Too few mental health beds for youth patients impacting Seattle Children’s Hospital

Seattle Children's nurses call for more resources and beds for psychiatric patients

Representatives from the Seattle Children’s nurse conference committee met with hospital leadership over growing concerns with the Psychiatry and Behavioral Medicine Unit.

SEATTLE - On Wednesday, representatives from the Seattle Children’s nurse conference committee met with hospital leadership over growing concerns with the Psychiatry and Behavioral Medicine Unit.

There has been a growing level of frustration following highly publicized attacks within the PBMU, though nurses tell FOX 13 News those attacks are part of the hospital’s inability to meet the needs of their patients.

As the youth mental health crisis in our state grows, there’s a lack of room for children with mental health needs. Seattle Children’s PBMU is meant to be a short-term stay, that, for many patients, has become a catch-all with children and teens staying for weeks, months or longer.

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Following complaints by nursing staff at Seattle Children’s about an inability to provide adequate care to patients, the hospital noted changes that were underway while pointing to an ongoing state mental health crisis.

"Seattle Children’s cannot solve this crisis alone," a representative of the hospital wrote in late November. "This work is ongoing, and we are actively collaborating with external partners at the local, state, and federal level to identify and eliminate barriers and find rapid solutions to address the extremely high number of patients seeking care for mental and behavioral health crises across the state."

A key issue has been ballooning wait times at facilities where youth mental health patients can be placed after treatment at hospitals.

Requests for data about how many mental health beds have been available year-to-year have gone unanswered by both Washington State Health Care Authority and the State Department of Health.

However, when it comes to Children's Long-term Inpatient Program [CLIP]—the state’s most intensive inpatient psych treatment for Washington children between the ages of 5-17—there are only four facilities that can accept patients.

The operators of one such facility told FOX 13 that the wait time can swing from 3–4 weeks, to 3–4 months. In the past, that service would have taken two weeks maximum.

"The amount of kids that are needing services here in Pierce County, we had over 100 kids on the waitlist for WISe [Wraparound with Intensive Services]," said Kymm Dozal, the executive director of Pearl Youth Residence, referring to an in-home program for Washington residents age 20 or younger with complex behavior health needs.

The facility Dozal runs falls within that state’s CLIP program. When fully staffed, they can provide beds for 27 patients. To enter the program one must meet several criteria and go through a state admissions process, or have a court order.

Dozal noted that the wait times are hard, but that it extends beyond the CLIP program that they’re part of. She pointed out that there were requests made by the state for a CLIP-like facility that would specialize in special needs, but that the state didn’t receive bids.

"The hospitals, it’s really hard to see kids sit there," said Dozal. "They could be there 3 months, 6 months, or more. They’re not getting what an adolescent or child needs. They’re sitting there waiting for a place that can meet their needs."

One of the issues is that the people with the most training to work with these populations have been stretched thin since the height of the COVID-19 pandemic.

As Dozal explained, her own group struggled for a long period to hold staffing. They’ve only recently been able to stabilize, and there’s a fear that stretching themselves too thin could have them reverting to past staffing issues. The difference of a few staff members could swing a facility’s ability to keep all of their beds open.

On top of those concerns, the cost to build facilities that meet requirements is a costly challenge. It takes large sums of money upfront, and there is a lot of red tape.

"If we can find a way to ease [restrictions] up to make a nice facility, to be able to get what’s needed for less money, or have someone front that cost – I think the buildings could get built. If you build it, we’ll come and provide the service there – we can’t take on trying to build it, afford it doing all these front-end grants and dollars to be able to start the service," said Dozal.

Meanwhile, hospitals like Seattle Children’s continue to face stressors. As nurses told FOX 13, they don’t turn patients away – but they don’t feel like they have enough support, space or staff to truly help their patients.

"We really are the last resort for a lot of families," said Lauren Swinney, a charge nurse at the PBMU unit at Seattle Children’s. "These are not new behaviors, we’re trained to deal with this – we just don’t have the resources to be able to."

"It’s not normal to be in a hospital for years and months on end," said Brayden Schander, a PBMU charge nurse who spoke with FOX 13. "That does something to a person."

The big ask for nurses at Seattle Children’s includes a safety officer role, additional staffing, spaces dedicated to PBMU patients, and a nurse-to-patient ratio no greater than 1:8.

It’s unclear what the fallout will be as nurses call on changes at Seattle Children’s. Those who work in the industry tell FOX 13 that they heavily rely on the facility in terms of youth mental health services.