Child and youth behavioral health services

Washington has developed a system for delivering intensive home and community-based mental health services to Medicaid-eligible children and youth. 

Learn about these efforts, including Wraparound with Intensive Services (WISe), what you need to know as a provider, and the governance structure that guides the work.

Stay up-to-date on children's behavioral health.

What treatment services are available?

The following fact sheets provide overviews of the efforts being implemented in Washington.

How do I become a behavioral health provider?

There are three provider options for behavioral health services in Washington:

  • Apple Health behavioral health fee-for-service (FFS) program
  • Apple Health managed care program
  • Services through behavioral health organizations (BHOs)

To learn more, visit our Become a behavioral health provider page.

Washington state children's behavioral health principles

The Health Care Authority (HCA) and Washington State’s Department of Social and Health Services (DSHS) believes that youth and families should have access to necessary services and supports in the least restrictive, most appropriate, and most effective environment possible. Washington State is committed to operating its Medicaid-funded mental health system that delivers services to youth, in a manner consistent with these principles.

Family and youth voice and choice

Family and youth voice, choice and preferences are intentionally elicited and prioritized during all phases of the process, including planning, delivery, transition, and evaluation of services. Services and interventions are family-focused and youth-centered from the first contact with or about the family or youth.


Services and supports are planned and delivered through a multi-agency, collaborative teaming approach. Team members are chosen by the family and the youth and are connected to them through natural, community, and formal support and service relationships. The team works together to develop and implement a plan to address unmet needs and work toward the youth’s and family’s vision.

Natural supports

The team actively seeks out and encourages the full participation of team members drawn from the youth’s and family members’ networks of interpersonal and community relationships (e.g. friends, neighbors, community and faith-based organizations). The care plan reflects activities and interventions that draw on sources of natural support to promote recovery and resiliency.


The system responds effectively to the behavioral health needs of multi-system involved youth and their caregivers, including youth in the child welfare, juvenile justice, developmental disabilities, substance use, primary care, and education systems.

Home- and community-based

Youth are first and foremost safely maintained in, or returned to, their own homes. Services and supports strategies take place in the most inclusive, most responsive, most accessible, most normative, and least restrictive setting possible.

Culturally relevant

Services are culturally relevant and provided with respect for the values, preferences, beliefs, culture, and identity of the participant/youth and family and their community.


Services, strategies, and supports are individualized and tailored to the unique strengths and needs of each youth and family. They are altered when necessary to meet changing needs and goals or in response to poor outcomes.


Services and supports are planned and delivered in a manner that identifies, builds on, and enhances the capabilities, knowledge, skills, and assets of the youth and family, their community, and other team members.


Based on the youth and family’s needs and vision, the team develops goals and strategies, ties them to observable indicators of success, monitors progress in terms of these indicators, and revises the plan accordingly. Services and supports are persistent and flexible so as to overcome setbacks and achieve their intended goals and outcomes. Safety, stability and permanency are priorities.


A youth and family team’s commitment to achieving its goals persists regardless of the youth’s behavior, placement setting, family’s circumstances, or availability of services in the community. The team continues to work with the family toward their goals until the family indicates that a formal process is no longer required.

Additional resources

Find information on current initiatives, governance, and resources you can share with clients and families on the prenatal, child, and young adult behavioral health client page.

Child welfare training for mental health therapists