As behavioral and mental health cases have surged over the last few years, children’s hospitals have been developing alternative approaches to address the crisis. In 2022, Children’s Health in Dallas and the Meadows Mental Health Policy Institute, a non-partisan policy and research organization, launched a pediatric mental health initiative to provide a proactive approach to diagnosing and treating pediatric mental health care.
The pediatric mental health initiative trains pediatric providers to detect and treat mild-to-moderate behavioral health conditions in the primary care setting, such as anxiety, stress and depression, so providers can address issues before they escalate to a crisis. Nearly 80% of pediatric mental health conditions are mild-to-moderate and can be effectively treated in primary care settings when physicians have the proper tools and support.
“We have a deep responsibility to care for our children’s mental health in a faster, more efficient way,” says Sabrina Browne, M.D., pediatric psychiatrist at Children’s Health and assistant professor at UT Southwestern Medical Center. “We simply cannot afford to experience a delay in care. Through this initiative, providers build upon their expertise to identify and treat a wider range of mental health diagnoses, shortening the amount of time to begin treatment.”
In its first year, this initiative has empowered pediatric primary care providers who care for more than 150,000 families, by providing them with training and resources to shift the focus of mental health care treatment to early intervention.
Data collected from participants indicate that providers increased their use of mental health screening tools, billing codes for behavioral health integration, and available clinical consultation as needed from the Child Psychiatry Access Network. These changes allowed them to effectively assess and treat a wider range of mental health diagnoses.
“This initiative has equipped providers to identify and meet the most pressing needs of their patients before it escalates to a crisis,” says Mia Best, M.D., pediatrician at Children’s Health. “Ultimately, this allows more families to place trust in their health care team to provide a comprehensive approach to care through enhanced screening, communication and coordination, addressing their concerns in a timely manner and allowing for early intervention.”
Due to the success of the pilot program, the initiative has already expanded to engage more providers. Additional results include:
- Increased provider confidence in their ability to evaluate and diagnose specific psychological conditions, improved billing strategies for behavioral health visits, and expanded ability to use tools that can identify early stages of depression and anxiety among their patients.
- High levels of provider-reported value from the program, with more than 85% of participants saying they would recommend the program to other providers.
- Development and implementation of formal evaluation tools and measures that demonstrate positive results and areas for future focus.
- Effective model to promote the broad adoption and optimization of collaborative care billing models through Medicaid that will support the integration of mental health screening and care in primary pediatric practice.
"What makes initiatives like this so important is the fact that mental illness is a pediatric disease, with 50% of most illnesses emerging by age 14," says Andy Keller, president and chief executive officer of the Meadows Mental Health Policy Institute. “This provides an essential path forward for pediatricians, children and their families."
Other children’s hospitals have been implementing similar initiatives, with some using a training program from the REACH Institute—a nonprofit led by pediatricians, clinical nurse specialists and child and adolescent psychiatrists—which offers interactive courses to equip providers to diagnose and treat common behavioral health issues.