How to Cultivate Resilience like a Starfish

Starfish are masters at letting turmoil wash around them. They are also excellent models of resilience. This short video uses imagery from the sea and provides a strategy to get grounded, steady the breath, and cultivate four key aspects of resilience: purpose, connection, adaptability, and hope.

Become present and let thinking float away as you treat yourself to this opportunity to take a few minutes to care for yourself.

Breathe Mindfully and Give Your Favorite Stuffy a Ride

Even young children can become grounded and calm if breathing with intention is fun and accessible to them. This short video features two young models showing how they give their stuffed animals a ride while they breathe into and out of their tummies.

Have your child choose a comfortable place to lie down and place their stuffed animal on their tummy. Help them to notice what it’s like to breathe and watch the stuffy go up and down. Ask them what it feels like to notice their breathing and their stuffy taking a ride.

Our five-year-old model says, “I loved it and felt like I could fall asleep.”

Health Information for Families as Schools Reopen During COVID Pandemic

As schools open for the 2021-22 school year, families have decisions to make about health and safety. This article provides information and resources to address some key questions:

  • What measures are schools required to take to keep children and staff safe?
  • What COVID precautions should our family consider?
  • What should we do if returning to in person school doesn’t feel safe for our family?
  • Will schools address children’s social and emotional well-being after everything that has happened?

This article provides information to address these questions and includes state and federal resources to support families in decision making.

Overall priorities at the state and national level include:

  1. Health and physical safety by following a layered approach with COVID protocols for masking and hygiene to the maximum practical extent
  2. Mental health and social emotional learning support for all students, with state and federal funds to enable schools to hire additional staff focused on student well-being
  3. Accelerated academics to help students recover from interrupted learning (See PAVE’s article on Recovery Services)

These priorities are listed in the US Department of Education’s Return to School Roadmap, which includes this guidance in its opening paragraphs:

“We must welcome families back in authentically, listen and seek to understand their concerns, and respond to their needs, so that all families feel comfortable sending their students to school this fall. As we start the 2021-2022 school year, schools and communities must address gaps that were exacerbated by the pandemic and build our education system back better than before.”

What measures are schools required to take to keep children and staff safe?

Washington’s Department of Health (DOH) issued a 13-page document on July 28, 2021, to detail requirements for the 2021-2022 school year. The state’s guidance mirrors recommendations from the Centers for Disease Control and Prevention (CDC). Priority is to minimize virus transmission while maximizing in-person learning.

Families with questions or who need access to the DOH information in another format are encouraged to contact the COVID-19 Information hotline: 1-800-525-0127. Hours are 6 am-6 pm, with additional hours until 10 pm on Mondays. For interpretative services, press # when they answer and say your language. To request DOH information in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email civil.rights@doh.wa.gov.

Here are key points from Washington’s DOH guidance:

  • Vaccination is recommended for anyone 12 and older, and schools must verify the vaccination status of staff and faculty as required by Labor and Industry. According to DOH, “Schools should promote vaccinations for eligible students, teachers, staff, and families.”
  • Face coverings are required for all students and staff indoors and during school transportation. Exemptions are made for “people with a medical condition, mental health condition, developmental or cognitive condition, or disability that prevents wearing a face covering.”
  • Physical distancing of three feet or more is recommended indoors as practical: “Physical distancing requirements should not prevent a school from offering full-time, in person learning to all students….”
  • Schools must maintain good ventilation: “Offer more outside time, open windows often, and adjust the HVAC system to allow the maximum amount of outside air to enter the program space and increase air filtration.”
  • Schools are tasked to teach and manage proper hygiene, including frequent handwashing and “respiratory etiquette” (cover coughs and sneezes/wash hands after blowing nose, etc.) to minimize viral spread: “Some students with disabilities might need assistance with handwashing and respiratory etiquette behaviors.”
  • Schools must clean and disinfect surfaces and spaces frequently, in accordance with guidance from the CDC and the Environmental Protection Agency (EPA).
  • Symptomatic students and staff are asked to stay home and seek a medical evaluation before returning to school.
  • Schools must ensure students and staff can access timely COVID testing.
  • Schools are recommended to screen students who are not fully vaccinated at least weekly when community transmission is at moderate or higher levels. In accordance with CDC guidance, the state is not recommending fully vaccinated people for routine screening. Additional testing is recommended for athletes, coaches, and others engaged in contact sports or activities such as singing, which generates aerosols from the mouth that can spread virus.
  • Isolation of ill individuals is required to be in a space reserved for first aid or a separated room with an open window or good ventilation: “If no appropriate indoor space is available and the child can be supervised and made comfortable, an outdoor setting is an acceptable emergency alternative if weather and privacy permitting.”
  • If a person tests positive for COVID, here’s when they can return to school:
    • 10 days since they first got sick (up to 20 days for severe illness or if immunocompromised)
    • 24 hours after fever is gone
    • Symptoms have improved

Students who need to stay home have educational rights

The CDC provides a Flow Chart to direct schools, students, and families about what to do if a student becomes ill at school.

