Treating Washington kids with serious mental illness is a perennial problem: Long waitlists mean families often reach dead ends, and emergency rooms regularly house youth for days or weeks because there’s nowhere else for them to go.
Soon it will become even harder to find care. Pearl Youth Residence in Tacoma, one of the state’s four intensive residential programs for children, is set to close in November.
The closure translates to a massive loss in Washington’s ability to treat kids with diagnoses so significant they can’t live with their families: Pearl Youth is home to a quarter of the state’s long-term youth psychiatric beds.
The cost of care has outpaced the state’s reimbursement rate, said Kim Zacher, CEO at Comprehensive Life Resources, a nonprofit behavioral health provider that operates the 27-bed facility. Looking ahead to what’s bound to be a difficult state budget cycle, there was “no guarantee that we were going to get the money we needed.”
“We’re not confident we’re creating the outcomes that underpin such a huge investment by the state,” she said. “It really was just kind of the end of the road.”
Dramatic staff turnover rates, budget losses and trouble discharging kids back to their homes overpowered the facility’s many attempts to stave off closure, Zacher said.
“It was death by a thousand paper cuts,” she said, noting the facility has lost $3 million since 2020.
Ninety-two staff are facing layoffs, and the facility plans to discharge its 16 youth residents to their homes or other programs, Zacher said. Pearl Youth has space to treat 27 kids but has operated well below its capacity for several years, she said. The agency has struggled to retain staff willing and qualified to treat kids with complicated medical histories and whose symptoms often include aggression or psychosis; staff turnover was at 114% in 2024, she said, and remains at 70%.
To serve kids in such serious crises, Washington state contracts with Pearl Youth and two other nonprofit residential providers; it also operates its own facility called the Child Study and Treatment Center, near Western State Hospital in Lakewood, Pierce County.
Together, the facilities make up the state’s 109-bed Children’s Long-term Inpatient Program, also known as CLIP, which was developed in the 1980s and, in the wake of several residential program closures and consolidations over the past decade, is one of the few remaining inpatient options for Washington youth.
Thirty-six kids are currently awaiting a CLIP bed, state officials said.
Pearl Youth’s closure will stress a system already bursting at its seams, behavioral health providers warn.
More youth will end up stuck in hospitals, they said, or worse.
“It’s whack-a-mole because if we remove one thing, it’s just going to put pressure on the system someplace else,” said Jim Leighty, who has worked with incarcerated youth and is the former program manager at Sunstone, a Burien CLIP facility that closed in 2021. “I hate to say it, but some of them are going to end up in juvenile detention.”
Karen Brady, CEO at Ryther, a mental health provider in Northeast Seattle, called Pearl Youth’s closure “very troubling.”
“You have to be pretty ill to even get approval to be in (CLIP), and then you have to wait for a bed, and then it comes open, and now they’re going to lose a fourth of (those beds). … I just think it’s a big loss.”
There’s a chance some CLIP beds could soon be added back.
Washington State Health Care Authority, which oversees CLIP, “is actively seeking opportunities to contract for replacement capacity,” agency spokesperson Katie Pope said. “We are in discussions with potential providers in other regions of the state but do not have additional details to share at this time.”
A beleaguered 16-bed youth residential facility called Lake Burien is seeking CLIP certification and could become part of the program, pending state inspections, state Department of Social and Health Services officials said. The facility, which opened in 2024 to meet the short-term needs of youth with significant developmental and mental health concerns, replaced its director in April after facing scathing reviews in an Office of Developmental Disabilities Ombuds report.
The facility is scheduled for its CLIP inspection in October, said a spokesperson at DSHS, which oversees the treatment center. DSHS said the change in status wouldn’t affect who gets admitted and that it will still have the same number of beds and admission requirements.
Kids living at Pearl Youth stay an average of seven to eight months and receive care from specialized medical and mental health providers. Budget woes and caring for kids from all corners of the state, Zacher said, have in recent years led to big shifts in how the program operates.
In the past, many of the facility’s youth were local and would often visit their families on the weekends and attend nearby public schools. But in recent years, Zacher said, 95% of Pearl Youth patients were admitted from faraway counties, making it tough for families to visit or stay engaged with their children’s care.
Some families are so burned out from caregiving for kids whose symptoms became progressively worse, even violent, that they refuse to take their kids back once they’re deemed ready to discharge from CLIP.
Zacher said some families have taken drastic measures to ensure their kids can’t come home; in one instance, a family moved away while their child was in treatment. When this happens, getting Child Protective Services to respond typically involves “berating them, barraging them, and they won’t come until the last minute,” she added, noting the state used to take abandoned children into custody, but no longer does so when kids are stranded at hospitals or other medical facilities.
“There’s very little a mental health provider can do to compel a parent to the table,” she said.
Comprehensive Life Services plans to sell the 23,000-square-foot facility that houses Pearl Youth, which was built in 2020 and paid for by nearly $10 million in the agency’s funds and a $1.95 million taxpayer-funded Department of Commerce grant.
Seattle Times reporter Jayati Ramakrishnan contributed to this report.
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