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There’s been a jump in the number of people accused or found guilty of crimes being referred to forensic wards at state mental hospitals over the past year — and no one can say exactly why, The News Tribune reports.

Forensic wards are for mentally ill people accused or convicted of a crime. They’re referred there to find out if they’re fit to stand trial. If they’re not, they’re given treatment with the hope that it will allow them to stand trial.

In 2016, 1,450 patients were referred to forensic wards in Washington state, compared to 1,076 in 2015. That’s an unusual 35 percent increase; in previous years, the increases have ranged from as low as less than one percent to just over 10 percent. Data from 2017 shows there’s been a jump this year as well.

The director of the state office of Forensic Mental Health Services Thomas Kinlen told The News Tribune that it’s hard to tell what’s behind the increase in referrals. There could be a lot of factors, including “struggles with opioid addiction, greater recognition of mental health problems, or practices by defense lawyers.” A Republican state lawmaker suggested that law enforcement may have gotten better at getting people into the mental health system.

The increase in referrals to forensic wards puts a strain on state psychiatric facilities, which are already crowded with long wait lists for care. As a result, people accused of crimes who may need mental health treatment have been stuck in local jails without care.