Mental Health

From: Dr. Jeff Ojemann, SVP and Chief Medical Officer, Dr. Ruth McDonald, VP and Associate Chief Medical Officer (Hospital Operations) and Dr. Tony Woodward, ED Medical Director

The ongoing youth mental health crisis is contributing to high patient volumes, high patient acuity and significant boarding in our Emergency Department (ED).

1. Patients experiencing an emergency should come to the ED without hesitation.
2. We have re-activated an Emergency Operations Center to ensure systemwide coordination as our leaders and teams address extreme capacity constraints in the ED with multiple, simultaneous approaches.
3. The Psychiatry and Behavioral Medicine Unit (PBMU) currently has limited capacity due to ongoing facility improvements for patient safety. Patients who require a psychiatric inpatient admission will be referred to all appropriate inpatient pediatric psychiatric facilities in Washington State. 
4. Please continue to identify and manage lower acuity complaints in outpatient settings to help maintain our limited capacity in the ED for higher acuity concerns.
5. When sending your patient to the ED, please contact our Mission Control team at 206-987-8899 and alert families to potentially expect longer-than-normal wait times.

For More Information:  Resources that may help providers manage patients in primary or urgent care instead of sending to the ED:

1. Emergency or Urgent Care Referral Guide
2. For urgent medical care not related to mental and behavioral health, remind families to schedule an in-person or virtual Urgent Care appointment as early as possible to help them get timely access. They can use the UC online scheduling system or call the hospital’s main number at 206-987-2000.
3. Algorithms and other PCP resources for 65+ conditions
4. The Partnership Access Line (PAL) supports primary care providers (doctors, nurse practitioners and physician assistants) with questions about mental health care such as diagnostic clarification, medication adjustment or treatment planning. Our child and adolescent psychiatrists are available to consult during business hours.
5. The Washington Mental Health Referral Service connects patients and families with evidence-supported outpatient mental health services in their community. This free, telephone-based referral service provides thorough mental health referrals for children and teens 17 and younger from across Washington.
6. First Approach Skills Training (FAST) programs are designed to provide brief, evidence-based behavioral therapy for youth and families with common mental health concerns, in settings such as primary care clinics or schools where longer-term treatment is not typically provided. Program materials, as well as engagement and assessment tools for Mental Health Clinicians are available on the FAST Website.
7. Seattle Children’s online mental health hub: provides resources for families and caregivers to reference for their child’s mental health and wellness. You can learn about common mental health problems in children and teens, how to recognize the signs of a problem and crisis, and learn how to help your child or teen as well as what services are available.
8. Family Resource Center – Child Mind Institute: provides information families and caregivers to help support children who are struggling with mental health, behavior or learning challenges.
9. Strategies for Clinical Settings for Youth Suicide Prevention (aap.org): provides a clinical pathway for addressing suicide prevention in pediatric practice.
10. Mental Health Practice Tools and Resources (aap.org): provides resources to help providers promote healthy mental development and address mental health concerns.

OCD Intensive Outpatient Program Now Has Openings for New Referrals

Seattle Children’s Obsessive-Compulsive Disorder (OCD) Intensive Outpatient Program (IOP) is once again being offered in person and is open for referrals. Offered at Seattle Children’s Magnuson building across from Magnuson Park, the program offers evidence-based cognitive behavior treatment for children and teens ages 11 to 18 (or older if they are still in high school). Participants must already be diagnosed with OCD and anxiety and not been able to make progress in regular outpatient treatment. To refer a patient, please write “OCD IOP evaluation” for the quickest routing within Psychiatry.

For more information, view the OCD-IOP program flyer, which includes detailed referral criteria.

4 FAST Trainings in April and May

The First Approach Skills Training (FAST) team is offering live, interactive trainings for managing common youth mental health conditions. FAST programs are designed to provide brief, evidence-based behavioral therapy for youth and families in primary care clinics and other settings where long-term treatment is not usually offered. The training is free.

