Self-Care Videos for Families Series

Feel What You Feel

When emotions overwhelm us, we sometimes react in ways that we later regret. “Name it to Tame it” is a concept from neuroscientist Dan Siegel. It means that if we identify our emotions and work with them, instead of pushing them away, we are better equipped for self-control. This simple body sensing meditation creates a way to practice emotional self-awareness and build mental muscles for emotional regulation.

For more videos about mindfulness, please go to wapave.org Thanks for watching!

What Parents Need to Know when Disability Impacts Behavior and Discipline at School

A Brief Overview

  • School discipline is resurfacing as a concern for many families as schools have reopened for in-person instruction. Read on for information about student rights in Washington and what families need to know when behavior impedes learning and disability may be a factor.
  • Schools are required to provide education and support before resorting to discipline. This article includes resources and information to help families ensure that students receive best-practice services and that disciplinary actions are non-discriminatory.
  • If the school calls to send a child home due to behavior, parents can ask whether the student is being suspended. If the school is not taking formal disciplinary action, parents are not required to take a child home. PAVE provides a video with information about what to do if the school wants to send a child home due to behavior.
  • If a student is excluded from school through suspension or expulsion, or if a student is isolated or restrained at school, specific reports are required. Read on for more detail.
  • Read on for information about Procedural Safeguards, which are downloadable through the Office of Superintendent of Public Instruction (OSPI), Washington’s lead educational agency.
  • PAVE provided a training about student rights, with some information specifically related to mental health, for the statewide NAMI conference Oct. 16, 2021. The recording is available through PAVE’s website: How to Navigate School for Youth with Mental Health Concerns.
  • Families can seek individualized assistance by clicking Get Help from PAVE’s website, wapave.org.

Full Article

Behavior is a form of communication, and children often try to express their needs and wants more through behavior than words. When a young person has a disability or has experienced trauma or other distress, adults and authorities may need to put in extra effort to understand. Missed cues and unmet needs can result in unexpected and sometimes explosive behaviors, which may lead schools to suspend or expel students. Best practice is to meet behavioral health needs and support students before disciplinary action is necessary.

Unfortunately, not all students are adequately supported. Before the COVID-19 pandemic, state data indicated that students with disabilities were disciplined at least 2.5 times more often than non-disabled peers (See WA State Report Card). For students with disabilities who are Black, Indigenous, or People of Color (BIPOC), the numbers are consistently higher.

Research clearly indicates that children’s behavioral health worsened during the pandemic. Governor Jay Inslee on March 14, 2021, issued an emergency proclamation declaring children’s mental health to be in crisis.

The governor’s order directed 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.”

As most schools reopened for in person instruction in 2021, a range of federal and state guidance documents encouraged schools to prioritize the psychological needs of students. The U.S. Office of Special Education and Rehabilitative Services (OSERS) on September 30, 2021, released a Return to School Roadmap that highlights considerations for students with disabilities. Included are recommendations to increase support for students who are struggling to maintain expected behavior and access their right to a free appropriate public education (FAPE) because of trauma and disruptions to learning:

“A child whose behavior impedes their learning may need new or increased services and supports for the child to receive FAPE. These increased services and supports may include new or adjusted specially designed instruction, academic supports, positive behavioral interventions, and other supports such as counseling, psychological services, school health services, and social work services.

“IEP Teams are encouraged to review the pre-pandemic services required to provide FAPE to the child and determine if the child did or did not receive them during the school closure and other disruptions in service. IEP Teams are also encouraged to make general observations about the child’s attendance, engagement, attention, behavior, progress, and home experience during the COVID‑19 pandemic.”

What is exclusionary discipline?

Any school disciplinary action that takes a student away from their regularly scheduled placement at school is called exclusionary discipline. Out-of-school suspensions, expulsions, and in-school suspensions count. Another element is isolation/restraint, which is an emergency response to imminent danger and not disciplinary. See below for more detail.

Families can empower themselves to advocate for their students by learning the federal framework for school-based services. Students who receive accommodations and supports through a Section 504 Plan have anti-discrimination protections from the Rehabilitation Act of 1973. Students with an Individualized Education Program (IEP) have Section 504 protections and specific rights and protections from the Individuals with Disabilities Education Act (IDEA).

Exclusionary discipline may violate FAPE

A student with an identified disability may be suspended for a behavioral violation that is outlined in district policy. State guidance is for schools to suspend students only if there are significant safety concerns. Schools are limited in their ability to exclude students from school because of behaviors that “manifest” (arise or express) from disability.

