As noted in recent Provider News updates, our Emergency Department (ED) continues to experience high patient volumes and high patient acuity due in large part to the ongoing youth mental health crisis.

A significant number of patients presenting with mental health concerns are having to wait more than 24 hours in the ED for the next step in care, which may be an inpatient bed in our Psychiatry and Behavioral Medicine Unit (PBMU), a transfer to an outside facility or a discharge plan.

Actions We Are Taking

We have been working closely with state partners seeking additional flexibilities in caring for patients presenting with mental health concerns, and the state recently granted those flexibilities.

Meanwhile, Seattle Children’s has reactivated our internal Emergency Operations Center to ensure systemwide coordination as our leaders and teams address the ED challenges with multiple simultaneous approaches.

We would like to once again offer these reminders:

  1. Patients experiencing an emergency should come to the ED (or go to their local ED) without hesitation.
  2. The 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. 
  3. Before sending your patient to the ED, contact our Mission Control team with as much notice as possible at 206-987-8899. Your early call allows the necessary time to plan for your patient’s arrival, and, in appropriate instances, we may be able to directly admit your patient to the hospital or arrange an urgent ambulatory clinic visit in lieu of an ED visit.
  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.

Resources for Providers

Resources that may help you 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 how to help your child or teen as well as what services are available.
  8. Family Resource Center – Child Mind Institute: Provides information for 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 ( Provides a clinical pathway for addressing suicide prevention in pediatric practice.
  10. Mental Health Practice Tools and Resources ( Provides resources to help providers promote healthy mental development and address mental health concerns.


Thank you for your continued partnership.