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Elaine Thompson, Associated Press
In this photo taken Thursday, Jan. 8, 2015, Gerald Elfendahl walks on a drive outside the property of his friend Karen Hellmuth, on Bainbridge Island, Wash. Since early October, Hellmuth, 73, a member of a noted family in this small Puget Sound community, has been held in solitary confinement at the Kitsap County Jail without treatment for what many say is a decline in her mental health. She was charged with trespassing and assaulting an officer on Oct. 4, following a blow-up with a neighbor and volatile confrontation with the arresting officer. Hellmuth was evaluated and found incompetent to face charges, but a lack of bed space has forced her to remain in jail on a wait list for more than three months. Although a federal judge ruled last month that holding mentally ill people in jails in competency cases without treatment violates their constitutional rights, the state of Washington has yet to implement changes or infuse more money into the system to address the long wait lists.

BAINBRIDGE ISLAND, Wash. — Karen Hellmuth lived in her small green trailer in the woods for decades, working with clients as an acupuncturist and staying strong by hauling water and heating with wood. The 72-year-old recently spent nearly 100 days in a Kitsap County Jail isolation cell without receiving treatment for what friends say is a decline in her mental health.

Hellmuth was arrested Oct. 4 following a blow-up with a Bainbridge Island neighbor and a violent confrontation with the arresting officer. A judge ruled Hellmuth was not competent to face charges and ordered her to Western State Hospital for treatment, but a lack of bed space forced her to remain in jail on a wait list through the holidays. Hellmuth's family said she was finally transferred to Western on Friday.

A federal judge ruled Dec. 22 in a civil case challenging the wait lists that holding mentally ill people in jails without treatment violates their constitutional rights, but Washington has yet to implement changes. Hundreds of people like Hellmuth remain jailed awaiting competency evaluations, some up to 13 weeks.

Judy Snow, the Pierce County Jail's mental health manager, has seen no change in the number of people awaiting transfer. As of Dec. 31, they had 26 people - six who have waited more than 30 days. Some state judges have held the state in contempt for failing to follow their orders for evaluations and treatment and have levied fines of more than $200,000.

Anita Khandelwal, an attorney at the Public Defender Association, said the situation is unacceptable.

"In its order, the court sent a strong message that the state is violating the rights of mentally ill defendants," Khandelwal said. "The current waitlists speak for themselves."

Jane Beyer, an assistant secretary for the Department of Social and Health Services, said holding mentally ill people in jails for extended periods of time is "indefensible," but said they lack the resources to adequately handle the competency cases.

"We do not want people sitting in jail for 100 days, but every forensic bed is full and the state forensic hospital is facing a fiscal shortfall," Beyer said.

Gov. Jay Inslee is including additional funding to help fix the problem in his next budget, she said, including funding for three evaluators and a new 30-bed ward at Western.

"Now we need the Legislature to support us," she said.

Sen. Steve O'Ban, a Republican who chairs the Human Services, Mental Health & Housing Committee, said making sure mental health receives needed funding is his "top priority."

"I have proposed legislation that would use marijuana sales tax revenues to increase spending on essential, mental health care services," he said in an email.

Bainbridge Island historian Gerald Elfendahl, a friend of Hellmuth's since 1970, said she is a good person from a well-respected family.

"Her family has done a lot here," he said.

Karen Hellmuth's mother, Elane, was considered an environmental hero who also established the island's first school for mentally disabled children. Karen Hellmuth helped start the area's first food co-op and recycling program, he said. But after her mother died in 2011 and she lost part of her property to foreclosure, Karen Hellmuth has struggled.

Elfendahl says Hellmuth sometimes acts out aggressively, but he believes it's a reaction to tough times.

Senji Kanaeda, a Buddist monk who runs a small temple next to Hellmuth's home, has been frightened by her aggression. She is sometimes friendly, he said, but other times she lashes out with racist comments or violent outbursts.

Elfendahl said Hellmuth, being a woman living alone in the woods, was nervous about the men who came to stay at the temple. That contributed to the friction with Kanaeda.

Another neighbor, Steve Clark, said when Hellmuth "started to go downhill," she would talk about aliens and other nonsensical topics, but he thought she was harmless.

Hellmuth's newest neighbor, the one who bought her foreclosed property and built a new house, said she was a threat to his family's safety.

Sandy Charyn said he retired two years ago from a 40-year career in mental health. Although he knew Hellmuth was having troubles, he and his social worker wife believed they could handle the situation. But when Hellmuth trespassed and complained to his wife about a small garden and trees with "evil spirits," he called the police.

"She had gotten more psychotic and was terrorizing the neighborhood," he said.

When Bainbridge Island Police Officer Maurine Stitch responded to the Oct. 4 call, she encountered a woman who would not cooperate, said Police Chief Matthew Hamner. When Stitch tried to use her Taser to slow Hellmuth down, "she round-housed her." Hamner said.

Hamner said the police know the people in the community and who is likely to have a psychotic episode, but the threshold is so high for civil commitments they have to wait until someone breaks the law before they can hold them. In Hellmuth's case, neighbors kept calling, but the police were not able to step in until the October outburst.

"Karen came to see me a couple of weeks before this happened," Hamner said. "I could tell things were not quite right ... Two weeks later this occurred. Neighbors felt threatened, but we could not get help for her."

Hellmuth will receive treatment at Western State Hospital, but before she was transferred her lawyer Steven Lewis said she spent weeks in "solitary confinement" in a small cell for 23 hours a day.

Jason West, Hellmuth's son who traveled from London to visit his mother over the holidays, was not happy about his mother's incarceration.

"I am very surprised that mom has been in jail for over three months without medical treatment," he said in an email. "The mental health system in Washington state is broken."

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