When Youth Behavioral Health Capacity Changes, We Need to Look at the Whole Continuum
By Karen Brady, Executive Director & CEO, Ryther
The announcement that Comprehensive Life Resources plans to close Pearl Youth Residence in Tacoma is an important development for Washington’s youth behavioral health system.
Pearl is a 27 bed Children’s Long Term Inpatient Program serving youth ages 12 to 17 from across Washington. Comprehensive Life Resources has said the program is expected to close in November and that the organization has experienced approximately $3 million in operational losses since 2020. The organization has also said that only 2% of Pearl’s clients over the past two years came from Pierce County.
The closure raises an important question for all of us working in youth behavioral health:
How do we build a sustainable continuum of care that gives young people access to the right level of treatment as their needs change?
Washington’s own data demonstrates the scale of the challenge.
The Washington State Health Care Authority’s Quantitative Landscape and Gap Analysis found significant gaps in behavioral health services for children and youth, including limited availability of intensive services and substantial geographic variation in access.
Washington’s CLIP system currently consists of four facilities with 109 funded beds. Pearl represents a quarter of these beds. CLIP provides the highest level of inpatient psychiatric care for Washington youth ages 5 to 17 who meet specific clinical criteria and have not been successfully served by community based mental health services.
But inpatient care is only one part of a much larger system.
Young people and families also need access to outpatient therapy, intensive outpatient treatment, partial hospitalization, residential treatment and appropriate services following more intensive treatment.
At Ryther, we have been working to build that continuum in Seattle.
Today, Ryther provides outpatient therapy, intensive outpatient programs and partial hospitalization, along with community based programs and services for children and families. These services allow young people to receive different levels of support depending on their needs.
We have also developed plans to add residential treatment to that continuum.
That program is not yet open. Before we can begin serving young people in residential treatment, Ryther is working with insurance partners to establish sustainable reimbursement for the level of care and staffing required to provide high quality residential treatment.
This is an important part of the broader conversation about behavioral health capacity.
Building a new program is only the first step. For a service to be available to families over time, the system has to support it financially.
Nonprofit behavioral health organizations cannot build and sustain intensive services on mission alone. Residential treatment requires significant clinical staffing, specialized facilities, around the clock care and coordination with families and community providers. Sustainable reimbursement is necessary to make that care possible.
The closure of Pearl highlights why we need to think about both sides of the equation: capacity and sustainability.
We need enough services at different levels of intensity to meet young people's needs. And we need a financing system that allows providers to sustain those services over time.
The goal of a continuum is straightforward. Young people should be able to receive an appropriate level of care, near their family and community, with the ability to move to a different level as their needs change.
That requires collaboration among providers, government, health plans, hospitals, schools, families and communities.
At Ryther, we are committed to continuing to build that continuum in Seattle that serves WA state. We believe young people and families deserve access to care that is connected, appropriately intensive and available when they need it.
Washington has important work ahead to ensure that behavioral health capacity is not only created, but sustained.
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