Students with identified disabilities supported through either an IEP or a 504 Plan are afforded access to a Free Appropriate Public Education (FAPE). Disciplinary actions that deny access to FAPE may be discriminatory. In other words, if a student with disabilities has unmet needs and is consistently sent home instead of helped, the school may be held accountable.

Read on for information about Procedural Safeguards, which are downloadable through the Office of Superintendent of Public Instruction (OSPI), Washington’s lead educational agency.

Unexpected behavior may indicate a disability and need for services

School districts have a duty to evaluate students to determine eligibility for special education if they have learning challenges or exhibit behavior that may indicate a disability. Under IDEA, this responsibility is called Child Find.

The Office for Civil Rights within the U.S. Department of Education in December 2016 issued a two-page Fact Sheet that includes this statement: “A student’s behavioral challenges, such as those that lead to an emergency situation in which a school believes restraint or seclusion is a justified response could be a sign that the student actually has a disability and needs special education or related aids and services in order to receive FAPE.”

Manifestation Determination

To avoid FAPE violations, schools are required to document missed educational time and meet with family to review the student’s circumstances if the time a student has been suspended or otherwise removed from their academic placement for discipline adds up to 10 days. That meeting is called a Manifestation Determination. Manifestation Determination is a distinct process for students with known or suspected disabilities and is separate from general education disciplinary hearings or procedures.

Under Section 504, schools are bound to consider disability-related factors through Manifestation Determination if the disciplinary removal is for more than 10 consecutive school days or when the child is sub­jected to a series of removals that constitute a pattern. OSPI provides a guidance form for Section 504 circumstances.

For a student with an IEP, removal from regularly scheduled classes for more than 10 days per school year constitutes a “change of placement” and a Manifestation Determination meeting is held to determine whether the disciplinary removals resulted from the school’s failure to implement the IEP. OSPI provides a guidance form for IEP circumstances.

During a Manifestation Determination meeting, a student’s circumstances and services are reviewed. An IEP can be amended to provide additional support. For students not yet identified for special education services, this meeting can initiate or expedite an evaluation if the school district knew or should have known that the student needed special education services. 

Family members are included in this process. According to WAC 392-172A-05146, “If the school district, the parent, and relevant members of the student’s IEP team determine the conduct was a manifestation of the student’s disability, the school district must take immediate steps to remedy those deficiencies.”

If the conduct is determined to be unrelated to disability, then school personnel may use general education discipline procedures. The school must still provide any special education services that the student has already been found to need. The IEP team decides the appropriate alternative setting and special education services to meet the student’s needs while suspended.

Note: With the exception of a firearm violation under federal law, school districts are not required to suspend or expel students for any behavioral violation. State law explicitly encourages school districts to consider alternative actions before administering suspension or expulsion. If a student’s conduct involves weapons, illegal drugs, or serious bodily injury, a student may be removed for up to 45 school days regardless of whether the student’s behavior was a manifestation of disability. However, a manifestation determination meeting still is required within the first 10 days of removal from school and educational services are provided.

Schools are required to support behavior and work with families

Schools are required to provide education and support before resorting to discipline for children who struggle with behavior because of their impairments. Under the IDEA, when behavior impedes the child’s learning or that of others, the IEP Team is required to consider the use of positive behavioral interventions and supports, and other strategies, to address that behavior. When necessary (for FAPE), the team must include those supports in the IEP.

These requirements are described in a federal Dear Colleague letter from August 1, 2016: “We are issuing this guidance to clarify that the failure to consider and provide for needed behavioral supports through the IEP process is likely to result in a child not receiving a meaningful educational benefit or FAPE.”

The letter, provided by the U.S. Department of Education, recommends specific alternatives to disciplinary removal and includes detail about the rights of families when there are behavioral concerns: “In general, IEP Team meetings provide parents (who are required members of the team) critical opportunities to participate in the decision-making process, raise questions and concerns regarding their child’s behavior, and provide input on the types of behavioral supports their children may need.”

When a student is suspended, the school is required to submit a report to the family and the state. That report must include an explanation of how school staff attempted to de-escalate a situation before resorting to disciplinary removal. OSPI provides information for schools and families related to state guidance and requirements. A one-page introductory handout for parents is a place to begin.

