Seattle Children’s Mental Health ED Patient Surge

Seattle Children’s is seeing very high numbers of pediatric patients with mental and behavioral health emergencies who require care in our Emergency Department and/or inpatient Psychiatry and Behavioral Medicine Unit (PBMU).

Patients experiencing a psychiatric emergency should go to the closest ED without hesitation, where acute issues will be addressed asap. Patients and families should be prepared for potentially longer wait times.

A significant number of patients presenting with mental health concerns are having to wait more than 24 hours in the ED (after initial assessments and interventions) for the next step in care, which may be an inpatient bed in our PBMU, a transfer to an outside facility or a discharge plan.

We are asking that you: 

1. Continue to identify and manage lower-acuity complaints in outpatient settings to help maintain ED capacity for higher-acuity concerns. Please see our Healthcare Professionals site for Resources for Community Providers.
2. For urgent mental and behavioral health concerns not needing the care of an emergency department, inform families they can visit Psychiatric Urgent Care to make an in-person or virtual (video) appointment. If today’s appointments are full, tomorrow’s appointments will open at midnight tonight.
3. Before sending your patient to the ED, contact our Mission Control team with as much notice as possible at 206-987-8899. This helps us plan for your patient’s arrival. In appropriate instances, we may be able to directly admit your patient to the hospital or arrange an urgent ambulatory clinic visit in lieu of an ED visit. 
4. Please be aware that our inpatient PBMU has limited capacity. Patients seen in our ED who need inpatient psychiatric admission will be referred to all appropriate inpatient pediatric psychiatric facilities in Washington. Patients will be re-evaluated daily and may discharge directly from the ED once clinical stability is reached. 
5. Help set realistic expectations about an ED visit and/or inpatient admission with children, families and partners. 
   • Patients and families should be prepared for potentially longer wait times. 
   • An ED visit for mental or behavioral health typically involves an evaluation to determine if the child needs an inpatient psychiatric admission or is appropriate to discharge home.
   • As noted earlier, referrals to the PBMU could experience significant wait times and may not result in admission; we are asking all external partners to consider referring patients who need inpatient admission to all appropriate inpatient pediatric psychiatric facilities in Washington and consistently re-assess need for inpatient admission.
   • An inpatient psychiatric admission is typically 5 to 10 days and focused on acute crisis stabilization. It is not a long-term placement.