DSHS - Children's Mental Health-Frequently Asked Questions
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Children's Mental Health-Frequently Asked Questions

How do I get Mental Health Services for my Child?

For a life-threatening emergency, call 911.

Suicide Prevention 1-800-273-8255 TTY Users 1-800-799-4TTY (4889)

For 24-hour help for crisis counseling and referrals:
Call the Recovery Help Line OR the Crisis Line in your area:

If this is not a crisis:
Please contact your local Mental Health Provider or Regional Support Network


  • Children and adults qualify for medically-necessary mental health services through their RSN if they are covered by Medicaid.
  • RSNs are managed care plans for mental health services.  They coordinate mental health services in their service area through contracts with community mental health agencies
  • Other people who do not qualify for Medicaid, but have a serious or long-term mental illness, can receive services as resources allow.
  • All citizens of the state qualify for crisis mental health services, disaster response services, and involuntary treatment services.

Community mental health agencies provide mental health services through contracts with the Regional Support Networks. Services could be provided at the mental health agency, in your home, or elsewhere in the community.  Treatment services should be individualized and tailored to meet the needs of your child and family.

Treatment may include:

  • Brief intervention or individual treatment: A solution focused, outcomes oriented, time limited intervention designed to achieve goals identified in the treatment plan.
  • Medication management: The prescribing and/or administering and reviewing of medications and their side effects.
  • Medication monitoring: Cueing, observing, and encouraging consumers to take their medication as prescribed and reporting back to persons licensed to perform medication management services.
  • Psychoeducation: A set of activities that teach and explore the provision of emotional support, education, reducing stressors, resources, and problem solving skills to consumers and their family members.
  • Group treatment: Face-to-face activities provided by one or more staff to two or more individuals under the supervision of a mental health professional.
  • Family support: Support groups and advocacy to families to which there is a seriously disturbed child or adolescent.
  • Other services and supports as defined in the treatment plan.
  • 24-Hour Telephone Crisis Evaluation and Triage
  • Mobile Crisis
  • Referrals
  • Crisis Plans

• Acute psychiatric inpatient treatment is provided in a community hospital or a certified freestanding Evaluation and Treatment facility (E&T facility)  when a child or adolescent is in need of immediate inpatient mental health services due to the acuity of their mental illness.

• For publicly funded services, a medical necessity determination is made by the RSN/PHP or Designated Mental Health Professional (DMHP).  For privately funded services, the family's insurance company makes that determination. The length of stay in the hospital is variable, depending upon the child's needs.

• The state of Washington defines medical necessity for inpatient care as "a requested service which is reasonably calculated to diagnose, correct, cure or alleviate a mental disorder or prevent the worsening of a mental condition that endanger life or cause suffering and pain or result in illness or infirmity or threaten to cause or aggravate a handicap, or cause physical deformity or malfunction and there is no adequate less restrictive alternative available." RCW 71.34.020 (12)

• For publicly funded admissions, the RSN or the DMHP  determines medical necessity for acute psychiatric care.

• The CLIP Administration  makes determination of medical necessity for voluntary long-term inpatient care regardless of whether the child has public or private insurance.

• For both levels of care, adolescents committed for 180 days of involuntary inpatient treatment have been determined to meet medical necessity through the detention and commitment process as defined in RCW 71.34.750

• Federal requirements apply to all inpatient services provided to Medicaid clients.

• To be eligible for public funds to help pay for acute inpatient treatment, the family must qualify for public assistance through the local DSHS Community Service Office.

• All minors certified for admission to publicly funded CLIP  beds are eligible for Medicaid.

• YES: The referral process, the prior authorization process, and the process of obtaining consent are the same regardless of who initiates the referral.
o School district personnel who refer minors to an inpatient treatment program must notify the parents within forty-eight hours. RCW 71.34.500-530.