As a local control state, individual school districts determine their specific policies related to disciplinary criteria and actions. According to OSPI, school districts are required to engage with community members and families when updating their discipline policies, which must align with state and federal regulations.

In general, Washington rules:

  • Encourage schools to minimize the use of suspensions and expulsions and focus instead on evidence-based, best-practice educational strategies
  • Prohibit schools from excluding students due to absences or tardiness
  • Limit use of exclusionary discipline for behaviors that do not present a safety threat
  • Prohibit expulsion for students in kindergarten through grade four (children in that age range cannot be excluded from their classroom placements/suspended for more than 10 cumulative days per academic term)
  • Require schools to provide educational access while a student is suspended or expelled

Schools must provide educational services during a suspension

State law requires that all suspended and expelled students have an opportunity to receive educational services (RCW 28A.600.015). According to the Washington Administrative Codes (WAC 392-400-610) educational services provided in an alternative setting must enable the student to:

  • Continue to participate in the general education curriculum
  • Meet the educational standards established within the district
  • Complete subject, grade-level, and graduation requirements

The American Civil Liberties Union of Washington provides a free, downloadable Parents’ Guide to Public School Discipline in Washington. Part III includes information about laws and procedures that are specific to students in special education. The ACLU guidebook encourages parents to gather as much information as possible when a student is disciplined:

“It is important to fully understand the type of proposed discipline, the underlying behavior, how the behavior relates to the student’s disability, and what additional supports may be available in order to fully advocate for your student.”

Schools can assess the behavior (FBA) to make a plan (BIP)

Regardless of whether the student has qualified for services, best practice is for the school to conduct a Functional Behavioral Assessment (FBA) following a significant disciplinary action. An FBA can be done for students with or without IEPs or Section 504 Plans.

The FBA is used to develop a Behavior Intervention Plan (BIP), which helps a child learn expected behaviors and prevent escalations. The BIP identifies target behaviors that disrupt learning and calls out “antecedents,” conditions or events that occur first—before the targeted behavior. A BIP supports “replacement” behavior so a student can develop skills for expected learning behaviors.  

In addition to a BIP, a student receiving special education services whose behavior impedes their learning may need Specially Designed Instruction (SDI) to support skill-development in an area of education called Social Emotional Learning (SEL). If targeted SEL instruction is needed, the student will have specific IEP goals to support the learning.

Another way that an IEP can support students with behavioral disabilities is through related services. 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.

All students access behavioral supports when schools use Multi-Tiered Systems of Support (MTSS). Families can ask school staff to describe their MTSS structure and how students receive support through Tier 1 (all students), Tier 2 (targeted groups), and Tier 3 (individualized support). An element of MTSS is Positive Behavioral Interventions and Supports (PBIS), which also supports students across levels of need.

PAVE provides an article with more information about MTSS/PBIS and how to support expected behaviors at school.

Do you need to pick up your student if the school calls?

In its guidance booklet, ACLU addresses the question, “Do you need to pick up your student every time the school calls?” A parent can ask whether the student is being suspended.  “If your student has not been officially suspended,” ACLU advises, “The school cannot force you to pick up the student.

“If you choose to pick up your student when he or she has not been suspended, the school may not record the removal from class and may not trigger additional protections (such as Manifestation Determination Hearings) that apply when students with disabilities are removed from school for 10 days or more.”

The ACLU guidebook includes a list of supports parents can ask for: “The law requires behavior supports to be based on evidence, and so you can ask for additional expert evaluation to determine whether the behavior supports offered to your student are appropriate.”

PAVE provides additional information about what to do if the school calls in a video.

Guidance related to isolation and restraint

The state has specific rules related to the use of isolation and restraint, which are implemented only when a student’s behavior poses an imminent likelihood of serious bodily harm and are discontinued when the likelihood of serious harm has passed. Isolation and restraint are not used as a form of standard discipline or aversive intervention.

The Washington State Governor’s Office of the Education Ombuds (OEO) offers an online resource page that details state guidance related to isolation and restraint. Included is this statement:

“Schools in Washington State are not allowed to use restraint or isolation as a form of discipline or punishment, or as a way to try to correct a child’s behavior. Restraint and isolation are only allowed as emergency measures, to be used if necessary, to keep a student or others safe from serious harm. They can continue only as long as the emergency continues.”

School districts are required to collect and report data on the use of restraint and isolation. That data is posted on OSPI’s website as part of the School Safety Resource Library. 

