Admission Waiting List
Riggs’ Admission Waiting List: What is it and how does it work?
In admissions we are often asked by referrers, prospective patients, and their families what the “waiting list” for admission to Riggs is all about and how the process of getting on the waiting list works.
The waiting list consists of prospective patients whose clinical situations have been reviewed by the director of admissions and then determined as potential candidates for admission. They are waiting for us to schedule the several hour face-to-face admissions consultation during which we make the actual determination about whether to offer admission—and admission is offered to approximately 90% of those seen for an admissions consultation.
Because of the open setting and our focus on intensive psychodynamic therapy, we need to be sure prospective patients seems like reasonable candidates before moving to the admissions consultation, which usually occurs on the day of admission.
- Does their history of suicide suggest they could be workable in a setting in which they are expected to take responsibility for keeping themselves alive?
- Have they been able to remain abstinent from substance use that may be confounding their treatment?
- Is there a complicating medical or pain-related condition we need to understand more fully so we can treat it at Riggs?
- Are they interested in treatment or just passively going along with someone else’s suggestion?
- Does a different form of treatment other than ours seem like it should be tried first?
We also try to ensure that funding is in place to support the minimum six-week initial evaluation and treatment phase——before putting someone on the waiting list. Information on financing your stay can be found here. (link to financing your stay page)
We have been managing a waiting list for over a decade and find the length of the list to be quite variable. Sometimes the wait has been a couple of months because we have learned to limit admissions to typically 2 patients weekly in order to help them acclimate to the open setting and community, and to help us to get to know them. At other times, the wait shrinks to just a week or so. It is unfortunate when the list is long, as we do not like asking prospective patients to wait because we understand that they are genuinely struggling. All of us in admissions want to offer admission as soon as we can. And we worry that long delays force patients to go elsewhere, or that clinicians and treatment centers that make frequent referrals to us will come to feel we are always full and unable to respond to their patient’s need in a timely way. However, drawing on the experience of therapists at Riggs for decades, we also value some short period of waiting during which a patient can sustain substance abstinence or demonstrate some capacity to refrain from acting on suicidal or self-destructive impulses. This can give them a running start once they get to Riggs.
The waiting list is managed strictly on a first come, first served basis. We long ago realized no one has the wisdom of Solomon that would be required to determine who was more in need than someone else. And we have learned over the years what most in the field know—that VIP treatment that makes exceptions and bends the rules is usually worse treatment, not better treatment. So, with three exceptions, everyone waits their turn.
Here are the exceptions, which together account for about 5-10% of our annual admissions:
- Former patients, who may have had to move to a locked setting for a period, or may have tried and failed at outpatient treatment, move to the top of the list.
- Prospective patients who are college students at Williams, Bennington or Dartmouth—the only schools with which we have negotiated this specific arrangement so far -- or patients currently at and referred by the Pavilion at McLean -- the only outside treatment setting with which we have negotiated this arrangement so far—get their admission “fast tracked” and move to the top of the list.
- If a prospective patient suddenly cancels their admissions consultation on short notice, we will offer that admissions consultation slot to the next patient who can make travel arrangements in time to get here for it—even if they are not next on the list.
It’s important to us that the waiting list operates with transparency and integrity.