If your child has a dual diagnosis of I/DD and mental illness, overlapping systems can make it difficult to know where to turn for crisis intervention, evaluation, and treatment (including individual therapy, group therapy and medication management). Except in the case of a life-threatening emergency—when it’s time to call 911—the following offers a simple guide to three main access points for mental health services, also known as behavioral health.
Primary Care Provider
Covered by: Apple Health (formerly Medicaid); Medicare; Private Insurance
For children and adults receiving Apple Health/Medicaid who do not meet Access to Care standards (see inset), and individuals covered under private insurance or Medicare. Contact your primary care provider for evaluation, treatment and/or referral to a mental health professional enrolled in Apple Health or your private health care plan. Some plans allow for self-referral to a mental health professional. Consult your plan for details.
Behavioral Health Organizations (BHO)
Covered by: DSHS Division of Behavioral Health & Recovery for Medicaid-eligible individuals
For children and adults who meet Access to Care standards (see below) for higher intensity mental health services not covered by the Apple Health plan, and for substance use treatment. BHOs coordinate mental health services through contracts with community mental health agencies in their area. BHOs exist in every county except Clark and Skamania (where all mental health services are provided through the individual’s Apple Health’s Managed Care Organization).
To access services:
- Contact your local BHO directly.
- Contact a BHO-contracted treatment agency directly; or,
- Contact the 24-hour, free and confidential Washington Recovery
Help Line at 1-866-789-1511 (TTY 1-206-461-3219). You will be referred to a BHO that will connect you with a provider.
Access to Care Standards
- The individual is determined to have a mental illness under a covered diagnosis.
- The individual’s impairment(s) and corresponding need(s) must be the result of a mental illness.
- The intervention is deemed to be reasonably calculated to improve, stabilize or prevent deterioration of functioning resulting from the presence of a mental illness.
- The individual is expected to benefit from the intervention.
- The individual’s unmet need would not be more appropriately met by any other formal or informal system or support.
Developmental Disabilities Administration (DDA)
Covered by: DDA Program Funding
For children and adults enrolled in DDA. Contact your DDA Case Resource Manager to request behavioral support or behavioral health stabilization services.
Resources for Children with I/DD and Mental Illness
The Where, What, When and How of Mental Health Evaluations
Autism and DDA Eligibility: The DSM Effect