IRT (Intensive Residential Treatment)
Our specialty program for adults with serious mental illness and co-occurring disorders, providing wrap-around, high-acuity outpatient care delivered directly in residential care settings. IRT supports long-term stability, reduces hospitalizations, and helps individuals remain successfully in their communities.
What is IRT?
Intensive Residential Treatment (IRT) is Emerald City Behavioral Health’s specialty outpatient program, designed for adults with the most complex and high-acuity mental health needs. We provide wrap-around clinical services for individuals living with serious mental illness—including schizophrenia, schizoaffective disorder, bipolar I disorder with psychotic features, and severe major depression with psychosis—as well as those with co-occurring substance use disorders.
IRT is not a residential facility.
Instead, our clinicians deliver care directly within DSHS/ALTSA residential care settings, so individuals receive structured and consistent treatment where they live. By combining psychiatric treatment, substance use counseling, medication management, and life skills support, IRT helps residents maintain stability, avoid relapse, and remain successful in their communities.
Who is Eligible?
To qualify for IRT, individuals must:
Have a DSM-5 (or successor) mental health diagnosis requiring clinical intervention.
Reside in a DSHS/ALTSA/HCS residential facility.
Present symptoms that place their ongoing community placement at risk without this level of support.
At intake, most individuals meet one of two pathways:
Diversion:
At risk for psychiatric hospitalization, involuntary treatment, loss of placement, or currently in a diversion or triage setting awaiting a suitable residential placement.
Discharge:
Preparing for discharge from an inpatient psychiatric facility, but symptoms present barriers to transitioning into a long-term care setting without IRT support.
How the Referral Process Works
We know that navigating referrals can feel overwhelming. Our team works with providers, courts, facilities, and families to make the process straightforward:
Initiate Referral
Referrals may be made by MCO liaisons, HCS staff, hospitals, courts, or local providers.
Review & Eligibility
MCO and HCS confirm eligibility and service availability. Court orders such as LRA or Conditional Release are reviewed to ensure conditions can be met.
Documentation
HCS staff prepare the referral packet, including the CARES assessment.
Assessment & Placement Coordination
ECBH clinicians assess the individual’s fit for the Adult Family Home (AFH) or Assisted Living Facility (ALF) setting, ensuring services do not overlap with RSW supports.
Acceptance & Engagement
Once accepted, the IRT team connects with the individual prior to discharge to introduce services and begin relationship-building.
📩 Referrals and completed forms can be sent to: IRT@emeraldcity.health
What Makes ECBH’s IRT Different
Multidisciplinary Team: Psychiatric prescribers, licensed therapists, SUD professionals, social workers, and peer support specialists.
Holistic Care: Plans tailored to clinical, social, and life-skill needs.
Community Integration: Designed to reduce re-hospitalization and promote stability.
Flexible Delivery: Services provided onsite with telehealth support when appropriate.
Compliance: Delivered in alignment with Washington HCA and DSHS standards.
Benefits for Facilities
Partner facilities receive a dedicated ECBH clinical team embedded onsite at no cost, as services are Medicaid-covered. Our staff coordinate with facility administration, MCO liaisons, and court partners to maintain consistency, stability, and clear communication.
Forms & Resources
Referral packets, consent forms, patient handbooks, and informational brochures are located in the IRT Resources section and are kept updated for easy access.