Schools are asked to keep records about people who are exposed to others who are sick. If the person who was exposed to illness has not been vaccinated, they will need to stay home/quarantine themselves until it’s clear they aren’t getting sick. If the person exposed to COVID has been vaccinated or has recovered from a past COVID infection, they don’t have to quarantine if they aren’t sick. Schools are required to release information about COVID-19 cases to local public health officials as part of a case or outbreak investigation.

A student staying home sick has the right to educational access, including special education services that are accessible and support progress toward educational goals. According to DOH, “Schools must have a response and communication plan in place that includes communication with staff, families, their school district, and their local health jurisdiction. Schools should prepare for instructing students and their families who are excluded from school due to illness or quarantine in accordance with all federal and state laws.”

What COVID precautions should our family consider?

The CDC provides guidance for families for talking about COVID-19 and slowing its spread. Here are a few ideas: 

  • Reassure children that they are safe. Share how you deal with your stress, so they learn to cope from you. If a child is anxious, reduce exposure to pandemic topics in the media.
  • Avoid language that might blame others and lead to stigma.
  • Provide information that is truthful and appropriate for the age and developmental level of the child. Use the information in this article to share a few ideas about how school might have new rules for protecting everyone.
  • Seek trusted information about vaccines to make an informed decision about who in the family can and should be vaccinated. The CDC provides a three-minute video with overview information, and Family Voices of Washington provides an article with more detail to support decision making. To find a vaccination site in your area, go to COVIDWA.com or call 1-833-VAX-HELP (833-829-4357). Language assistance is available. You can also text your zip code to 438-829 for vaccine locations near you.
  • Teach everyday actions to reduce the spread of germs. Remind children to wash hands frequently and to cough or sneeze into a tissue or their elbow.
  • Practice mask wearing and choose face coverings that will work all day at school. If appropriate, involve students in a plan to keep the face coverings clean and ready for each school day. If a child’s disability prevents mask wearing, talk about why that will be okay and prepare to share disability specific information with school staff. DOH provides guidance about mask wearing and exemptions in an Order from the Secretary of Health

What should we do if returning to in person school doesn’t feel safe for our family?

The U.S. Department of Education with the CDC presented at a Parent Town Hall on July 29, 2021.  During the virtual event, Department of Education staff responded to a question by a parent who wanted her child to keep learning from home for health and safety reasons. The parent was reminded that the department provides guidance and best practice strategies but does not regulate state educational agencies or local districts.

The advice was to ask for a meeting with school and/or district staff to discuss a plan for ongoing distance learning. If a workable plan isn’t developed, families are advised to contact their state educational agency (OSPI in Washington), local school board, or governor’s office. Note that Washington is a local control state, so individual districts are responsible to write their own policies and procedures within the limits of state and federal law.

No student rights are waived due to the pandemic, and students have levels of educational protections depending on their circumstances. Every child has the right to a free public education, through Every Student Succeeds Act (ESSA). Students with disabilities have the right to a Free Appropriate Public Education (FAPE) that is equitable, accessible and designed to meet their individualized needs. The right to FAPE is protected by Section 504 of the Rehabilitation Act of 1973 and by the Individuals with Disabilities Education Act (IDEA).

If a student is eligible for an Individualized Education Program (IEP), the IEP team is responsible to make decisions about the best placement for a student to receive FAPE. FAPE requirements include the right to an IEP that is reasonably calculated to enable progress appropriate in light of the student’s circumstances.

If family caregivers believe that home-based instruction is necessary for safety and well-being, then the IEP team must consider the family’s request and document its decision process through Prior Written Notice (PWN). If the school makes a decision that the family disagrees with, parents of children with disabilities have Procedural Safeguards that protect their right to mediation or a complaint process.