Emergency Response Protocol (ERP)

If emergency responses and/or severe disciplinary actions become frequent, schools might ask the parent/guardian to sign an Emergency Response Protocol (ERP) for an individual student. Families are not required to sign this.

The ERP explains what the school’s policies are related to isolation and restraint and what the training requirements are for staff authorized to conduct isolation and restraint. Parents can request a copy of the district’s general education policies on this topic. The ERP can include a statement about how parents are contacted if the school uses isolation or restraint.

Reporting requirements for disciplinary removal

Schools are required to provide a report to the parent/guardian and to the state any time formal disciplinary or emergency actions are taken.

The Washington Administrative Code (WAC 392-400-455) describes what is required in a notice to students and parents when a student is suspended or expelled from school:

  • Initial notice. Before administering any suspension or expulsion, a school district must attempt to notify the student’s parents, as soon as reasonably possible, regarding the behavioral violation.
  • Written notice. No later than one school business day following the initial hearing with the student in WAC 392-400-450, a school district must provide written notice of the suspension or expulsion to the student and parents in person, by mail, or by email. The written notice must include:
    • A description of the student’s behavior and how the behavior violated the school district’s policy adopted under WAC 392-400-110;
    • The duration and conditions of the suspension or expulsion, including the dates on which the suspension or expulsion will begin and end;
    • The other forms of discipline that the school district considered or attempted, and an explanation of the district’s decision to administer the suspension or expulsion;
    • The opportunity to receive educational services during the suspension or expulsion under WAC 392-400-610;
    • The student’s and parents’ right to an informal conference with the principal or designee under WAC 392-400-460;
    • The student’s and parents’ right to appeal the suspension or expulsion under WAC 392-400-465, including where and to whom the appeal must be requested; and
    • For a long-term suspension or expulsion, the opportunity for the student and parents to participate in a reengagement meeting under WAC 392-400-710.
  • Language assistance. The school district must ensure the initial and written notices required under this section are provided in a language the student and parents understand, which may require language assistance for students and parents with limited-English proficiency under Title VI of the Civil Rights Act of 1964.

Reporting requirements for isolation/restraint

The state has similar reporting requirements when a student is isolated or restrained at school. Following are statements from the Revised Code of Washington (RCW 28A.600.485):

“Any school employee, resource officer, or school security officer who uses isolation or restraint on a student during school-sponsored instruction or activities must inform the building administrator or building administrator’s designee as soon as possible, and within two business days submit a written report of the incident to the district office. The written report must include, at a minimum, the following information:

  • The date and time of the incident
  • The name and job title of the individual who administered the restraint or isolation
  • A description of the activity that led to the restraint or isolation
  • The type of restraint or isolation used on the student, including the duration
  • Whether the student or staff was physically injured during the restraint or isolation incident and any medical care provided
  • Any recommendations for changing the nature or amount of resources available to the student and staff members in order to avoid similar incidents”

The RCW also states that school staff “must make a reasonable effort to verbally inform the student’s parent or guardian within 24 hours of the incident and must send written notification as soon as practical but postmarked no later than five business days after the restraint or isolation occurred. If the school or school district customarily provides the parent or guardian with school-related information in a language other than English, the written report under this section must be provided to the parent or guardian in that language.”

Equity work in student discipline is ongoing

A graph that shows disparity in discipline is provided on OSPI’s website, which includes training and materials for schools to support improvements. “Like other states, Washington has experienced significant and persistent disparities in the discipline of students based upon race/ethnicity, disability status, language, sex and other factors,” OSPI’s website states. “While overall rates of exclusionary discipline (suspension and expulsion) have declined over the last decade, significant disparities persist. These trends warrant serious attention from school districts, as well as OSPI, to work toward equitable opportunities and outcomes for each and every student.”

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 Healthy Minds Healthy Futures.
  • 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 behavioral health challenges. The program is part of the Center of Parent Excellence (COPE), managed by the state’s Health Care Authority, which provides contact information for regional lead parent support specialists.

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 school-based services and mental health literacy

Advocacy for direct school-based mental health services and education about mental health topics 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 SMART Center in partnership with the non-profit Chad’s Legacy Project in 2021 established an online Student/Youth Mental Health Literacy Library. Intended for staff at middle and high schools, the library provides resources to help schools choose curricula for mental health education on topics that include Social Emotional Learning, Substance Use Disorder, and Suicide Prevention. Goals of mental health literacy are:

  • Understanding how to foster and maintain good mental health
  • Understanding mental disorders and their treatments
  • Decreasing Stigma
  • Understanding how to seek help effectively for self and others

TIP: Families can direct their schools to this resource to support development or growth of a mental health education program.