• A child in the legal custody of the Division of Children and Family Services may be referred by their Department of Social and Health Services (DSHS) social worker. However, the child's parent must provide the consent for the admission. In an emergency and if the parent is unavailable, the social worker may give consent for an inpatient admission. However, a court hearing must occur by the next judicial day and a judge must authorize that emergency consent. A judge cannot order any child into inpatient treatment except in accordance with RCW 71.34.

COORDINATED SERVICES:


Families may be involved in more than one child-serving system (i.e. special education, child welfare, juvenile justice) and can benefit from a coordinated planning that is thorough and comprehensive and reduces overlapping or conflicting assessments, plans, time limits, and requirements. Such a coordinated plan enhances achievement of family self-sufficiency and stability and thus supports the best interests of the parents/guardian and child.

Information coming soon...

• Child and Family Team or Wraparound is NOT a program, a type of service, or family therapy. It is a process based on the idea that services should be tailored to meet the needs of children and their families. There is an underlying value and commitment to create services and supports "one kid at a time" to promote community-based options to support children and youths with complex needs and their families.

• Often one or more agencies are involved with the family and work collaboratively with them and others who are close to the family. They function as a team to support the family and each other, working towards common goals.

FAMILY DRIVEN CARE:


Family-centered care and supports are developed with the philosophy that recognizes the pivotal role of the family in the lives of children. This approach ensures that families are supported in the natural care giving and decision-making roles for their children by building on their unique strengths as people.

Information coming soon...

AGE WHEN A YOUTH MAKES DECISIONS ABOUT TREATMENT:


If your adolescent is over thirteen, be aware he or she will be asked to sign a release of information before you can access your adolescent's mental health records.RCW 70.02 and RCW 71.34

• Youths age 13 and older can request outpatient services without the consent of the minor's parent. RCW 71.34.500

• Parental authorization is required for outpatient treatment of a minor under the age of thirteen. RCW 71.34.500

• YES: A parent may bring his or her minor child to a provider of outpatient mental health treatment and request that the minor be examined to determine whether the minor has a mental disorder and is in need of treatment. The consent of the minor is not required for evaluation. RCW 71.34.600

• The professional person may do an assessment to determine whether the minor has a mental disorder and is in need of outpatient treatment. RCW 71.34.600

• Community mental health centers primarily serve publicly funded clients. If you have private insurance, you may be eligible for services at a community mental health agency or one of your insurer's preferred providers.

• For publicly funded services, an appointment is necessary.

No, you are not financially liable if you have not given consent. Once you give consent, you may be financially liable unless your child or adolescent is eligible for Medicaid.

• Admission to any inpatient setting requires a determination of medical necessity, financial eligibility, and willingness of the program to admit the youth.

• The following are referred to as voluntary admissions:
o For all minors under 13 years of age, a parent must give consent.
o A minor 13-18 years of age and their parents may jointly give consent.
o A minor 13-18 years of age may give consent for admission without parental agreement.

• The treatment facility must notify the parents in a way that will most likely reach the parent within twenty-four hours of the admission. RCW 71.34.044

• Involuntary admission:
o In the event of any minor 13 years of age or older (and/or his/her parent) refuses admission, the minor may be evaluated and detained involuntarily by a DMHP (DMHP)  in accordance with RCW 71.34.
o If the DMHP makes a decision that the minor does not require inpatient treatment, the parent can seek review of that decision made by the DMHP in court. RCW 71.34

• Parent initiated admission
(an option created in 1995 through legislation known as the At Risk Youth or "Becca" bill):
o A parent may give consent for admission of their minor child. The consent of the minor is not required. RCW 71.34
o A parent may give consent for continued in patient care in the event his/her previously unwilling minor child requests discharge during an inpatient stay. RCW 71.34
o Providers are not obligated to provide treatment to a minor under the provisions of this section. RCW 71.34 (4)
o This is NOT considered an “involuntary admission” in spite of the fact it is against the minor's will.

