In August 1976 Walter Harper was sentenced to prison for robbery and incarcerated at the Washington State Penitentiary, where he spent most of his time in the mental health unit and consented to antipsychotic medication.
In 1980 Harper was paroled on the condition that he participate in psychiatric treatment, which he received at Harborview Medical Center and later at Western State Hospital under a civil commitment order. His parole was revoked in December 1981 after he assaulted two nurses at a hospital in Seattle.
Upon his return to prison, respondent was sent to the Special Offender Center, a 144-bed correctional institute established by the Washington Department of Corrections to diagnose and treat convicted felons with serious mental disorders. At the Center, Harper was diagnosed with a manic-depressive disorder and initially consented to treatment, including antipsychotic drugs, but in November 1982 he refused further medication.
The treating psychiatrist then invoked SOC Policy 600.30 to administer the drugs involuntarily after a committee hearing found that Harper suffered from a mental disorder and posed a likelihood of serious harm to others. Harper was involuntarily medicated for about one year beginning November 23, 1982, then transferred to the Washington State Reformatory in November 1983 where he took no medication and his condition deteriorated, prompting his retransfer to the Center and another involuntary medication approval.
He continued receiving the drugs subject to periodic reviews until his transfer to the Washington State Penitentiary in June 1986. In February 1985 Harper filed suit in state court under 42 U.S.C. § 1983 against the State and individual defendants, alleging that the failure to provide a judicial hearing before involuntary administration of antipsychotic medication violated due process and other constitutional provisions.
After a bench trial in March 1987 the trial court upheld the policy's procedures as satisfying due process, but the Washington Supreme Court reversed, holding that a judicial hearing with full adversarial protections and proof by clear, cogent, and convincing evidence was required. The United States Supreme Court granted certiorari in 1989 to review the constitutional questions presented by the state court's decision.