Mental Health support to students is a statewide priority

Top priority for the statewide Student Behavioral Health and Suicide Prevention advisory group is to increase school staff who directly support students, including licensed mental health professionals imbedded in schools, counselors, social workers, school nurses and other support staff. The larger Children and Youth Behavioral Health Work Group (CYBHWG) shares that priority as an aspect of assessing and rethinking behavioral health delivery systems throughout the state.

In its recommendations to the 2022 legislature, CYBHWG recommends that the state fund a facilitated process to develop a strategic plan “to ensure that all Washington children and youth ages 0-25 years and families have timely access to high-quality, equitable, well-resourced behavioral health education, care, and supports across the continuum and where they need it.” School-based mental health services are listed as an aspect of those recommendations.

As schools returned to in-person learning in 2021, the Office of Superintendent of Public Instruction (OSPI) created a guidance document that addresses student mental health needs as a top concern: Questions and Answers: Provision of Services to Students with Disabilities During COVID-19 in the 2021–22 School Year. Included is this statement:

“The work of Washington public schools is to prepare students for postsecondary pathways, careers, and civic engagement. Washington must create the conditions for each student to be educated in racially literate, culturally sustaining, positive, and predictable environments that intentionally prioritize the instruction and development of social-emotional skills and mental health in addition to our primary focus on academic content.”

TIP: Family caregivers can ask their school what staff are on site to support students with their mental health needs. Some school districts seek support from an Educational Service District (ESD) to meet student behavioral health needs, so families can also ask whether ESD supports are available. Note that some ESDs are licensed as behavioral health providers.

What is MTSS, and why learn this acronym to ask the school about it?

Another priority for agencies involved in the statewide work is widespread implementation of Multi-Tiered Systems of Support (MTSS). Through MTSS, schools support well-being for all students and offer higher levels of support based on student need. Social Emotional Learning (SEL) is key to an MTSS framework, which can create a structure for implementing positive behavioral supports and trauma-informed interventions.

OSPI, 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 help districts implement MTSS. 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:  

Take a Mindful Walk in Nature

Mindfulness can mean anything that helps you slow down and show up for what’s happening in a moment. This video demonstrates how to notice all of the body’s senses on a nature walk. Once it’s familiar, the concept could be useful in any environment, including indoors. Get creative and if it’s developmentally appropriate, you can encourage children to make up their own journey through their senses.

Get Calm by Getting Organized

When overwhelm is happening, it’s hard to imagine that getting organized will help. But here’s why it’s worth it: When you feel satisfied that you’ve done something, your brain releases happiness chemicals and hormones. This video provides information about how that works and how families can tap into happy by getting organized and taking time each day to celebrate everyone’s accomplishments.

How to Navigate School for Youth with Mental Health Concerns

Staff from PAVE’s Parent Training and Information (PTI) program provided a workshop as part of the statewide virtual conference hosted by NAMI Washington October 16, 2021.

This recorded training provides a general overview of student rights in education. Some information is specific to students impacted by mental health conditions.

The formal content begins about four minutes into the video and ends at about 46 minutes.

Here are a few examples of topics addressed:

  • Does my student have the right to be evaluated for special education if they refuse to go to school because of anxiety?
  • What accommodations are reasonable to ask for?
  • What services might be possible for my student who struggles with emotional regulation?
  • Can counseling be a related service?
  • Are there protections for a student because of suicidal thoughts or attempts?
  • What support is available for a student with a disability condition who isn’t prepared for adulthood because high school got interrupted by the pandemic?

Additional information about mental health education and services at school, the overall layout of youth behavioral health in Washington State, and where to find family support is included in a PAVE article: Mental Health Education and Support at School can be Critical.

To seek education, training, and support from the National Alliance on Mental illness, look for a virtual training or information about a local affiliate near you, listed on the NAMI WA website.

One place to access behavioral health services for children and youth anywhere in Washington is through the Seattle Children’s Hospital Mental Health Referral Service: 833-303-5437, Monday-Friday, 8 a.m. to 5 p.m.

Families and young people can reach out for individualized assistance from PAVE’s Parent Training and Information (PTI) staff at PAVE. Click Get Help or call 800-572-7368.

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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.”