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Minor-Initiated Treatment (Voluntarya) Family-Initiated Treatment Minor can self-admit to inpatient facility without guardian approval if clinician in charge of facility agrees admission is medically necessary and is the least restrictive option.
Upon admitting minor, facility must notify minor’s guardians within 24 hours.
Minor may request discharge at any time, in writing, and must be discharged within two judicial days of request (unless admission status changes).
Minor can consent to psychiatric medications without guardian approval, and guardian cannot compel the minor to receive psychiatric medications without guardian approval
Guardian can bring minor to inpatient facility and request minor be admitted and evaluated to determine whether the minor has a mental disorder and whether inpatient treatment is medically necessary.
Evaluation must be completed within 72 hours; treatment is limited to minimum required for stabilization and evaluation.
Minor’s consent is not required for admission or evaluation.
If evaluation indicates inpatient treatment is medically necessary, the minor may be held for treatment.
Independent evaluator must review admission to ensure it is medically necessary between 7 and 14 days of admission.
If not medically necessary, facility must release minor to guardian within 24 hours of notification
If medically necessary, minor may petition court for release 5 daysafter initial evaluation completed.
Minor must be released within 30 daysb of either:
Notice of independent evaluation results
Minor’s filing of petition for release
Minor can consent to psychiatric medications without guardian approval, and guardian cannot compel the minor to receive psychiatric medications without minor’s consent
From Washington State Legislature Chapter 71.34 RCW: Behavioral Health Services for Minors, 2020.
↵a Children under 13 may only be admitted for inpatient mental health treatment with the consent of their guardian and are not subject to the Involuntary Treatment Act.
↵b In the absence of civil commitment.
Community Inpatient Facility Treating mental health professional evaluates minor and determines the minor:
Has a mental disorder
Requires immediate inpatient treatment
Does not consent to treatment
Minor is held up to 12 hours to allow evaluation by a designated crisis responder to commit the minor involuntarily to an inpatient facility.
Inpatient provider pursues involuntary commitment for a minor initially admitted under voluntary or family-initiated treatment:
Treating provider writes petition for commitment and contactsCCORS.c
CCORS representative evaluates patient and writes petitionforcommitment.
Treating provider contacts designated crisis responder to evaluatefor involuntary commitment.
Designated crisis responder has until 5 p.m. of 2nd judicial daytoevaluate patient for involuntary commitment.
Minor advised of rights within 24 hours of commitment.
14-Day Commitment If further inpatient treatment is believed to be necessary, facility may petition for a 14-day commitment hearing to be held within 72 judicial hours of initial commitment.
At a 14-day commitment hearing, evidence in support of petition is presented by the county prosecutor.
The minor has a right to representation by an attorney, may present evidence, may question or cross-examine witnesses, and may waive presence at hearing.
Guardians may oppose the petition and may be represented by an attorney (court-appointed if indigent).
For a 14-day commitment, burden of proof is on petitioners to demonstrate the minor:
Has a mental disorder and as a result presents a “likelihood of serious harm” or is “gravely disabled”
Requires the treatment provided by the petitioning inpatient facility or a less restrictive alternative treatment found to be in the best interests of the minor
Is unwilling or unable in good faith to consent to voluntary treatment
Judge rules on the outcome of the hearing and advises minor of rights in closing remarks.d
180-Day Commitment If further treatment beyond the 14-day commitment is believed to be necessary, a petition for a 180-day commitment hearinge must be filed by the facility at least three days prior to the expiration of the 14-day order.
For a 180-day commitment, the court must find that the minor:
From Washington State Legislature Chapter 71.34 RCW: Behavioral Health Services for Minors, 2020.
↵a Minor’s guardians are notified of detention and admission.
↵b Minors retain the same rights as adults (i.e., attorney representation, communication/visitation).
↵c Children’s Crisis Outreach Response System.
↵d Once placed on a 14-day commitment, the minor preemptively loses the right to possess firearms at age 18.
↵e Minor and guardian rights during the 180-day hearing and the 14-day hearing are the same.
↵f Successive 180-day commitments are allowed (petition must be filed five days prior to expiration of previous 180-day commitment).
↵g Minor may be conditionally released under “least restrictive option” and subject to reasonable conditions, including outpatient treatment upon release; conditional release may be revoked if the minor fails to adhere to the conditions.
↵h A minor on a 180-day commitment automatically becomes eligible for admission to the state-funded Children’s Long-Term Inpatient Program.
