viable treatment here,” resident Sam Donaghe wrote in a 2006 letter to the judge. “I cannot impress too strongly upon you the problems here, past, present, and undoubtedly future.”
The judge agreed in part but said the state was in substantial enough compliance and judicial oversight was not meant to be indefinite. He dismissed the injunction in 2007.
But Donaghe was prescient. By 2011, an on-site inspection by the Inspection of Care or IOC team stated in a report that the facility’s treatment “falls short of what a civil program should be offering.” The facility offered five hours of treatment weekly, and just two hours for residents with cognitive disabilities.
The state’s own internal standards at the time were six hours for “core” track residents; the IOC said at least four hours was necessary for those on the “high-acuity” track, residents with an IQ below 80.
The inspectors urged DSHS to quickly correct this deficit. Instead, in 2012, DSHS lowered its treatment standards to five hours per week, state records show.
“The longer the current level of performance is maintained the more ‘acceptable’ it will become within SCC and the State,” the IOC warned.
The three IOC inspectors who write the report are paid by DSHS to conduct an annual weeklong inspection. But the IOC has no power to require the state to make changes and cannot issue penalties. The only way to compel change is through a lawsuit or legislation.
Nationally, the majority of sexual civil commitment programs offered six hours of sex offense treatment weekly and 12 to 16 hours of additional therapies monthly, according to a 2018 survey by the Sex Offender Civil Commitment Programs Network, a professional association for people who work in sexual civil commitment.
In the past 14 years, DSHS has never hit six hours of weekly sex offense treatment, inspection team reports and policy documents show.
Disability Rights Washington, a nonprofit that advocates for the rights of people with disabilities, has an ongoing legal settlement with the state for providing inadequate treatment to residents with cognitive disabilities, alleging DSHS essentially “warehoused” people whose disabilities or mental health conditions prevented them from participating in the very treatment required for their release. In a federal complaint, the group also found the IOC had also substantially inflated the amount of treatment offered.
Special needs residents were provided 2.5 hours of weekly group sex offense treatment, Disability Rights Washington found in 2015, a third of the amount cited by the IOC, and more than any resident is receiving at the facility today.
Lack of clinical staff
In 2023, an internal, anonymous survey of Special Commitment Center staff showed brewing signs of discontent. Employees said they were understaffed and overworked and cited a toxic culture and mismanagement contributing to frequent turnover, according to documents reviewed by the Times.
Of the 115 employees who responded to the survey, 64% said they were treated with respect, but the rest expressed distress about the workplace and inappropriate behavior among certain staff, and half reported burnout.
“This work environment is the worst I’ve seen it, in my almost 2 decades working here,” one wrote.
“We run with unsafe staffing levels, and are criticized when something goes wrong,” another wrote. “We have staff that are exhausted. We have some staff that shouldn’t even be working with this population and they are still here. We need more therapies to be addressed for the residents, their trauma issues, addiction issues, and more counseling time.”
And despite the federal injunction’s requirement for clinicians to be experienced in sex offense treatment and for DSHS to provide training, a psychological associate said in a 2023 deposition they had no prior experience in sex offense treatment and their training was on the job, “sink or swim” style.
These issues undermine the therapeutic environment that should exist on the island, according to multiple employees’ survey responses and interviews with the Times.
In interviews from the island, residents said they had little opportunity to make positive changes or progress because of the limited amount of treatment. Others declined or were kicked out of treatment because of a bad experience with a clinician or because the information disclosed in treatment can be used in court.
Residents can decline treatment, but the only way they can petition for release is if they show they’ve made progress in treatment or experienced a severe physiological change like a stroke. The CEO of the Special Commitment Center can also recommend release or a resident’s annual report can find they no longer appear likely to reoffend.
Hemstreet said DSHS has been working on offering other types of activities outside of the classroom. But a schedule reviewed by the Times shows few extra groups for “core” track residents.
The employee who said they feared retaliation told the Times that residents’ traumatic backgrounds are often disregarded. McNeil Island focuses almost exclusively on sex offense treatment, and residents get less than an hour of individual therapy monthly. Residents “are not being treated for their past, for any trauma that they have endured or any addiction issues,” the employee said.
Another longtime employee who also cited retaliation concerns said, “Our job is to deliver treatment to prepare people for release and hope they don’t reoffend. … We are not setting them up for successful release.”
Rebecca Moss: rmoss@seattletimes.com. Rebecca Moss is an investigative reporter at the Seattle Times.