• April 4: 9 to 11 a.m. – FAST-Depression (learn more and register)
• April 18: 8:30 to 11:30 a.m. – FAST-Trauma (learn more and register)
• May 9: 9 to 11 a.m. – FAST-Parenting Teens (learn more and register)
• May 16: 9 to 11 a.m. – FAST-Early Childhood Concerns (learn more and register)

Providers can learn more about FAST and access free assessment tools for initial screening, treatment planning and progress monitoring on the FAST website. Program materials were developed by a team of child and adolescent psychologists with funding support from the Washington State Healthcare Authority. Please direct any questions to FAST@seattlechildrens.org.

4 Free “Finding Mental Health” Classes for Families, April–July

Nationally, one in five children and teens has a treatable mental health disorder, and half of these are not receiving help from a mental health professional. “Finding Mental Health Care in Washington State” is a free two-part class series from Seattle Children’s focused on educating families about resources outside of Seattle Children’s to help families connect to care as quickly as possible. Classes are 30 minutes. Families do not need to take Part 1 to take Part 2. Registration is required. Video recordings of the classes, without Q&A, are available on our website in English and Spanish.

• April 19: Part 1 – Outpatient Services (English)
• May 17: Part 1 – Outpatient Services (Spanish)
• June 21: Part 2 – Higher-Level Services (English)
• July 19: Part 2 – Higher-Level Services (Spanish)

Please share this class information with any families who may be interested. More information is available on our website.

“You Are a Miracle”: One Patient’s Journey With an Eating Disorder

Read the inspiring story of 19-year-old Emme’s personal experience at Seattle Children’s, in her own words — from diagnosis to ongoing recovery and the lessons she learned along the way.

Emme’s story reminds us that early intervention and treatment are effective, recovery is possible and many people live healthy, fulfilling lives when they get the right help.

Seattle Children’s Eating Disorders Recovery Program diagnoses and treats children and teens with anorexia nervosa, bulimia nervosa and other eating disorders. All patients referred to the program will receive a one-time telehealth visit with either a medical provider, psychologist or mental health therapist depending on their needs. If you are referring a patient, please review our eating disorder referral guidelines.

New Handout for Families: “5 Most Common ADHD Questions Asked by Parents”

The 5 Most Common ADHD Questions Asked by Parents, written by Seattle Children’s Erin Gonzalez, PhD, addresses common questions from concerned caregivers and parents. It discusses ways to support children with ADHD, school resources and answers common questions about medications. Gonzalez provides links to many ADHD resources for parents and caregivers, including Seattle Children’s videos and classes.

We encourage providers to share this article with patient families who may be concerned about their child with ADHD.

Reminder: Seattle Children’s Mental Health Hub Is a Resource for Providers and Families

Additional resources on common pediatric mental health concerns are available at Seattle Children’s mental health resources hub. To let patients and families know about these resources, print and share our Mental Health Hub flyer, available in both English and Spanish.

Written by Katie Scaff for Seattle Children’s On the Pulse

Seattle Children’s Care Network (SCCN) Integrated Behavioral Health Program helps kids receive behavioral health services from specialists embedded in their primary care clinic.

Seattle Children’s has teamed up with primary care pediatricians in the Puget Sound region to implement a new approach to address the growing youth mental health crisis.

Seattle Children’s Care Network (SCCN) and Seattle Children’s Psychiatry and Behavioral Medicine launched a Pediatric Integrated Behavioral Health Program in 2020 to provide children and their families with the mental and behavioral health support they need earlier and closer to home.

The innovative program aims to empower primary care teams to identify, manage and coordinate mental and behavioral health services within their community settings with the long-term goal of alleviating pressure on hospitals and specialty care practices.

“We know we can make a difference for a significant number of kids with mental and behavioral health conditions,” said Dr. Sheryl Morelli, chief medical officer for Seattle Children’s Care Network. “By screening and treating kids in primary care, when appropriate, more kids can receive treatment and we can create capacity in the system. The program takes a bigger, population health approach to meeting the behavioral mental health need of kids in our community.”

