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Family initiated treatment (FIT)

Family information page

Washington State youth behavioral health system of care 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 for their need.

Under RCW 71.34.600 No provider is obligated to provide treatment to an adolescent under the provisions of this section except that no provider may refuse to treat an adolescent under the provisions of this section solely on the basis that the adolescent has not consented to the treatment. No provider may admit an adolescent to treatment under this section unless it is medically necessary.

Eligibility: Youth aged 13 to 17

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:

  • FIT is a way for adolescents and/or their parents to seek out behavioral health treatment.
  • Up to 12 visits with an outpatient  behavioral health provider for as long as three, three-month periods.
  • Gives providers an opportunity to meet youth where they are and to engage them in treatment.
  • Inpatient FIT can last up to 30 days.
  • Regular reviews are conduct for all youth in outpatient and inpatient services, to continually assess medical necessity.

What FIT is not:

  • FIT does not guaranteed immediate access to behavioral health treatment services. 
  • Services beyond three months cannot be continued without the adolescents consent.
  • FIT does not supersede federal Substance Use Disorder laws.
  • Each provider’s intake and assessment process may  be different.
  • Services in inpatient FIT cannot continue beyond 30 days without the adolescents consent

Register for FIT training

Learn about adolescent initiated treatment (AIT)

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

According to RCW 71.34.500 – 530, youth adolescents 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, they adolescent 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 adolescent 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 of the adolescent 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 2/2020).

Outpatient treatment services

Outpatient treatment services, accessed through FIT, can last up to 3 months and include up to 12 visits, after which services may only be continued with the youth’s consent.

For more information, see the FIT parent information sheet (updated 3/27/2020).

Inpatient treatment services

Inpatient treatment may last up to 30 days. At 30 days the adolescent must be discharged, unless the adolescent voluntarily agrees to further treatment, 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 more information, see the FIT parent information sheet (updated 3/27/2020).

For additional information about Children’s Long-term Inpatient Program, also known as CLIP, click here: Children’s inpatient program

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 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 see the mental health service disclosure guide.


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.

Page last updated: April, 2021


Email: hcafamilyinitiatedtreatment@hca.wa.gov

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