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Mental Health Frequently Asked Questions

 

Feeling Better 
A guide to the mental health system and getting the help you need


  • YES: The best treatments for serious mental illnesses today are highly effective. Between 70 and 90 percent of individuals have a significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports.
  • For children and adolescents, research shows improved functioning and school performance, improved quality of life and reduction in violence and self-destructive behaviors.
  • Treatment also decreased recidivism rates for juveniles previously incarcerated in correctional facilities.

ELIGIBILITY FOR STATE-FUNDED SERVICES


In an Emergency:

  • Call 911 for police assistance if the emergency is life threatening, or may result in immediate physical harm to a person or substantial destruction to property.
  • For 24-hour help for crisis counseling and referrals:
    Call the Recovery Help Line or the 24-hour Crisis Line  in your area.
  • Suicide Prevention - 1-800-273-8255
    TTY Users 1-800-799-4TTY (4889) 
  • When the situation is NOT life threatening:
    Contact your local Regional Support Network 

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

  • Medicaid recipients are automatically enrolled in a local mental health managed care plan which is called the Regional Support Network (RSN). RSNs coordinate mental health services offered within their service area through contracts with community mental health agencies.
  • People who receive Medicaid coupons are eligible for medically necessary mental health services at no cost. Any person needing mental health crisis services is eligible to receive them. If you think that you may need mental health services, you can call or drop by one of the authorized agencies located in the RSN where you live to schedule an appointment to learn what you may need. A list of agencies can be found on the RSN pages. All services must be authorized by the RSN in your area. This process will happen between your agency and RSN.

Hospital and outpatient mental health services are available to you and your family if they are needed. Some of services include:

  • Crisis services;
  • Individual therapy;
  • Group therapy; and
  • Medication evaluation, prescription and management.

You may also receive employment support services, case management and other services through your RSN.

For more detailed information, please call the RSN for your community listed on the RSN pages or call the Division of Behavioral Health and Recovery at 1-888-713-6010.

Interpreter services are available upon request. Most written materials are translated into languages other than English based upon the service area population.

Some community mental health agencies have staff who speak other languages besides English. There is more information on the page for your RSN. If you or someone you know wants services in another language, your RSN must provide language assistance at no cost to you. Assistance can be provided both orally and in writing.

If you need mental health services, an individual service plan will be developed with you. Your plan will consider your age and your culture. You may receive one or more of the services listed above. The plan will be fit to you, according to your strengths and needs. Your mental health care provider will decide with you which services you will be provided and for how long.

Your mental health care provider may also ask permission to work with people who provide you other services such as housing, healthcare, and employment.

Other Medicaid benefits may be available to you. Here are some reference numbers:
Physical health: Contact information on back of your card
Substance Abuse: 1-877-301-4557
Transportation Broker: 1-800-562-3022/911 for crisis

  • The Designated Mental Health Professional (DMHP) investigates facts and credibility of the persons providing information, that an individual presents a likelihood of serious harm or is gravely disabled as a result of a mental disorder.
  • Based upon that investigation, the DMHP makes decides whether that individual should be detained for further evaluation and treatment. RCW 71.34.050

If you received services from an agency that is not contracted with your RSN, you may be responsible for costs. If your coupon was not active, you may have to pay. If you had a coupon and receive a bill for an agencies services in error, contact the agency billing office. If you need further help, contact your Regional Support Network (RSN).

There are two types of formal complaints that you may make. One type is an appeal, which is a formal complaint about an action. An action is a denial, suspension, reduction, or termination of certain services. See Benefits booklet  for more information.

LEVELS OF CARE


  • An assessment is a process performed by a clinician to determine if treatment is necessary, functioning level, the diagnosis and if your child meets the Access to Care Standards. Additional information will be gathered to determine medical necessity, the length and level of care. This is done through an interview with the youth and could include parents and other family members. The clinician will also ask for historical and family information. In this process, it is important to remember that this is about exploring solutions and not about blaming.
  • Information and records with the consent of the parent, legal guardian or youth if appropriate might be gathered from other sources. These could be medical, mental health, school, juvenile justice and other types of records.
  • The assessment also includes the child and family's strengths, needs and situation. The clinician might also perform diagnostic tests.
  • Based on the assessment, a determination of whether the individual meets all the following requirements to be considered for a level of care assignment:
    • The individual is determined to have a mental illness. The diagnosis must be included as a covered diagnosis in the list of Covered Childhood Disorders.
    • The individual's impairment(s) and corresponding need(s) must be the result of a mental illness.
    • The intervention is deemed to be reasonably calculated to improve, stabilize or prevent deterioration of functioning resulting from the presence of a mental illness.
    • The individual is expected to benefit from the intervention.
    • The individual's unmet need would not be more appropriately met by any other formal or informal system or support
  • If a level of care is assigned, a decision on the appropriate course of treatment will be made by the parents or legal guardian, the child or adolescent if appropriate, and the clinician.
  • 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 modalities could be:
    • 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.
  • Acute psychiatric inpatient treatment is provided in a community hospital or a certified freestanding Evaluation and Treatment facility (E&T).
  • For publicly funded services, a medical necessity determination is made by the RSN/PIHP or Designated Mental Health Professional (DMHP).  For privately funded services, the individual's insurance company makes that determination. The length of stay in the hospital is variable, depending upon the individual'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.

Psychiatric hospital services are available to Medicaid enrollees. These services may be at no cost, but must be approved in advance. If you think you need to be hospitalized, contact your mental health care provider. Your provider will help you with hospital services if they are necessary.

A less restrictive alternative (LRA) is outpatient treatment provided to an individual who meets criteria for commitment but is not residing in a facility providing inpatient treatment. If the court finds that the individual meets the criteria for commitment, the court can either authorize commitment of the individual for inpatient treatment or for a less restrictive alternative treatment. Release under a less restrictive alternative is subject to conditions set by the court.

If the professional in charge of the outpatient treatment program or a DMHP determines that an individual is failing to adhere to the conditions of the court for a less restrictive alternative treatment or conditions for the release or if there is deterioration in functioning, the individual can be taken into custody and transported to an inpatient evaluation and treatment facility. The DMHP must then file a petition with the court for revocation of less restrictive alternative treatment. RCW 71.34.740 (5), RCW 71.34.740 (10).

  • Psychiatrist: A person having a license to practice as a physician and surgeon in this state and in addition has completed three years of graduate training in
    psychiatry in a program approved by the American Medical Association or the American Osteopathic Association and is certified or eligible to be certified by the American Board of Psychiatry and Neurology. RCW 71.34.020
  • Psychologist: A person licensed by a state examining board. This person must pass an oral or written exam or both as prescribed by the examining board. In addition, this person must have a doctoral degree from a regionally accredited institution obtained from an integrated program of graduate study in psychology. This person must also have had at least two years of supervised experience of which at least was one must have been after the doctoral degree was granted. RCW 18.83.070
  • MSW: A person with a masters or further advanced degree from a school of social work or a degree deemed equivalent under rules adopted by the Secretary of DSHS. RCW 71.34.020

SERVICES FOR YOUTH


  • 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

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.

Both the public mental health and chemical dependency (Division of Alcohol and Substance Abuse) 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.

  • Call the Regional Support Network (RSN) that serves the county you reside in and request the name and phone number of the mental health agency that serves your area.
  • Call the mental health agency for an appointment. They may do a screening over the phone and schedule an intake appointment.
  • Outpatient mental health services are provided by community mental health agencies. Services could be provided at the mental health agency, in your home, or elsewhere in the community.
  • 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.

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

  • 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.
     
  • Wraparound or ITC 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.