After an increase in behavioral health issues presenting in the emergency room, providers at Cohen Children’s Medical Center in Queens, New York, realized there was a need for earlier intervention and improved communication in the community.
At the 2021 Annual Leadership Conference, Vera Feuer, M.D., director, Pediatric Emergency Psychiatry and Behavioral Health Urgent Care, and Gina-Marie Bounds, admin director, Health Partnership, highlighted the organization’s effort to develop relationships with surrounding school districts and serve as a connection point between families and providers.
Feuer outlined the difficulties pediatric providers face when children first prevent with behavioral health crises in the ED and the need for earlier intervention. Often, the issues have escalated to a point where immediate care is needed and Cohen Children’s set out to change that.
“Let’s write a different story,” says Feuer. “Let’s engage in a different way.”
Collaborating with schools
The program, which launched in January 2020, acts as an assessment and referral system where kids are assessed at school and connected directly with providers at one of Cohen Children’s two behavioral health centers.
However, Cohen Children’s work extends beyond just patient care. Through district-wide initiatives including educational opportunities for students and staff, an anti-bullying initiative and support staff, they have formed a partnership with 29 school districts.
As of October 2021, the program is working inside 182 schools, reaching 132,000 students in surrounding areas. In total, roughly 65% of the students in Nassau County, New York, have immediate access to behavioral health care.
The continuum of school behavioral health services
“Our teams are there complementing each other, we are not there to replace the work that the school districts are already doing,” Feuer says.
Feuer also highlighted the spectrum of services that encompass behavioral health care. While the initial need was to reduce ED admissions, the broader goal includes expansive access to services.
The primary goals of the relationship include providing assessment, coordinating care, short-term crisis care, improving communications, education and support for families and school staff, and avoiding hospital admissions/emergency room visits.
Bounds highlighted the ever-changing nature of these services as well, including pivots through telehealth, virtual school, a pandemic and the efforts toward anti-racism in the summer of 2020.
By establishing free-standing behavioral health care centers, Cohen Children’s is able to avoid a clinical setting by creating a more comfortable, office-like setting. “There is a big emphasis on creating a welcoming, destigmatized environment,” says Bounds. It’s important to meet patients where they are.”
This also allows for increased, broader community access to resources such as education sessions, newsletters and most recently COVID-19 vaccine education and support.
Currently, around half of the referrals come from the school and the other half are self-referrals coming directly from the community. As a result of their efforts, Cohen Children’s has seen a significant decrease in emergency room deferrals from the districts they work with.
“This work allows us to serve as a central hub for the community,” says Feuer.