WA cuts ‘boarding' time for young psychiatric patients stuck in hospitals

A statewide crisis that left hundreds of Washington youth warehoused inside hospitals awaiting psychiatric care is beginning to ease, according to a new report released this week from the office of the governor.

But healthcare providers say Washington’s supply of beds for youth and insurance payments for their care are still woefully low.

In the years leading up to and during the pandemic, children and teens wound up stuck for weeks or months “boarding” inside hospital wards - sometimes in windowless ER rooms without their own bathroom or access to the outdoors - because there was nowhere else for them to go. The state estimates it now takes less than half as long as it did a few years ago to find appropriate care for these children.

Kids with the most acute needs who once spent more than a year in the hospital are now spending about 200 days there. Children with less intensive symptoms are spending about a month, down from about 78 days in 2024.

Lawmakers unanimously passed legislation in 2023 to address the crisis following a Seattle Times investigation that found kids were being hospitalized for psychiatric conditions twice as often as a decade earlier. Charges to state health plans for their care had risen to more than $150 million a year. Elected leaders failed to prioritize programs for kids in mental health crisis even as the number of hospitalizations surged, the investigation revealed.

These hospitalizations kept kids in a liminal space: confined in highly restrictive wards that were neither therapeutic nor medically necessary and without specialized care for their serious symptoms of psychosis, intellectual disability or both.

At the time, no state agencies were responsible for finding these kids care.

A key attribute of the 2023 legislation was holding the governor’s office accountable for pooling resources, speeding hospital discharges and smoothing the path to residential treatment. In particular, the bill created a new statewide care coordinator role and set aside funds to help families pay for daily living supplies, travel, lodging and housing.

The state has also created three contract peer support roles that pay parents who’ve navigated the mental health care system to help families like their own. The report shows the number of days kids languished in hospitals or went without care dropped significantly since these peer roles, plus $1.2 million in family support funds, came online in October 2024.

“We really do have promising outcomes that unfortunately we don’t very often get to see” when government takes on really complex issues like this, said Taku Mineshita, who oversees the state’s care coordination team.

Between January 2024 and June 2025, the new coordination team received an average of seven referrals each month, the state’s new report shows. A quarter of all referrals were for children living in King County.

Seattle Children’s, which has submitted at least 45 referrals according to the report, routinely boards children in both its emergency department and short-term inpatient psychiatric unit. The unit is the only one of its kind in Washington following the closure of Providence Sacred Heart Medical Center’s youth psychiatric unit in 2024. No other hospitals offer short-term inpatient psychiatric treatment for kids under 13 or those with developmental disabilities who need significant support.

The statewide care coordination team is a “vital step forward” that’s cleared red tape during the discharge process, said Laura Knapp, vice president of mental and behavioral health services at Seattle Children’s. But she said efforts to date “have not addressed the underlying issue of limited resources.” Although patients are staying fewer days in the hospital, “the total number of youth requiring these complex discharge solutions remains high.”

Washington pays for 109 residential beds at four long-term inpatient facilities through the Children’s Long-term Inpatient Program, which serves about 200 children and teens each year. But staffing and funding shortages have for years prevented these facilities from operating at full capacity. At least 1 in 6 kids served by the state’s new care coordination services still end up sent out of state for residential care, the state’s new report shows.

Seeing the need for more youth crisis beds, state officials in 2024 took over a closed residential campus in Lake Burien. In the year and a half since the Lake Burien Transitional Care Facility opened, the state’s largest disability rights organization has alleged abuse and neglect there. Parents say their children have been touched inappropriately, left hungry and found with unexplained bruises on their bodies. The facility replaced its executive director after the office of developmental disabilities ombuds published its findings earlier this year.

Building more beds is still a priority, Mineshita said, but should be coupled with services that prevent youth from reaching a crisis point in the first place.

It can be difficult for families to get outpatient care because many providers don’t accept public insurance, and among those that do, some say Medicaid rates often don’t cover the high costs of treating youth with significant mental and behavioral health needs. Nearly half of kids served by the state’s new coordination services had at least four diagnosed conditions.

The 2023 legislation, Knapp said, “has made significant progress in fixing the ‘how’ of navigating the system, and we look forward to working together to expand the ‘where’ regarding the physical capacity of our state’s continuum of care.”

Copyright 2026 Tribune Content Agency. All Rights Reserved.

This story was originally published May 15, 2026 at 9:51 AM.