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3 Ways Healthcare Leaders Can Become Champions for Pediatric Behavioral Health
As school counselors sound a cry for help after a surge in students’ mental health needs, healthcare leaders have an important opportunity to be “ambassadors for pediatric health” in their communities.
Four out of 5 parents say they are seeing new or increased signs of mental health issues in their teen, according to a spring 2022 survey commissioned by Cigna. These challenges range from anxiety to depression to behavioral problems or problems with social interactions. Yet it has never been harder to access mental healthcare for their child:
- 60% of parents surveyed say they have encountered barriers in obtaining mental healthcare for their child in a reasonable amount of time. Furthermore, even when a behavioral health specialist is available, many parents worry they cannot afford this expertise.
- Within schools, access to a school psychologist is tight: Just 1 psychologist exists for every 1200 students in the United States, according to the Economist survey, far lower than the recommendation of one for every 500 students.
Meanwhile, school psychologists, counselors, and staff fear they are ill-equipped to spot the signs of mental illness in children or connect them with the right resources, given waitlists for outside therapists—as long as 9 months in some geographies.
It’s an area where healthcare leaders could make a substantial difference by facilitating access to mental health screenings, consultations, and care, whether through technology, specialty training, school-based support, or a combination of these. Such an approach can help alleviate the shortage and misdistribution of behavioral health providers. It can also address emerging and worsening symptoms before children and teens reach a crisis state.
Here are 3 ways hospitals and health systems can help increase access to behavioral healthcare for children and teens and pair them with the right support, including virtually.
- Shift away from a standalone behavioral health services model to an embedded model—including in schools. Even when parents can find a behavioral health specialist for their child, a primary barrier to care is transportation, including long travel times for visits. Time spent away from work to take children to behavioral health appointments also is a major concern for parents, the Cigna study shows: 55% do not receive enough support from their employers to make these visits possible—especially because they may require a weekly commitment in the first stages of care. Not to mention, parents don’t want to take their kids away from school for an appointment. Therefore, integration of mental healthcare across the continuum of care and in schools is vital.
At Nemours Children’s Health, a 1-year pilot program funded by a grant enabled the organization to embed pediatric psychologists, clinical social workers and professional counselors in pediatricians’ offices, then settings where children receive most of their care. Launched in November 2021, the initiative is designed to support equitable access to mental healthcare for children. Meanwhile, Children’s Health in Dallas provides school-based telebehavioral health. Children’s Health also has a Teen Recovery Program that assists students who are recovering from substance use disorder or facing mental health challenges. Families, too, can access a behavioral health provider by scheduling an appointment via the Children’s Health app. When prescriptions are needed, the Children’s Health team works directly with parents to meet the child’s needs and assist with medication adherence.
- Provide training for community members, like school nurses, counselors, parents and staff, and resources for screening. Half of mental health conditions begin by the age of 14, according to the World Health Organization—but the average delay between onset of mental illness symptoms and treatment is 11 years. For schools and parents, this adds enormous pressure to discern when a child needs mental healthcare and when a condition has reached the need for urgent assistance. Healthcare organizations can provide valuable assistance by teaching community members such as school nurses, counselors and staff what to look for as part of regular training programs. They can offer guidance on when and how to reach out for specialized assistance, and establish mechanisms for accessing immediate assistance, including virtually. They can also provide schools with tools for automated screenings and connect counselors with behavioral health experts in real time when the results indicate a student faces an urgent need for care.
Workshops for parents also are integral to educating the community on warning signs to look for and how to seek help for their child. Such workshops can be offered virtually, easing time constraints for busy parents and ensuring as many parents as possible can access the information.
- Explore automated solutions for connecting parents and kids with live behavioral health expertise. Innovations in digital health accelerated during the pandemic, and behavioral health is no exception. Today, evidence-based tools for screening and treatment exist that personalize interactions according to the child’s needs and preferences. These include options for self-guided therapy as well as virtual therapy delivered by licensed therapists and board-certified psychiatrists, as indicated—an option made possible by relaxed regulations that enable telebehavioral health to be delivered across state borders. At Children’s Health in Dallas, app-based access to behavioral health services has demonstrated strong clinical improvement among students, with children and teens experiencing a 32% improvement, according to self-ratings of efficacy.
One tip: Ensure that app-based care is device-agnostic. This will enable families to access care from their smartphone or mobile device, no matter the brand.
Reaching Kids in Crisis
One out of 3 high school students say they have experienced poor mental health during the pandemic, a recent Centers for Disease Control and Prevention survey shows, and 44% report feeling helpless or depressed. Healthcare leaders can play a vital role in getting kids the help they need by exploring new solutions for overcoming barriers to behavioral health services, including virtually. The health of their communities depends on it.
Anthony Sossong, MD, is chief medical director of behavioral health for Amwell.
The views expressed in Perspectives are solely those of the author and do not necessarily reflect the views of Behavioral Healthcare Executive, the Psychiatry & Behavioral Health Learning Network, or other Network authors. Perspectives entries are not medical advice.
References
Sounding the alarm: parent perceptions of teen mental health in the US. The Economist; 2022.
