In 1990, the Washington Supreme Court upheld Washington State laws allowing prison and jail officials to have compelled medications policies. The State Department of Corrections policy requires that a psychiatrist determine that the use of medication is essential to treatment and that an inmate who refuses medications have a board hearing. However, the King County Correctional Facility clearly does not meet the criteria of a treatment facility. The psychiatric unit's staffing consists of three nurses, who assess the inmate's mental status at intervals ranging from daily to weekly. The most acutely ill inmates are housed in single cells measuring 7 by 10 feet and are allowed out of their cells 1 hour per day and for variable times to meet with attorneys and visitors. In addition, it is unethical to prescribe medications for people when avenues for appropriate follow-up and monitoring of their effects are not available. The short-term nature of jail incarceration does not permit the development of rapport between inmates and care providers. Practical problems and costs are further barriers to the use of compelled medications. 9 references