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Family initiated treatment (FIT)

As a parent or family member, FIT is a way for you, your family, and/or your youth to seek out behavioral health treatment. Learn more about the program and what is available to assist you and your family in accessing care.

Note: As long as providers have the capacity and skill, they must treat the youth, even if the youth refuses care. Providers can only admit an adolescent to treatment if it is medically necessary. (See RCW 71.34.600 for details.)

FIT training for families: Learn more about FIT through online training. This training helps parents and family members understand what FIT is and how to navigate the system.

FIT goals

The goals of FIT are to provide parents (as defined in RCW 71.34.020) a way to access services when they feel a youth may need behavioral health treatment (mental health or substance use), and for providers to engage youth in a manner that shows them the benefits of treatment so they are willing to provide their consent.

What FIT is:

  • A way for youth and/or their parents to seek out behavioral health treatment.
  • May be used to access medically necessary outpatient, inpatient, and residential services.
  • An opportunity for providers to meet youth where they are and to engage them in treatment.
  • Regular reviews are conducted for all youth in outpatient, inpatient, and residential services, to continually assess medical necessity.

What FIT is not:

  • FIT does not guaranteed immediate access to behavioral health treatment services.
  • Services cannot continue beyond medical necessity.
  • FIT does not supersede federal substance use disorder laws.
  • Each provider’s intake and assessment process may be different.

About adolescent initiated treatment (AIT)

Who is eligible? Youth aged 13-17 years old.

According to RCW 71.34.500 – 530, youth may request an evaluation for outpatient or inpatient mental health or substance use disorder treatment without parental consent.

If it is determined that they meet the medical necessity for the level of treatment requested, the youth may be offered and allowed to consent for their own services.

For a minor under the age of 13, either parental consent or consent from an approved guardian is required for services.

Any youth seeking services under AIT may choose to end or leave services on their own at any time.

Learn about FIT and consent

Under FIT parents are able to provide consent on behalf of youth. Consent from the youth is not required. The youth would have to meet medical necessity before treatment can be initiated. The FIT process creates an additional access point and but does not guarantee care on demand. Providers will have individual processes and requirements for their admission process. Learn about behavioral health treatment options (updated July 2023).

Outpatient treatment services

Medically necessary, outpatient treatment services may be accessed through FIT.

For more information

Inpatient family initiated treatment and residential inpatient process

Medically necessary, inpatient treatment services may be accessed through FIT.

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

For more information, see the parents guide to Family Initiated Treatment (updated April 2022)

For information about the Children’s Long-term Inpatient Program, also known as CLIP, visit the CLIP administration website.

For adolescents receiving treatment within a residential treatment facility and is not released by a court, they may remain in a residential treatment facility so long as it continues to be a medical necessity for the adolescent to receive such treatment (RCW 71.34.630(2)).

Mental health service disclosure guide

Washington State law about what information mental health professionals can share has changed. Mental health providers are now allowed to communicate some youth (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 see the mental health service disclosure guide (updated November 2021).

Background and core values

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 system 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, 2019, the legislature enacted Engrossed Second Substitute House Bill 1874.

The Washington State prenatal through 25 behavioral health system is guided by three core values:

  • Family and youth driven
  • Culturally based services
  • Services that address diversity and health disparities

Youth who need services have the right to get those services in the least restrictive setting that best meet their needs and keep them within their community whenever possible.

Page last updated: March 23, 2022



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