In communities where the mental health response system is often siloed and overwhelmed, matching resources appropriate to a patient's behavioral health needs can be a challenge. One program at the Children's Hospital of Richmond at VCU in Virginia is working to help match families with the behavioral health resources they need.
The hospital recognized the huge need for families to reach out to mental health providers—but it's not easy. Maybe that provider is not taking new patients, doesn't accept the family's insurance, or is located too far from home. "So, the family stays home until there's a crisis, and they end up in our crisis services. But we want them to get help and support earlier," says Rachel Reynolds, manager of the Cameron K. Gallagher Mental Health Resource Center at Children's Hospital of Richmond at VCU at the 2020 Behavioral Health Summit. "We want to get them somewhere faster."
She says the answer is care navigation. "Care navigation services are like the GPS of health care. It makes it easy to get you to where you need to go." Care navigation at Children's of Richmond helps families identify what they need to do to find a provider and educates them on the care their child needs. The program interfaces with the community, pediatricians and other mental health care providers and reduces the stigma associated with mental health challenges.
Listening to families' needs
Family navigators are key to helping families make the right connections. They are there to listen to families and provide psychoeducation. "They explain what will happen when they seek care, and they discuss the difference between a psychiatrist and a counselor," says Reynolds. "We help families search a database of providers and we keep it curated and updated to assist families in accessing those resources." The navigators then follow up with families to they get what they need. The follow up is important—it's not about just giving them resources.
This effort, now in its 10th year, is funded through individual grants and philanthropy efforts. Most of the funding goes toward the family navigators, and a small portion is for administration and operations. The team consists of two full-time and two part-time family navigators—all are from different backgrounds. "One of our navigators is a family member with a lot of life experience and does a great job interacting with our families," Reynolds says. "We also have navigators with a background in social work and nursing."
Families come to the navigators by referral, either from the hospital or health system, community calls, or parents can even refer themselves. The daily referral volume increased from 5.89 in 2018 to 8.80 to date in 2020.
Helping families and primary care providers
The hospital sees the efforts of the family navigators making a difference. More than 90% of families who were provided with referrals attended their appointments. Families also say it's a service they would recommend to others. "They say more often than anything that someone finally listened to them," Reynolds says. The service also receives positive feedback from primary care providers, who refer families to the navigators.