Read full post »

The Partnership Access Line (PAL) is offering another series of free training events for PCPs and primary care–based behavioral health providers in Washington, starting February 28, 2023. The First Approach Skills Training (FAST) team will offer live, interactive trainings for treating anxiety, depression, behavior problems, posttraumatic stress, teen behavior challenges and early childhood concerns in integrated primary care settings.

• February 28, 9 to 11 a.m.:FAST-Behavior (learn more and register)
• March 14, 9 to 11 a.m.: FAST-Anxiety (learn more and register)
• March 28, 9 to 11 a.m.: FAST-Early Childhood Concerns (learn more and register)
• April 4, 9 to 11 a.m.: FAST-Depression (learn more and register)
• April 18: 8:30 to 11:30 a.m.: FAST-Trauma (learn more and register)
• May 9, 9 to 11 a.m.: FAST-Parenting Teens (learn more and register)
• May 16, 9 to 11 a.m.: FAST-Early Childhood Concerns (learn more and register)

FAST programs are designed to provide brief, evidence-based behavioral therapy for youth and families in primary care clinics and other settings where long-term treatment is not usually offered.

Program materials were developed by child and adolescent psychologists Drs. Nat Jungbluth, Erin Gonzalez, Kendra Read, Jennifer Blossom, Jessica Jenness and Maggie Sibley, with funding support from the Washington State Healthcare Authority.

Providers can learn more about FAST and access free assessment tools for initial screening, treatment planning and progress monitoring on the FAST website.

With the 2023 Washington state legislative session underway as of January 9, Seattle Children’s top priority for the session continues to be youth mental health. In particular, we are urging legislators to support a package of recommendations that will prevent children from being stuck in hospitals’ inpatient psychiatric units and emergency departments (EDs) and help them instead be supported at home, in the community or with residential services.

The issue of inadequate services/supports contributing to child abandonment in hospitals is longstanding and felt statewide. Exacerbating the problem has been a change in the legal interpretation of the term “abandoned” by the Washington State Department of Children, Youth and Families (DCYF) in April 2021 wherein state agencies no longer step in when children are abandoned in EDs. As a result of this gap in our system, and no state plan to fill it, we estimate that at least 15 patients at Seattle Children’s stayed longer than was medically necessary, resulting in more than 700 days hospitalized unnecessarily. At both Seattle Children’s and Mary Bridge Children’s Hospital, some patients in this circumstance were admitted unnecessarily for a year or longer.

Read full post »

A family arrives for their first appointment at Seattle Children’s Magnuson

Seattle Children’s is pleased to share that on December 12, 2022, Seattle Children’s Magnuson opened as the new showcase home for Seattle Children’s Autism Center and outpatient behavioral health services.

The new 45,000-square-foot clinic was entirely funded by donations as a result of the vision of Seattle Children’s Generation REACH initiative to transform mental health care for all youth and families.

“Seattle Children’s is working to create a future where every young person has access to evidence-based mental and behavioral health services when and where they need them,” said Dr. Carol Rockhill, medical director, Child and Adolescent Psychiatry Clinics, Seattle Children’s. “Seattle Children’s Magnuson is a huge step in that direction, providing more treatment rooms and clinical spaces, better technology, gathering spaces for families and children with mental health care needs, autism and more.” Read full post »

Wait times are currently low for families requesting assistance from the Washington Mental Health Referral Service for Children and Teens. Families are able to get an intake appointment within a few days, which is about the quickest since the program’s inception in 2019.

After speaking with the intake specialist, families will receive a list within a few weeks of mental health therapists in their local area who are taking new patients and accept their insurance. Even though the entire process may take up to a month, we encourage families to get started by contacting the referral service to get in the queue.

The number to call for an intake appointment is 833-303-5437 (interpreter line: 866-583-1527). Teens who are 13 and older can call the referral service for themselves. An online option is also available.

The service is for children and teens through age 17 who live in Washington state.