Additionally, Washington families can contact their local school board, which is required to conduct its work through an Open Meeting process that allows for public comment. The Governor’s Office of the Education Ombuds (OEO) provides guidance to families and schools that need support to reach agreement.  

Will schools address social and emotional well-being?

Washington’s Office of Superintendent of Public Instruction (OSPI) has made clear in its guidance that student well-being is a priority as schools reopen. State and federal dollars, including those from the American Rescue Plan, enable schools to hire staff such as nurses and counselors to support student well-being.

OSPI provides a guidebook: Academic and Student Well-Being Recovery Plan: Planning Guide 2021 For School Districts, Tribal Compact Schools, and Charter Schools. Included is information about how state and federal dollars are awarded based on formal plans submitted by districts.

In their plans, districts must include statements about how student well-being will be supported. Districts are asked to prioritize social emotional learning and equity issues related to the disproportionate impact of the pandemic on different populations.

Families impacted by trauma, death, or other challenges during the pandemic can review their district’s Recovery Plan and consider whether their student’s needs are likely to be met. If there are concerns, family members can meet with school and district staff to request a more individualized approach. For students with IEPs, needs related to specific losses and trauma can be discussed in the context of an IEP Recovery Services plan. For more information about Recovery Services, see PAVE’s article: Recovery Services: What Families Need to Know as Schools Reopen.

Families who have experienced elevated stress due to COVID and want more support can reach out to the Washington Listens help line: 1-833-681-0211.

PAVE’s Family-to-Family Health Information Center (F2F) provides direct assistance for questions related to health and wellness, insurance, and access to medical services. For questions about school-based services, our Parent Training and Information (PTI) staff can help. Click Get Help from our home page at wapave.org to request individualized support.

Body Sensing Meditation for Help with Sleep

Anxiety around bedtime is a struggle for many people of all ages. Whether the challenge is to fall asleep or stay asleep, worry doesn’t make getting enough zees any easier. Here is a strategy for calming that uses a body scanning strategy combined with breath awareness.

Parents might share this practice out loud to help a child go to sleep. The child also might learn to use all or parts of the technique on their own. Once you understand the basic strategy you can adapt the wording to meet your own needs or the needs of the person you are sharing this with. Some might even fall asleep before you get through the whole practice!

If you or another person experiencing this practice do not have all of their body parts you can ask whether it feels good to imagine those body parts while doing the body scan or whether it feels better to include only body parts that are present. For a person who is deaf or hard of hearing or for people who respond well to sensory touch, there is the option to gently touch parts of the body while moving through the practice. Once learned, the practice can be silent, internal, and personalized. Be creative about how to make it workable and useful for any person who might benefit.

To help with sleep, body sensing starts with the feet…

Please make yourself comfortable in bed or another space where you can relax and listen to the 10-minute meditation provided in this video.

When you are finished listening, if you are not yet ready for sleep, you may wish to begin again with the body sensing, always starting with your feet and traveling awareness up through the body, noticing the breath throughout your own journey into rest.

The Meditation Script

If you prefer to read this script aloud to someone else or to yourself, here are the words from the video:

Notice that you have two feet. On your feet there are toes, big toes, second toes, middle toes, fourth toes, and baby toes. Notice your feet and toes. Notice what your feet and toes are touching. Is it soft or hard? Cool or warm? Are your toes and feet relaxed? Notice that you have ankles. Your legs have a lower part. You have two knees. Your legs have an upper part. You have hips. Notice what your hips, legs and feet are resting on. Is there anything you could change to be even just a little bit more comfortable?

Notice your tummy. Notice that as you breathe in your tummy goes up. As you breathe out your tummy goes down. Notice what it feels like to breathe in and out of your tummy. As you breathe in, you are noticing that your tummy is filling up. As you breathe out, you are noticing that your tummy is getting empty. What does breathing feel like? Just notice.

Notice that behind your tummy is your back. You have a lower back, a middle back, and an upper back. Inside your back there are ribs, and your ribs have a back part, two sides, and a front part. Your front ribs meet at your chest.

Notice that when you breathe in, your tummy fills up and so does your chest. Your ribs get a little wider. When you breathe out your chest goes down and so does your tummy. Your ribs settle in. See if you can notice what it feels like when your tummy and chest fill up with breath and when they empty of breath. Notice how long it takes for a breath to come all the way in and to go all the way back out again. Your body knows how to breathe all by itself and does this all day long. Notice how it feels to pay attention to your body breathing.

