Office of Forensic Mental Health Services

The Office of Forensic Mental Health Services - OFMHS is responsible for the leadership and management of Washington’s adult forensic mental health care system. The OFMHS provides forensic evaluations, competency restoration, Not Guilty by Reason of Insanity - NGRI treatment services, and liaison services to effectively coordinate efforts with system partners to meet shared goals. The OFMHS is supported by RCW 10.77.280. View the OFMHS organizational chart.

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The mission of OFMHS is to lead and manage a system of forensic mental health care that assists the courts and justice system to protect both public safety and the rights of accused mentally ill persons, by providing timely, high quality, and data informed mental health services.

The vision of OFMHS is to lead the nation in innovative and quality forensic mental health services.

For information on forensic programs outside of OFMHS, please see RCW 71.05 which covers felony conversions and violent felony conversions, and RCW 71.09 which covers sexually violent predators.

What does OFMHS do?


The OFMHS works in collaboration with the Governor’s office, state agencies, community partners, and stakeholders to lead and implement robust diversion efforts to prevent citizens with mental illness from unnecessarily entering the criminal justice system. The Office has a vested interest in the protection of defendant rights, the efficient delivery of necessary behavioral health services, and public safety. The OFMHS focuses diversion initiatives around four goals: 1) preventing individuals with behavioral health issues from recidivism and frequent involvement in the criminal justice system; 2) reducing the demand for competency services; 3) reducing long-term incarceration for individuals with behavioral health issues; and 4) serving defendants in the least restrictive environment possible.


The Triage Consultation and Expedited Admissions - TCEA process is a mechanism by which a defendant who is in custody could be admitted to the hospital more quickly if it is determined that they require additional psychiatric intervention. If you are a jail or defense counsel who believes that an in-custody defendant awaiting inpatient competency evaluation or competency restoration services is currently in danger related to life-threatening psychotic symptoms, and/or has active suicidal intent or action, please click here.

Competency Evaluations

Washington State law requires that a defendant be mentally competent to stand trial. In following the Dusky standard, a defendant must have both a logical and rational understanding of the court proceedings against them, and also be able to meaningfully assist her/his attorney in their own defense. When such competence is called into question, the court may order that a competency evaluation be completed to determine if the person is indeed competent, or if they are not currently competent as the direct result of a mental disease or defect. OFMHS staff includes 43  Forensic Evaluators who perform these specialized evaluations. Community competency evaluations may also be ordered by approved Counties as stipulated in RCW 10.77.073.

Competency Restoration Treatment

Roughly half of our competency evaluations result in a finding that the individual is not competent to stand trial. In these cases, the court may order the person into competency restoration treatment. DSHS provides competency restoration treatment at Western State Hospital, Eastern State Hospital, and also at two Residential Treatment Facilities - one in Yakima and one at the former Maple Lane School near Centralia.

Not Guilty by Reason of Insanity (NGRI) Assessment and Treatment

An NGRI plea occurs when a defendant is competent to stand trial, but evidence supports that their mental health symptoms were highly acute at the time of the alleged crime, and they are therefore requesting that the court consider them not guilty of the crime. For example, the defendant might describe suffering from delusions or hallucinations that directly led them to commit the alleged crime. When an NGRI plea is entered, the court hears testimony presented by prosecution and defense, and then a decision as to whether or not the person is found NGRI is reached. If not NGRI, and the person is found guilty, the court will sentence the defendant per usual procedures. However, if the court finds the individual NGRI, then the individual is remanded to the custody of DSHS and is placed into an NGRI treatment ward at either Western State Hospital or Eastern State Hospital. State psychiatric hospitals are now working to improve NGRI treatment services as per the Ross Settlement Project.

Quality Improvement

The Office of Forensic Mental Health Services Quality Team is tasked with conducting quality reviews of forensic services that fulfill statutory obligations under RCW 10.77.280. The quality reviews focus on best practices and inform improvements to the quality of forensic mental health services within the state of Washington.

Workforce Development and Training

Essential for an effective forensic mental health care system is a well-trained, competent, and quality-focused workforce. The OFMHS develops, implements and oversees a statewide, systematic and comprehensive forensic mental health services workforce development program, to include competency evaluation, competency restoration, forensic risk assessment and NGRI treatment. In addition to training the workforce, the OFMHS recognizes the value of training the broader community regarding forensic mental health services and processes. Training is also provided to the courts, attorneys, legislative staff, and other involved stakeholders.

Hot Topics

Trueblood et al v. Washington State DSHS

Ross Settlement Project

Partner Resources

Forensic Mental Health Guidebook Telehealth Implementation Guidebook
Forensic Guide Health Guidebook


Communications with Stakeholders

Related Statutes and Legislation

  • SB 6656 (2016) – An act relating to the reform practices at state hospitals.
  • SB 5177 (2015) - An act relating to improving timeliness of competency evaluation and restoration services by clarifying alternative locations for the provision of competency restoration services and defining time periods of commitment.
  • SB 6492 (2012) – Improving timeliness, efficiency, and accountability of forensic resource utilization associated with competency to stand trial
  • RCW 10.77 – Criminally Insane - Procedures