Provider Referral - Behavioral Health Unit
Overlake’s mental and behavioral health services are a trusted extension of your care team. When your adult patient needs behavioral or mental health support, Overlake offers compassionate, evidence-based care across a continuum of services. Our multidisciplinary team works with patients and providers to connect individuals with the appropriate level of care. Explore the service that best meets your patient’s needs.
Thank you for considering your patient for the Overlake Behavioral Health Unit (BHU).
The BHU is a voluntary 14-bed inpatient psychiatric unit for adults who require short-stay crisis stabilization, including care for patients with co-occurring substance use disorders when inpatient psychiatric admission criteria are met.
Program Overview
Program type
Adult voluntary inpatient psychiatric crisis stabilization unit
Capacity
14 beds, all private rooms with bathrooms
Population served
Adults aged 18 and older
Primary clinical focus
Acute psychiatric symptoms requiring 24-hour supervised inpatient care, daily psychiatric provider evaluation, medication management, therapeutic structure, and discharge planning
Typical length of stay
Average of 4 to 5 days, though actual length of stay varies based on safety, symptoms, treatment progress, medical necessity, and discharge planning needs
Treatment model
Short-stay crisis stabilization with 24-hour nursing, daily psychiatrist or psychiatric nurse practitioner evaluation, group and milieu therapy, medication management, and discharge planning beginning at admission
Substance use treatment
Co-occurring capable. Substance use disorder may be addressed when acute psychiatric symptoms also require inpatient psychiatric level of care. Primary substance use disorder, intoxication, or withdrawal alone is generally not appropriate for BHU admission.
Referral pathways
BHU admissions require medical clearance. Referrals are received from emergency departments or inpatient medical units. Referrals from other inpatient psychiatric units are not accepted.
When to Consider Referral
- The patient is 18 or older and is voluntarily seeking inpatient psychiatric treatment.
- The patient is experiencing an acute episode or acute exacerbation of a mental health condition with elevated safety risk, significant functional decline, or inability to stabilize safely in a less restrictive setting.
- The patient requires 24-hour supervised care with daily psychiatric provider evaluation and an active treatment plan.
- Medication initiation, adjustment, or monitoring is needed at an intensity that cannot be safely managed in routine outpatient, intensive outpatient, or partial hospitalization care.
- The patient can participate in a structured therapeutic milieu, group programming, medication treatment, and discharge planning.
- Co-occurring substance use may be present, provided the primary need is inpatient psychiatric stabilization and the patient is not in acute intoxication or withdrawal requiring a medical level of care.
Patients Who May Need a Different Level of Care
Each case is reviewed individually, but the BHU may not be appropriate when the patient’s primary need is outside the unit’s capability, such as:
- Involuntary admission or inability/unwillingness to provide voluntary informed consent and follow unit expectations.
- Medical or surgical care needs beyond BHU capability, including unstable vital signs, active delirium from medical causes, continuous IV therapy, central/PICC line care, oxygen therapy, tracheostomy care, intensive wound care, uncontrolled seizures, active chemotherapy, or other intensive nursing needs.
- Active infection, infestation, uncontained wound drainage, or communicable disease requiring precautions that cannot be safely managed on the unit.
- Primary substance use disorder without acute psychiatric symptoms requiring inpatient psychiatric stabilization, or acute alcohol/drug intoxication or withdrawal requiring a medical level of care.
- A primary neurocognitive or intellectual disability-related concern without a treatable acute psychiatric condition expected to improve with short-term inpatient treatment (including diagnosed dementia or cases where dementia is suspected).
- A pattern of aggressive or violent behavior that is primarily intentional in nature, not related to a treatable psychiatric disorder, or not expected to improve with brief inpatient psychiatric care.
What Patients Should Understand Before Admission
Patients should understand that BHU is a voluntary, structured inpatient program focused on short-term crisis stabilization, safety, medication evaluation, group programming, and discharge planning. Patients are generally expected to participate in treatment programming, including 5 to 6 groups per day unless excused by the treatment team, take medications as ordered, maintain safe behavior, and participate in discharge planning.
Personal cell phones and personal electronic devices are not used on the unit, though unit phones are available during designated times and patients may be able to retrieve numbers from personal devices under staff supervision.
Frequently Asked Questions for Referring Providers
What diagnoses or conditions are typically appropriate for the BHU?
The BHU may be appropriate for acute psychiatric presentations such as severe depression, mania, psychosis, suicidal ideation or behavior, serious self-harm risk, homicidal ideation or behavior, or significant deterioration in functioning when 24-hour supervised inpatient care is clinically indicated.
Is the BHU voluntary or involuntary?
Patients admitted to BHU are voluntary and may ask to leave. If a patient requests discharge before the treatment team believes discharge is clinically appropriate, staff will review safety, treatment progress, and discharge planning. If there are serious safety concerns, including concern for risk of harm to self, harm to others, or grave disability due to a behavioral health disorder, the hospital may contact a Designated Crisis Responder for evaluation under Washington law.
Can outpatient providers refer directly to the BHU?
Direct admission from outpatient or self-referral is not accepted because patients require medical clearance and clinical review before admission. Outpatient providers who believe inpatient psychiatric care may be needed should direct the patient to an emergency department or appropriate crisis evaluation pathway.
Can external emergency departments or inpatient medical units refer patients?
Yes. External emergency departments and inpatient medical units may be appropriate referral sources after medical clearance and clinical review. Acceptance depends on bed availability, voluntary status, medical stability, and fit with BHU admission criteria and unit capability.
What medical clearance is expected before admission?
Patients should have a medical evaluation that confirms medical stability for inpatient psychiatric level of care and rules out medical causes of the psychiatric presentation. Recommended screening may include vital signs, history and physical examination, CMP, CBC, TSH, toxicology including alcohol and urine drug screen, and HCG when clinically applicable.
Is the BHU appropriate for substance use disorder?
The BHU is co-occurring capable when acute psychiatric admission criteria are met. Primary substance use disorder alone, acute intoxication, or active withdrawal requiring medical management is generally not appropriate for BHU admission.
What should I tell patients to expect?
Patients should expect a locked, structured, therapeutic inpatient environment focused on safety, stabilization, medication evaluation, coping skills, group programming, relapse prevention as appropriate, and discharge planning. The average stay is 4 to 5 days, but the actual discharge date is determined by the treatment team based on clinical progress and safety.
Is individual psychotherapy offered on the unit?
No. The BHU is not an individual psychotherapy program. Treatment is focused on short-term stabilization through psychiatric provider care, nursing support, medication management, group and milieu therapy, safety planning, and discharge planning.
When should a patient be sent to the emergency department?
If there is imminent risk of harm to self or others, inability to maintain safety, acute intoxication or withdrawal, unstable medical symptoms, or uncertainty about the appropriate level of care, the patient should be evaluated through an emergency or crisis pathway.
How do I know if a bed is available?
The BHU will not release census or bed availability over the phone. Please direct a patient to an emergency department for evaluation. The patient can ask the emergency department provider or social worker to reach out to Overlake BHU for bed availability and fitness for admission.
Important note: This guide is intended to support referral conversations and does not guarantee admission. All potential admissions are reviewed individually based on clinical need, voluntary status, medical stability, unit capability, and bed availability.