Notice that your chest is in between your shoulders. Your shoulders are connected to your arms.  Your arms have an upper part. You have elbows. Your arms have a lower part, and you have two wrists. Notice your hands. You have fingers. Each hand has a thumb, first finger, second finger, third finger and a baby finger. Your hands have a back part and a palm. Notice what your shoulders, arms and hands are resting on. Is it soft or hard? Cool or warm? Are your arms, hands, and fingers relaxed? Is there anything you could change to be even just a tiny bit more comfortable?

Notice that your heart is beating inside your chest. You are breathing, and your heart is beating. Your body is taking care of its basic needs to be healthy and alive. Notice that right now you are safe. Notice the room you are in and whether there is lightness or darkness or some of both. Notice any sounds that are near or far. Notice that your body is breathing. Your chest and belly fill up each time you breathe in and empty each time you breathe out. Make any little changes that you need to be slightly more comfortable.

Notice that you have a neck and a head. Notice what the back of your head is resting on. Your head has a top part and two sides. You have eyebrows and two eyes. Your eyes can close so that your top eyelashes and your bottom eyelashes touch each other. Imagine that there is a color behind your closed eyes that is a soft dark blue. Notice how you feel when you peer into this deep blue space behind your eyes. Notice if there are any edges to the dark blue or if it seems to stretch forever, like the night sky.

Notice that you have a mouth. Inside your mouth there is a tongue, and you have teeth. Your mouth has a right side and a left side. Your mouth is resting.

Notice that you have a nose with two nostrils. Air comes into your nostrils and goes out through your nostrils. Notice that air traveling into your nostrils moves down into your chest and tummy. After the air empties from your tummy and chest it leaves through your nostrils. Notice the long journey that your breath takes through the body, from the nostrils to the chest and belly. Out from the belly, the chest, and the nostrils. What does it feel like to watch your body breathing?

Notice the shape of your whole body and what your body is resting on. You have feet and legs. You have a tummy and a back. Your arms and hands are resting. Your whole body is comfortable and resting. You are breathing with your nose, your chest and your belly. Your eyes are closed, and there’s a dark blue color behind your eyelids. We’re breathing in and breathing out through our noses. We are safe and resting. We are noticing what it feels like to rest.

Download the meditation script

Mental Health Education and Support at School can be Critical

A Brief Overview

  • Alarming statistics indicate the pandemic has worsened behavioral health outcomes for young people. Governor Jay Inslee on March 14, 2021, issued an emergency proclamation declaring children’s mental health to be in crisis.
  • Students eligible for special education services through the federal category of Emotional Disturbance are more than twice as likely as other disabled peers to quit school before graduating.
  • These outcomes make adolescence a critical time for mental health promotion, early identification and intervention. Read on for further information and resources.
  • Seattle Children’s Hospital has a referral helpline. Families can call 833-303-5437, Monday-Friday, 8-5, to connect with a referral specialist. The service is free for families statewide.
  • Help is available 24/7 from the Suicide Prevention Lifeline: 1-800-273-TALK.
  • Text HEAL to 741741 to reach a trained Crisis Text Line counselor.
  • For youth who need support related to LGBTQ issues, the Trevor Projectprovides targeted resources and a helpline: 866-488-7386.
  • A place to connect with other families is a Facebook group called Youth Behavioral Healthcare Advocates (YBHA-WA).
  • Family caregivers can request support and training from A Common Voice, a statewide non-profit staffed with Parent Support Specialists who have lived experience parenting a child with mental illness or behavioral health challenges. Contact Jasmine@acommonvoice.org/253-732-4944.

Full Article

Alarming statistics indicate the COVID-19 pandemic has worsened circumstances for young people who were already struggling to maintain mental health. Washington’s most recent Healthy Youth Survey, from 2018, revealed that 10 percent of high-school students had attempted suicide within the year. Governor Jay Inslee on March 14, 2021, issued an emergency proclamation declaring children’s mental health to be in crisis.

The governor’s order requires schools to provide in-person learning options and directs the Health Care Authority and Department of Health to “immediately begin work on recommendations on how to support the behavioral health needs of our children and youth over the next 6 to 12 months and to address and triage the full spectrum of rising pediatric behavioral health needs.”

The Children and Youth Behavioral Health Work Group (CYBHWG) was created in 2016 by the Legislature (HB 2439) to promote system improvement. CYBHWG supports several advisory groups, including one for Student Behavioral Health and Suicide Prevention. The work groups include representatives from the Legislature, state agencies, health care providers, tribal governments, community health services, and other organizations, as well as parents of children and youth who have received services. Meetings include opportunities for public comment. Meeting schedules and reports are posted on the Health Care Authority (HCA) website.

