When your child turns 13 in Washington State, parents lose the ability to make medically necessary mental health treatment decisions. This presentation walks parents through the steps to access care and how to become involved in changing our system.

1. What can parents do?
Accessing behavioral health treatment for minor children

2. Session Goals
• Who is in the Room?
• Understanding the System 101
• Age of Consent
• Outline pathways for intervention in our existing system
• Provide hope
• Answer your questions

3. Burning Questions

4. Assumptions
• Families are the most effective way to
raise children
• Most parents want to help their
struggling children.
• Best practices find family-inclusive
therapy has the best outcomes.
• Treatment isn’t the same for each youth
or each family.
• Treatment does not have to be financed
through any single or specific funding
stream.
• Treatment for mental illness isn’t easy –
we shouldn’t pretend that it is.
• Recovery is possible.
TY Cathy Callahan-Clem

5. Harsh Realities
• The “system” is broken
• Money talks, sort of
• Normal adolescent development
includes defiance, impulsiveness,
and risky behavior.
• Providers don’t understand
oppositional defiance or
attachment disorder
• Change takes time, commitment &
hard work – by you

6. More Realities
• Unhealthy children treated as
juvenile offenders or expected to
behave like adults.
• Many threats to children’s health
are not considered under the
definition of medical necessity.
• System requires multiple failures to
get assistance without protecting
child during this time.
• Wait times are long and services
scarce.
“They won’t get better until they are ready.”

7. Never underestimate the power of a
mother with a squeaky wheel.

8. Laying the foundation
• Behavioral Health
• Stages of Development
• Age of Consent

9. Behavioral Health
School to
Prison
Pipeline

10. How we view children & youth

11. When are you an adult?
Very Young Children Youth Young Adult
Independent
Adult
Ageofconsent
Puberty

12. When are you an adult?
Very Young Children Youth Young Adult
Independent
Adult
Ageofconsent
Adolescent Brain (Siegel)
Voting,Tobacco,
HIPAA
KCWISe21
Puberty
Inebriants21
CarRental,
Insurance25
KCYouth24

13. Mental Health Age of Consent

14. Intervention Paths

15. Terms to understand
• Behavioral Health
• Stages of Development
• Age of Consent
• System of Care
• WISe (CCORS)
• ARY
• CHINS
• PIT
• CLIP
• Involuntary Treatment (ITA)

16. Insurance v Medicaid
• Medicaid (WISe, CLIP)
• School District (FAPE) Nonpublic Agencies
• Private Insurance (King Co Wrap Team free to all)

17. Evaluation
•SBIRT (Screening, Brief
Intervention, and Referral to
Treatment)
•IEP & 504 Plans
•Drug abuse assessment
•CANS Assessment (Child and
Adolescent Needs and
Strengths)
Outpatient Individual
and Group Therapy
Intensive Outpatient
•Substance Abuse Disorder
Programs
•WISe (Intensive Outpatient
Services: Wrap Team + CCORS)
State Safety Net
•ARY (At Risk Youth Petition)
•Parent Initiated Treatment
(PIT)
•CLIP (Children’s Long Term
Inpatient Program)
Inpatient Treatment
•CHINS (Child in Need of
Services)
•Out-of-State wilderness &
residential programs
Support: 12-step groups, on-line groups, church, close friends, books

18. RCW definitions
• "Medical necessity" for inpatient care means a requested service which is reasonably calculated to: (a)
Diagnose, correct, cure, or alleviate a mental disorder; or (b) prevent the worsening of mental conditions
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.
• "Mental disorder" means any organic, mental, or emotional impairment that has substantial adverse effects
on an individual's cognitive or volitional functions. The presence of alcohol abuse, drug abuse, juvenile
criminal history, antisocial behavior, or intellectual disabilities alone is insufficient to justify a finding of
"mental disorder" within the meaning of this section.
• "Likelihood of serious harm" means either: (a) A substantial risk that physical harm will be inflicted by an
individual upon his or her own person, as evidenced by threats or attempts to commit suicide or inflict
physical harm on oneself; (b) a substantial risk that physical harm will be inflicted by an individual upon
another, as evidenced by behavior which has caused such harm or which places another person or persons
in reasonable fear of sustaining such harm; or (c) a substantial risk that physical harm will be inflicted by an
individual upon the property of others, as evidenced by behavior which has caused substantial loss or
damage to the property of others.
• "Gravely disabled minor" means a minor who, as a result of a mental disorder, is in danger of serious
physical harm resulting from a failure to provide for his or her essential human needs of health or safety, or
manifests severe deterioration in routine functioning evidenced by repeated and escalating loss of cognitive
or volitional control over his or her actions and is not receiving such care as is essential for his or her health
or safety.

19. King County Access to Long Term Treatment

20. Building a Model that Works for You
• WISe Certified Peer Counselors
• Lived experience supports the
family journey
• Recovery v. Medical Model
• Skills Training: DBT
• Trauma-informed care
• Substance Abuse Disorder
• Interoception
• Self Care!
Put on your own oxygen mask first

21. Steps to Accessing Care
• Accept
• Identify
• Locate
• Access
• Fund
• Persist

22. Let’s fix the system
Your lived experience matters!

23. Get Involved
 Join your local NAMI Chapter
 Join “Support SB 5706” Facebook Group
 Write down your story and share it
 Attend local behavioral health forums (March 16)
 Follow Legislative Children’s Mental Health Workgroup
 Advocate within your local school district PTA
 Join your local FYSPRT
 Other ideas?

24. Contact
about.me/peggydolane
(206) 854-8619
peggy.dolane@gmail.com