DESC Downtown Behavioral Health Clinic

515 Third Ave.

The DESC Downtown Behavioral Health Clinic is a welcoming, low-barrier space offering comprehensive health and other services for adults experiencing homelessness, serious mental health challenges, and substance use disorders. Located on the second floor of DESC’s Morrison building, the clinic expands access to health, recovery, and stabilization services — all in one place. 

At the heart of the clinic is a commitment to person-centered care. Whether someone is seeking mental health support, treatment for substance use disorder, basic health services, peer support, or help with other basic needs, the clinic meets people where they are with dignity, compassion, and flexibility. 

Integrated Behavorial Health Services Under One Roof 

Lew Middleton Drop-In Center 
Open weekdays from 9 a.m. to 3 p.m., this peer-led space offers DESC clients living essentials like breakfast, showers, laundry, hygiene supplies, basic first aid, and a place to rest. Certified Peer Counselors — drawing from their own experiences with behavioral health challenges — build connections with clients through harm reduction, recovery planning, and wellness support. Our counselors also host support groups in the afternoons at the drop-in space.  

The drop-in center, formerly located at 216 James St., serves as a welcoming space for community, connection, and support. It often plays a crucial role in reaching people who may be hesitant or uncertain about seeking formal behavioral health care. 

In addition to peer counselors, the clinic has Client Engagement Specialists positioned in key areas throughout the space to build rapport with clients and support de-escalation when needed. They keep an eye on the overall environment, greet and interact with clients, and help guide them to services that might be helpful. 

Outpatient Mental Health & Addiction Services  

The Downtown Clinic offers a range of outpatient services to support mental health, addiction recovery, and overall well-being: 

  • SAGE (Support, Advocacy, Growth, and Employment) 
    SAGE provides intensive outpatient mental health services, including case management, psychiatric assessment and diagnosis, medication management, counseling, therapy, money management, and help with housing and employment. 
  • Substance Use Disorder (SUD) Services 
    Clinic staff connect clients to our SUD team, based at DESC’s permanent supportive housing sites, for personalized, trauma-informed care rooted in harm reduction. Services include counseling, case management, and help connecting clients to medication-assisted treatment at DESC, as well as inpatient SUD treatment at other facilities. 
  • ORCA: Opioid Recovery & Care Access Center 
A medical assistant prepares an area for a patient in DESC's Opioid Recovery and Care Access Center
Kay Weaver, medical assistant, prepares a medical area for the next patients at the ORCA Center. Photo credit: Karen Ducey, Seattle Times. Not for reuse.

The ORCA Center is a 24/7 program within DESC’s Downtown Behavioral Health Clinic that offers urgent, low-barrier support for people after an overdose or during high-risk substance use. It’s a safe, welcoming space where individuals can stabilize, begin treatment, and take steps toward recovery — without judgment or unnecessary obstacles. ORCA offers post-overdose care for up to eight people at a time, with walk-in services available daily from 9 a.m. to 11 p.m.  

ORCA services include: 

  • 24/7 post-overdose stabilization for up to eight (8) people 
  • Walk-in access to care daily from 9 a.m. to 11 p.m. 
  • Medications for opioid use disorder (MOUD), including buprenorphine and methadone 
  • Basic health services: wound care, infection testing, and vaccinations 
  • Showers, snacks, and laundry access during treatment 
  • One-on-one support from medical staff and peer specialists 
  • Safer use education and harm reduction supplies 
  • Referrals to long-term behavioral health and housing support 

All of these services work together to meet people where they are and support their recovery goals. 

Medical and Nursing Services 

The clinic also has medical and nursing services for clients, including exam rooms, an on-site nursing team, and a provider from Harborview to address acute and preventative healthcare needs. Services such as medication management, routine health check-ups, and wound care are available to DESC clients. These services help reduce ER visits and help our clients maintain their health.  

Street Outreach for People with Psychiatric Disorders 

HOST (Homeless Outreach Stabilization and Transition):  

HOST is a mobile team that meets people where they are — on the streets, in shelters, or in the community — who are experiencing homelessness, mental health challenges, and often substance use. The team helps connect people to care, provides basic survival supplies, and supports them in finding shelter and housing. 

The DESC Downtown Behavioral Health Clinic is a key part of our continuum of care — bringing essential lifesaving services together in one place to help people move toward health and stability.