A press for more school-based services

Advocacy for more school-based mental health services comes from the University of Washington’s SMART Center. SMART stands for School Mental Health Assessment Research and Training. The SMART center in 2020 provided the legislative work group with a report: The Case for School Mental Health. The document includes state and national data that strongly indicate school-based behavioral health services are effective:

“Increased access to mental health services and supports in schools is vital to improving the physical and psychological safety of our students and schools, as well as academic performance and problem-solving skills. Availability of comprehensive school mental health promotes a school culture in which students feel safe to report safety concerns, which is proven to be among the most effective school safety strategies.”

The statewide Student Behavioral Health and Suicide Prevention advisory group has recommended widespread implementation of Multi-Tiered Systems of Support (MTSS). Through MTSS, schools support well-being for all students through school-wide programming and offer higher levels of support based on student need. Social Emotional Learning (SEL) is a key component of an MTSS framework, which also creates a structure for providing Positive Behavioral Interventions and Supports (PBIS) at various levels of need.

The Office of Superintendent of Public Instruction, the guidance agency for Washington schools, prioritized 2021 budget requests to Empower all Schools to Support the Whole Child, including through MTSS. In January, 2021, OSPI was awarded a five-year, $5.3 million grant from the U.S. Department of Education to build regional coaching capacity to support districts in their MTSS implementation. As a local control state, Washington districts determine their own specific policies and procedures.

TIP: Families can ask school and district staff to describe their MTSS framework and how students are receiving support through the various levels/tiers.

Special Education is one pathway for more help

Students may access mental health support through the special education system. Emotional Disturbance is a federal category of disability under the Individuals with Disabilities Education Act (IDEA). Appropriate support can be especially critical for these students: According to the U.S. Office of Special Education Programs (OSEP), students eligible for school-based services under the ED category are twice as likely to drop out of high school before graduating.

Note that a student with a mental health condition could qualify for an IEP under the category of Other Health Impairment (OHI), which captures needs related to various medical diagnoses.

In Washington State, the ED category is referred to as Emotional Behavioral Disability (EBD). If the student’s behavioral health is impaired to a degree that the student is struggling to access school, and the student needs specially designed interventions, then the student may be eligible for an Individualized Education Program (IEP). Keep in mind that academic subjects are only a part of learning in school: Social Emotional Learning (SEL) is part of the core curriculum. 

An educational evaluation determines whether a student has a disability that significantly impacts access to school and whether specially designed instruction and/or related services are needed for the student to receive a Free Appropriate Public Education (FAPE). FAPE is the entitlement of a student eligible for special education services and an IEP team determines how FAPE/educational services are provided to an individual student.

Behavioral health counseling can be part of an IEP

Counseling can be written into an IEP as a related service. When included in a student’s IEP as educationally necessary for FAPE, a school district is responsible to provide and fund those services. School districts can receive reimbursement for 70 percent of the cost of behavioral health services for students who are covered by Medicaid and on an IEP.

A student with a mental health condition who doesn’t qualify for an IEP might be eligible for a Section 504 Plan. A disability that impairs a major life activity triggers Section 504 protections, which include the right to appropriate and individualized accommodations at school. Section 504 is an aspect of the Rehabilitation Act of 1973, a Civil Rights law that protects against disability discrimination. Students with IEPs and 504 plans are protected by Section 504 rights.

Behavioral Health encompasses a wide range of disability conditions, including those related to substance use disorder, that impact a person’s ability to manage behavior. Sometimes students with behavioral health disabilities bump into disciplinary issues at school. Students with identified disabilities have protections in the disciplinary process: PAVE provides a detailed article about student and family rights related to school discipline.

Placement options for students who struggle with behavior

IEP teams determine the program and placement for a student. In accordance with federal law (IDEA), students have a right to FAPE in the Least Restrictive Environment (LRE) to the maximum extent appropriate. That means educational services and supports are designed to help students access their general education classroom first. If they are unable to make meaningful progress there because of their individual circumstances and disability condition, then the IEP team considers more restrictive placement options. See PAVE’s article: Special Education is a Service, Not a Place.

Sometimes the IEP team, which includes family, will determine that in order to receive FAPE a student needs to be placed in a Day Treatment or Residential school. OSPI maintains a list of Non-Public Agencies that districts might pay to support the educational needs of a student.

