Seattle Children’s Autism Center is beginning to restructure its psychiatric medication management program with the goal of reducing long wait times for appointments and improving overall access to care. Wait times for a first-time appointment are currently one year or more. The medication management program is also actively recruiting new providers to fill gaps left by several staff departures last year.

The new medication management program will no longer see patients year after year for ongoing medication management, but will instead aim to provide a short-term, consultative model that helps patients get stabilized and on the right medication program, then return to their primary care provider or a community psychiatrist to receive ongoing medication management. In most cases, patients would require 3 to 5 visits, although patients needing more time to find the right regimen and stabilize would be seen longer.

PCPs who are comfortable managing their patient’s psychiatric medications are offered assistance in navigating the Washington Partnership Access Line (PAL), and will be given a detailed handoff to ensure a smooth transition back to their care. In some cases, patients are directed to a community psychiatrist if their medication provider at Seattle Children’s determines their medication regimen is sufficiently complex or if their PCP isn’t comfortable managing their medications. Seattle Children’s maintains a list of community mental health providers for families seeking ongoing psychiatric medication management, and also uses the Washington Mental Health Referral Service for Children and Teens to help families access local community psychiatrists who accept their insurance.

If a patient destabilizes (i.e. has an extreme change in behavior or cognition, is repeatedly hospitalized, has new mental health concerns, or ongoing suicidality, etc.), then it may be appropriate for them to return to the psychiatric medication management program at the Autism Center. In those instances, we would ask that there be communication between the community provider/PCP and the team at the Autism Center to see whether it is appropriate for the patient to come back for further consultation.

“It’s working smoothly so far,” says Jessica Arambul, BSN, RN-BC with the Autism Center. “Patients and providers have been very receptive. Patients and families like it because when you are discharged from our clinic, it says you’re stable and doing well, and that you don’t need this specialized level of care anymore.”

The Autism Center’s switch to a short-term consultative model is confined to the medication management aspect of its program; patients receiving other services (i.e. general Autism care planning, behavior programming, feeding support, etc.) will continue to have access to that care.

For more information about changes to the psychiatric medication management program at the Autism Center, email Jessica Arambul.