YES: A parent may bring a minor in acute need of inpatient care to an evaluation and treatment (E&T) facility  and request that the professional person examine the minor to determine whether the minor has a mental disorder and is in need of inpatient treatment.  RCW 71.34.600-660(1)  NOTE: There are very few acute inpatient evaluation and treatment facilities in Washington State. A parent may NOT bring a minor to a CLIP facility for an assessment because CLIP  facilities do not provide emergency or urgent care. They only provide long-term inpatient care.

The consent of the minor is not required for admission, evaluation, and treatment if the parent brings the minor to the facility. RCW 71.34.600-660(2) 

A minor cannot be admitted to inpatient treatment unless it is medically necessary as a result of a mental disorder. RCW 71.34.052 (4) Prior approval by the RSN is necessary for all admissions for publicly funded treatment in acute inpatient facilities.

• While the law states that a parent can authorize the bringing of his or her minor child to an evaluation and treatment facility, it does not establish specific procedures, responsibilities or funding for transporting minors to an evaluation and treatment facility for evaluation of medical necessity for admission. It does not require law enforcement to transport or apprehend minors in these circumstances.

• When called upon to assess whether a minor needs involuntary treatment, a DMHP may take the minor or cause the minor to be taken into custody and transported to an Evaluation and Treatment facility providing inpatient treatment. RCW 71.34.600-660

• If the minor is not taken into custody for evaluation and treatment, the parent can seek review of the decision made by the DMHP in court. RCW 71.34.600-660

Parents have the right to participate in hearings and be represented by counsel when decisions are made to involuntarily commit their minor. After the hearing, the final decision of the court is binding.

• A minor thirteen years or older may admit himself or herself to an evaluation and treatment facility for inpatient mental health treatment without parental consent. RCW 71.34.500-530

• The professional person in charge of the facility must agree that inpatient treatment is necessary because of a mental disorder and that it is not feasible to treat the minor in any less restrictive setting or the minor's home. RCW 71.34.500-530

• Written renewal of voluntary consent must be obtained every twelve months and the need for continued inpatient treatment shall be reviewed and documented every one hundred and eighty days. RCW 71.34.500-530. NOTE: Given the short stays in acute inpatient care, this rule only applies to minors being served in CLIP  facilities. Even in a CLIP facility, this type of admission rarely, if ever occurs.

The treatment facility must notify the parents in a way that will most likely reach the parent within twenty-four hours of the admission. RCW 71.34.500-530

• Any minor thirteen years or older who voluntarily admitted to an evaluation and treatment facility with the consent of his/her parents may give notice of intent to leave at any time.
o The notice has to be written and intent discerned.
o The professional person must discharge the minor from the facility immediately upon receiving the notice of intent to leave. RCW 71.34.500-530

• Any minor thirteen years or older who voluntarily admitted to an evaluation and treatment facility without the consent of his/her parents may give notice of intent to leave at any time.
o The notice has to be written and intent discerned.
o Copies of the notice shall be sent to the minor's attorney if any, the DMHP  and the parent.
o The professional person shall discharge the minor by the second judicial day following receipt of the minor's notice of intent to leave. RCW 71.34.500-530

• Under a “parent-initiated” admission :
o A minor receiving inpatient treatment cannot be discharged from the facility based solely on his or her request. RCW 71.34.052.
o The minor admitted under this section may, however petition the superior court for release from the facility. RCW 71.34.052 (6)

• Minors involuntarily committed for 180 days of inpatient treatment cannot legally sign themselves out of treatment.

WHAT IF MY CHILD HAS SUBSTANCE USE PROBLEMS AND MENTAL HEALTH ISSUES?


Both the public mental health and chemical dependency  (DBHR youth substance abuse services)  systems have specialists able to assess and diagnose a range of disorders. In the past few years, there has been an increase in the number of mental health providers that are also chemical dependency providers.

CONCERNS ABOUT MY CHILD'S CARE


Your adolescent can:

  • File a grievance with the inpatient provider.
  • File a grievance with the Mental Health Ombuds  service from his/her home region.
  • Apply for a fair hearing.
  • The adolescent may seek the assistance of his or her attorney.