A precedent-setting court ruling in 2017 was Edmonds v. A.T. The parents of a student with behavioral disabilities filed due process against the Edmonds School District for reimbursement of residential education. The administrative law judge ruled that the district must pay for the residential services because “students cannot be separated from their disabilities.”

Strategies and safety measures for families

With the release of the Healthy Youth Survey in Spring, 2019, the state issued a two-page Guide to Mental Health Information and Resources to provide more detail about the survey and to direct families and school staff toward resources for support.

Included is a list of factors that help youth remain resilient to mental health challenges:

  • Support and encouragement from parents/guardians and other family members, friends, school professionals, and other caring adults
  • Feeling that there are people who believe in them, care about them, and whom they can talk to about important matters
  • Safe communities and learning environments
  • Self-esteem, a sense of control and responsibility, and problem-solving and coping skills
  • Having an outlet for self-expression and participation in various activities

The handout includes tips for parents and other adults supporting teens who feel anxious or depressed:

  • Bond with them: Unconditional love includes clear statements that you value them, and your actions show you want to stay involved in their lives.
  • Talk with teens about their feelings and show you care. Listen to their point of view. Suicidal thinking often comes from a wish to end psychological pain.
  • Help teens learn effective coping strategies and resiliency skills to deal with stress, expectations of others, relationship problems, and challenging life events.
  • Have an evening as a family where everyone creates their own mental health safety plan.
  • Learn about warning signs and where to get help
  • Ask: “Are you thinking about suicide?” Don’t be afraid that talking about it will give them the idea. If you’ve observed any warning signs, chances are they’re already thinking about it.
  • If you own a firearm, keep it secured where a teen could not access it. Lock up medications they shouldn’t have access to.

State options for behavioral health services and support

For Washington children and youth with Medicaid insurance, the highest level of community-based care in behavioral health is provided through Wraparound with Intensive Services (WISe). The WISe program was begun as part of the settlement of a class-action lawsuit, TR v Dreyfus, in which a federal court found that Washington wasn’t providing adequate mental-health services to youth. WISe teams provide a wide range of therapies and supports with a goal to keep the young person out of the hospital.

Young people under 18 who need residential care to meet medical needs may be referred to the Children’s Long-Term Inpatient program: PAVE’s website provides an article about CLIP.

If a person ages 15-40 is newly experiencing psychosis, Washington offers a wraparound-style program called New Journeys. This website link includes access to a referral form.

The Family, Youth and System Partner Round Table (FYSPRT) provides a meeting space for family members and professionals to talk about what’s working and what isn’t working in mental healthcare. FYSPRT groups provide informal networking and can provide ways for families to meet up and support one another under challenging circumstances.

Federal parity laws require insurers to provide coverage for behavioral health services that are equitable to coverage for physical health conditions. The National Health Law Program (NHLP) provides information and advocacy related to behavioral healthcare access and offers handouts to help families know what to expect from their insurance coverage and what to do if they suspect a parity law violation:

Family Initiated Treatment (FIT) is an option in Washington

Youth older than 13 have the right to consent or not consent to any medical treatment in Washington State. Parents and lawmakers throughout 2018-2019 engaged in conversations about how that creates barriers to care for some teens struggling with behavioral health conditions. The Adolescent Behavioral Health Care Access Act (HB 1874), became law in May 2019. PAVE provides an article about the law and its provision for Family Initiated Treatment.  

Places to seek referrals and information

Seattle Children’s Hospital in 2019 launched a referral helpline. Families can call 833-303-5437, Monday-Friday, 8-5, to connect with a referral specialist. The service is for families statewide. In addition to helping to connect families with services, the hospital is gathering data to identify gaps in care.

PAVE’s Family-to-Family Health Information Center provides technical assistance to families navigating health systems related to disability. Click Get Help at wapave.org or call 800-572-7368 for individualized assistance. Family Voices of Washington provides further information and resources.

Key Resources

For information, help during a crisis, emotional support, and referrals:  

  • Suicide Prevention Lifeline (1-800-273-TALK)
  • Text “HEAL” to 741741 to reach a trained Crisis Text Line counselor
  • Trevor Project Lifeline (LGBTQ) (1-866-488-7386)
  • The Washington Recovery Help Line (1-866-789-1511)
  • TeenLink (1-866-833-6546; 6pm-10pm PST)

Further information on mental health and suicide: