New Program Offered Through Seattle Children’s Connects Families to Local Mental Health Providers

Growing demand for child and adolescent mental health care is, unfortunately, coupled with a severe shortage of providers. Families, especially those in rural and semi-rural areas, routinely face long waits to see a local provider or long drives to an out-of-area provider, or simply go without care.

To help, Seattle Children’s in March began partnering with Washington state on a new referral service. Washington’s Mental Health Referral Service for Children and Teens connects families to licensed providers in their local area with current availability who fit a child’s mental health needs and insurance coverage. Washington Healthcare Authority funds the referral service, and Seattle Children’s operates it.

The free, telephone-based referral service works closely with the existing Partnership Access Line (PAL) mental health consult line at Seattle Children’s. We make referrals for children and teens 17 and younger from across Washington, connecting families with evidence-supported outpatient mental health services in their community.

How to Access Washington’s Mental Health Referral Service for Children and Teens

Families can call 833-303-5437, Monday through Friday from 8 a.m. to 5 p.m. Pacific time, to connect with a referral specialist.

  • We will ask your patient for information including their mental health needs, location and health insurance plan.
  • Within 7 business days, a referral specialist will call and email the family with at least 2 providers who fit their needs and have openings.
  • We’ll also fax the referral suggestions to you.
  • Within 2 weeks, we’ll follow up with your patient’s family to see if they were able to make an appointment and provide further assistance if needed.

Or, as part of a PAL consultation call, primary care providers can request that we connect your patient with mental health providers in their local area who can meet their needs. We will ask about your patient’s needs, location and health insurance plan. We will follow up with the family to complete the intake process.

For complete information, including how the referral service identifies providers and what therapies providers offer, click here.

Caring for Transgender Youth

A Q&A With Dr. Juanita Hodax

Dr. Juanita Hodax

Juanita Hodax

Who needs to make the referral, and what happens once the referral is placed?

Dr. Juanita Hodax, physician, Seattle Children’s: A patient can be referred to the Gender Clinic by one of their providers, or they can self-refer. Once a referral is placed, they will receive a call to first schedule an intake call with a social worker who is the Gender Clinic care coordinator. During the intake call, we get a brief history and discuss goals of the appointment and provide resources (for mental health providers, local community resources, etc.) that may be helpful to the patient and family even before they have their appointment. After the intake call is done, an appointment with a medical provider is made.

What ages do you see?

Dr. Hodax: We see pediatric patients up to age 21 years old. As patients approach age 21, we work with them to find an adult provider who can take over the management of their transgender care. Many times, this is a primary care provider who has some experience in transgender care.

Does a patient need parent permission to get services from the Gender Clinic, and if not, at what point does the parent need to be involved?

Dr. Hodax: While some treatments require parental consent for patients under the age of 18 years, some treatments are available to patients without formal parental consent. Gender-affirming hormones (estradiol or testosterone) do require parental consent from all parents who have medical decision-making power, because these treatments have the potential for irreversible long-term effects. Puberty blockers (Lupron injections or histrelin implant) are a reversible treatment but do require parental consent, as patients are typically at a younger age when this treatment is being considered.

Complete parental consent is not required for medications used to suppress menstrual cycles in transgender boys or for some testosterone blockers in transgender girls. Parental permission is also not required to schedule an appointment in the Gender Clinic. However, our providers and our social work team try very hard to work with parents to help them understand why treatment is important and necessary for their child. Read full post »

New Clinical Standard Work Pathway for Suicide

Suicide is the second leading cause of death in children and adolescents ages 10 to 24. Screening for suicide is now a requirement of hospital accreditation organizations DNV Healthcare and The Joint Commission.

In March 2019 Seattle Children’s began universal, standardized suicide risk screening and triage for patients ages 10 and older who are seen in our Emergency Department (nonacute) or admitted as an inpatient. Read more about Seattle Children’s Zero Suicide Initiative Pathway.

For questions about this Pathway, please email ZeroSuicideInitiativePathway@seattlechildrens.org.

Research Findings: Smoking During Pregnancy Doubles the Risk of Sudden Unexpected Infant Death Syndrome (SUID)

The first findings to result from a collaboration between Seattle Children’s Research Institute and Microsoft data scientists provide expecting mothers new information about how smoking before and during pregnancy contributes to the risk of an infant dying suddenly and unexpectedly before their first birthday.

According to the study published in Pediatrics, any amount of smoking during pregnancy — even just one cigarette a day — doubles the risk of an infant dying from SUID. For women who smoked an average of 1 to 20 cigarettes a day, the odds of SUID increased by 0.07 with each additional cigarette smoked.

