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Family initiated treatment (FIT)

Parents may consent on behalf of adolescents who meet medical necessity. Consent of the adolescent is not required. The family initiated treatment (FIT) process creates an additional access point but does not guarantee care on demand for adolescents admitted through FIT. Providers will have individual processes and requirements for evaluation and admission to services.

FIT eligibility requirements

Adolescents ages 13-17 years old.

What does FIT mean for adolescent behavioral health providers?

The provider must inform the parent or guardian of all available treatment options. 

For more information, see the behavioral health treatment options for adolescents form.

Learn about FIT behavioral health treatment options.

Outpatient FIT

FIT outpatient services can last up to three months and include up to 12 visits. After this period, services may only be continued with the adolescent's consent.

For specific, step by step directions, see the provider's guide to family initiated treatment (updated 3/27/2020).

Inpatient FIT 

Any adolescent who receives inpatient services through FIT must be discharged within 30 days of the independent review, unless:

  • The adolescent’s status changes to voluntary, or
  • A Designated Crisis Responder (DCR) initiates involuntary commitment proceedings.

Adolescents admitted to inpatient facilities under FIT must be released immediately upon the written request of the parent.

For specific, step by step directions, see the provider's guide to family initiated treatment (updated 3/27/2020).

Review notifications

Within 24 hours of all inpatient or outpatient admissions under FIT, the provider must notify HCA’s contractor, the FIT administration office, via secure email at  fitreporting@fitadministration.com or via secure fax 206-859-6432. 

For more information about the review process and what it should include, see the provider's guide to family initiated treatment (updated 3/27/2020).

Frequently asked questions (FAQ)

Partial hospitalization and intensive outpatient are services that are covered under the outpatient guidance for FIT.

When SHB 2883 is signed and in active statute, residential services will be covered under the inpatient guidance for FIT.

Mental health information disclosure

Washington state law about what information mental health professionals can share has changed. Mental health providers are now allowed to communicate some adolescents’ (age 13-17) treatment information to parents, if the provider believes that sharing this information would benefit the treatment process. This includes sharing information through Family Initiated Treatment (FIT). For more information about mental health disclosure see the mental health information disclosure guidance.


FIT was developed, based in part on recommendations made by the Parent Initiated Treatment (PIT) Stakeholder Advisory Group that included youth, parents, clinicians, hospitals/emergency departments, and child systems advocates. PIT for acute inpatient evaluation and treatment is long standing and has evolved into FIT, which provides an avenue for outpatient evaluation and treatment as well as additional guidelines associated with the FIT legislation. The stakeholder group's findings and recommendations were delivered to the Children's Mental Health Work Group on December 1, 2018. In 2019, the Legislature enacted Engrossed Second Substitute House Bill 1874.

Page last updated: March 27, 2020