CT expanding pediatrician training on mental health; setting up more school-based, ER resources
The Access Mental Health Connecticut program is expanding under an $80 million allocation in the federal Bipartisan Safer Communities Act. Lawmakers and mental health experts gathered at Wheeler Family Health & Wellness Center in New Britain Monday to discuss how the funds should be used to fill gaps in pediatric mental health care.
“Pediatricians need the support, and we want to be able to train and support pediatricians and we want to give them direct access to mental health experts so that they can care for the children they see in their offices every day,” said Carole Johnson, administrator of the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services.
Wheeler Family Health & Wellness Center provides teleconsultation to pediatricians in real time when a child or teen is experiencing a mental health crisis at the pediatrician’s office. The center is one of three hubs providing pediatric mental health teleconsultation support to primary care doctors in Connecticut.
Nationally concerns and incidents of mental illness have been rising in children and teenagers, and Connecticut is no exception. Clinicians at Wheeler said mental health support services to pediatricians increased by 33% in the last year, and more than 85% of pediatricians in Connecticut use the program.
“I can tell you that my practice [in] pediatrics is nothing today the way it looked 28 years ago,” said Dr. Barbara Ziogas, a pediatrician with a private practice in Farmington. “I never was trained in mental health. Now at least 20% to 25% of patients that I see every day are kids that have behavioral issues. And if I look at all the screening I do when you screen these children, you open up Pandora’s box.”
Ziogas credited the Access Mental Health program for training her “in the nuances of what medication doesn’t work, and when I have to cross-titrate medication, and when I’m having a side effect of the medication.”
“I can’t tell you how much they’ve supported me,” she said. “I’ve had kids that are suicidal in my office, and I'm able to call a mobile crisis unit and I've made appointments at that moment. And I've made an appointment for them to come back to my office two days later. Because of Access, I know how to work the resources. They helped me navigate the system.”
Dr. Gregory Germain, associate chief of pediatrics at Yale New Haven Children's Hospital and a community pediatrician in New Haven, also spoke of treating a growing number of children for mental health.
“On Thursday of last week, I had a pretty typical day, my general pediatric practice,” he said. “Did my usual routine physicals and ear infections, and I had four separate patients in acute mental health crisis who came to my office that day. And I think it shows that we’ve pretty much saturated the community availability. So our school systems are saturated, our community mental health providers are saturated. Our pediatric psychiatrists have been saturated for years.”
Germain said he turns to Wheeler frequently for support.
“Our consultative services have gone up over 50,000 over the years,” said Dr. Richard Miller, a child and adolescent psychiatrist at Wheeler. “We can see them [patients] as soon as the parent is able to make an appointment as early as the very next day.”
The Access Mental Health program began “after the shortcomings of mental health screening and access to care became painfully clear, following the horrors of the Sandy Hook massacre,” Miller said. Clinician teams are based in Hartford and at Yale and Wheeler.
But the ongoing workforce shortage in health care is exacerbating the crisis at a time when the demand for mental health care is climbing.
“We have a number of staff that are members of the National Health Service Corps, the Nurse Corps,” said Sabrina Trocchi, president and CEO, Wheeler, explaining how Wheeler was bridging the shortages.
Rep. Jahana Hayes, running for reelection in the 5th Congressional District, pointed to legislation signed into law to support Historically Black Colleges and Universities, she said, “to improve their medical programs and recruit and retain more people from the communities that are the hardest hit to serve in these fields, go back into those communities.”
Vanessa Dorantes, commissioner of the state Department of Children and families, also emphasized workforce shortages and the need to adopt a long-term strategy.
“Our legislature has allowed for some of that parity across state lines to be able to really get clinicians into our state that have a specialty to understand trauma,” she said. “[We need to] think about how these funds can stretch beyond the temporary nature for sustainability.”
The $80 million funding will also support schools and emergency departments offering child and teen mental health care.