Intensive Behavioral Health Treatment Facilities (IBHTFs) in Washington State

An Intensive Behavioral Health Treatment Facility (IBHTF) is a secure, specialized residential treatment program in Washington State for adults who need a high level of behavioral health care following psychiatric hospitalization or civil commitment.

IBHTFs support individuals with severe mental illness who require structured, 24/7 clinical care and stabilization before safely returning to a community setting. These facilities bridge the gap between inpatient psychiatric care and long-term residential services, offering a therapeutic, recovery-oriented environment designed to prevent rehospitalization and help individuals rebuild functioning and independence.

Who IBHTFs Are For

IBHTFs serve adults who:

Have severe and persistent mental illness, often with a history of multiple hospitalizations.
Have been civilly committed or detained involuntarily under Washington’s Involuntary Treatment Act.
Need a secure, structured treatment setting to stabilize before stepping down to lower-intensity care.
Require continuous clinical intervention, including psychiatric assessment, medication management, and behavioral therapy.
Cannot safely return to an Enhanced Services Facility (ESF), adult family home, assisted living, or independent housing without intensive stabilization.

IBHTFs are designed specifically for individuals who need more than outpatient care but no longer require the intensity of a hospital psychiatric unit.

How Someone Enters an IBHTF

People are admitted to an IBHTF through highly coordinated clinical pathways. The most common referral sources include:

1. State Psychiatric Hospitals and Community Inpatient Units

Individuals who reach psychiatric stability but are not yet ready for community living often transition to an IBHTF for continued treatment.

2. Civil Commitment Courts

Judges may order treatment at an IBHTF as part of a person’s involuntary commitment plan when secure behavioral health stabilization is required.

3. Designated Crisis Responders (DCRs)

DCRs may refer individuals who require a secure therapeutic environment after a behavioral health crisis.

4. Managed Care Organizations (MCOs) and Care Coordinators

Health plan partners identify IBHTFs as the appropriate next level of care for members who need intensive stabilization and 24/7 supervision.

All potential residents are evaluated for medical necessity, safety needs, and appropriateness before admission.

What Life in an IBHTF Looks Like

IBHTFs provide a highly structured, clinical environment focused on stabilization, treatment, and transition planning. Services typically include:

Psychiatric care and medication management
Individual, group, and family therapy
Substance use disorder treatment for co-occurring needs
24/7 nursing coverage and behavioral health support
Crisis prevention and intervention
Functional skills training and daily living support
Discharge and transition planning to step-down levels of care
Trauma-informed and recovery-focused care
Coordination with future housing and outpatient providers

Residents generally stay for several months, depending on progress, court requirements, and clinical stability.

Why IBHTFs Matter

Intensive Behavioral Health Treatment Facilities play a critical role in Washington’s behavioral health continuum. They:

Reduce psychiatric hospital overcrowding
Prevent unnecessary readmissions
Provide safe, secure stabilization for individuals in crisis
Support recovery and reduce long-term system involvement
Create a pathway back to community living with the right supports in place

For many individuals with severe mental health conditions, an IBHTF is the step that makes long-term stability possible.

Facilities

Tacoma Outpatient Clinic

Spokane Outpatient Clinic

Emerald City Youth - Federal Way Intensive Residential Treatment (IRT) (June 2026)

Affiliated Facilities

Emerald City Enhanced Services

Emerald City IBHTFs/RTFs (Opening 2025)

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