In Texas, the national emergency in child and adolescent mental health is especially acute. According to data from Children’s Health:
- 1 in 3 children in Texas experience a mental health disorder in a typical year—more than the national average of 1 in 5.
- Early in the pandemic, the proportion of mental-health-related emergency room visits increased 24% among children ages 5 to 11 and 31% among adolescents ages 12 to 17.
- The rate of pediatric emergency room visits for suicide is now double pre-pandemic levels.
- The ratio of children and adolescents to pediatric psychiatrists in Texas is 10,000 to 1.
“It's clear that to be able to meet the mental health needs of kids and support their families, we can't just make little adjustments at the margins,” says Brent Christopher, president of Children’s Medical Center Foundation in Dallas. “We've got to take innovative initiatives to see if we can achieve at scale an entirely different way of supporting kids.”
Program leverages primary care practices for early interventions
Children’s Health estimates that 80% of pediatric mental health conditions are mild to moderate, so it launched an initiative to help area pediatricians provide early interventional care.
The program trains primary care providers to assess and treat children and adolescents for depression, anxiety and substance abuse. Children’s Health is collaborating on the project with the Meadows Mental Health Policy Institute, a nonprofit organization focused on effective and efficient mental health policy and programs in Texas.
The training is offered online and in-person at a Children’s Health primary care clinic, and providers have access to computer-based training, peer-to-peer learning communities and opportunities to shadow integrated care providers and receive technical assistance.
Behavioral health specialists are also available for immediate referrals when patients require care that can’t be provided in a primary care setting.
There are currently 31 providers participating in the training program’s first cohort, which is expected to last nine months. Subsequent cohorts will complete the training in about six months. The hospital aims to train about 100 providers in the program’s first year.
Making the program sustainable
The pediatric mental health initiative has three primary components:
- Training. In addition to educating pediatricians to confidently assess and treat patients, the program offers instruction to help make it financially sustainable for their practices. “New collaborative care billing codes available in Texas enable pediatricians to invest the extra time required to address the mental health needs of their patients and get paid for that work,” Christopher says. “These improvements will make a marked difference in the ability of primary care providers to step into this kind of a role, so the billing training is a critical part of the package.”
- Evolution. Gathering data from patients and providers to evaluate and understand the effectiveness of the new strategies will help Children’s Health assess how best to continue developing and enhancing the program over time.
- Advocacy. “The sustainability and scalability of this model relies on building upon what the data will show and what happens during the first few years of this new initiative so that it can ultimately help form policy decisions statewide,” Christopher says.