Dr. Tatiana Anderson

Tatiana Anderson

“With this information, doctors can better counsel pregnant women about their smoking habits, knowing that the number of cigarettes smoked daily during pregnancy significantly impacts the risk for SUID,” said Dr. Tatiana Anderson, a researcher in Seattle Children’s Center for Integrative Brain Research and lead author on the study. “Similar to public health campaigns that educated parents about the importance of infant sleep position, leading to a 50% decrease in sudden infant death syndrome (SIDS) rates, we hope advising women about this risk will result in [fewer] babies dying from these tragic causes.”

Ongoing Research: Examining the Link Between a Baby’s Microbiome and Developing Immune System

Scientists at Seattle Children’s Research Institute are looking for new clues in an important indicator of overall infant health — a baby’s developing immune system and microbiome.

Ongoing research not only examines how an infant’s microbiome can evolve to help protect against HIV infection but also what factors, such as diet, alter an infant’s susceptibility when exposed to HIV through their mother’s breast milk. Read more about the research being conducted by Dr. Heather Jaspan of Seattle Children’s Center for Global Infectious Disease Research.

PAL Expands Child and Adolescent Mental Healthcare to Alaska

Seattle Children’s Partnership Access Line (PAL) program has expanded to serve Alaska.

The new service, PAL-Pediatric Alaska (PAL-PAK), offers immediate support to pediatric care providers (doctors, nurse practitioners and physician assistants) throughout Alaska who have questions about child and adolescent mental healthcare, such as diagnostic clarification, medication adjustment or treatment planning.

Consultations can be patient specific or can be general questions related to child psychiatry. The phone consultation is covered by HIPAA, section 45 CFR 164.506; no additional release of patient information is required to consult by phone.

There is no charge to primary care providers for calling the consultation line; the consultation service is state and federal HRSA* grant funded. Providers may call for assistance with any patient, regardless of the patient’s insurance type.

Please call 855-599-7257 (toll free), Monday through Friday, 7 a.m. to 4 p.m., Alaska Time, to be directly connected to a child and adolescent psychiatrist.

*HRSA disclaimer: This resource is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $2,215,029 with 20% financed with nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, HRSA, HHS or the U.S. government. For more information, please visit HRSA.gov.

New Referral Information for Autism Center

In response to growing demand for services, our Autism Center has created a new page to help providers understand and use the Autism Center’s referral process. The webpage contains the forms and fax numbers needed to make a referral and helps providers understand what their patients can expect once their referral is submitted. It also links to helpful resources families can access while they wait for their first appointment.

Families who are referred to the Autism Center receive a call when an appointment becomes available. Families are also welcome to ask to be placed on our cancelation list to help them get in sooner. We recently created this 2-minute, “What to Expect” video for the Autism Center that providers are welcome to view and share with their patients.

If you have questions, call the Autism Center. Or you are always welcome to call the hospital’s provider-to-provider line at 206-987-7777 or 877-985-4637 (toll free) for any reason or for a consultation.

Register Today for 15th Annual Pediatric Bioethics Conference

The Treuman Katz Center for Pediatric Bioethics will host the 15th Annual Pediatric Bioethics Conference July 19 to 20, at the Bell Harbor International Conference Center in Seattle. This year’s theme is “Defining Moments in Pediatric Bioethics: Future Insights From Past Controversies.” Join a distinguished group of bioethicists for challenging and illuminating presentations and discussions exploring the complex questions this topic raises. Abstracts must be submitted by May 10 and early registration pricing ends June 14. To learn more and to register, visit the Pediatric Bioethics Conference website.

Grand Rounds April 2019

Seattle Children’s holds Grand Rounds every Thursday in the hospital’s Wright Auditorium from 8 to 9 a.m. Area providers are welcome to attend.

The month ahead:

  • April 4, 2019: The Impact of Childhood Chronic Diseases on Skeletal Development: A Life Course Perspective (Resident/Fellow Research Day)

Mary Leonard, MD, MSCE – Arline and Pete Harman Professor and Professor of Medicine (Nephrology); Health Research and Policy (Epidemiology); Chair of Pediatrics, Stanford

  • April 11, 2019: High Maintenance?! Nephrological Thoughts About the Tonicity of Intravenous Fluids

Jens Goebel, MD – Professor, Pediatrics-Nephrology, University of Colorado

  • April 18, 2019: Is My Daughter a Virgin? An Ethical Analysis of a Loaded Question (Sconyers/Godfrey Ethics Lecture)

Dena Davis, JD, PhD – Professor, Bioethics; Presidential Endowed Chair in Health, Lehigh University. Case Presentation: Doug Diekema, MD, MPH; Professor, Bioethics; Professor, Emergency Medicine, Seattle Children’s. Moderator: Doug Opel, MD, MPH; Associate Professor, Division of Bioethics Department of Pediatrics, Seattle Children’s Read full post »

Video Education

Seattle Children’s videos are produced for informational, educational and knowledge-sharing purposes. Some of our recently produced videos that you may find of interest include: