According to the CDC, major depression is among children’s most common health disorders. The Annie E. Casey Foundation found that the number of Texas children diagnosed with anxiety or depression increased by 23 percent between 2016 and 2020, from the first year of the COVID-19 pandemic.
Texas Children’s Hospital hopes to change those alarming percentages. Recently, the nation’s largest children’s hospital raised more than $11 million to launch multiple community-based mental health initiatives and programs. Texas Children’s recently formed a dedicated Behavioral Health Task Force and several workgroups to develop and implement new and expanded system-wide services for patients needing specialized care.
They aim to help equip primary care physicians with necessary information and training in suicide assessments, common interventions, and medicine prescriptions to eliminate turning patients away and referring them to specialty care in psychiatry. These programs will subsequently lead to employing more behavioral health clinicians within the primary practices as a helpful reinforcement to primary care physicians.
Dr. Karin Price, chief of psychology at the Texas Children’s Hospital, revealed the number of mental health crisis patients arriving at their Houston area emergency centers since the pandemic in early 2020 has increased by an alarming 800%. “Before the pandemic, we routinely saw between 50 to 100 behavioral health patients combined from our emergency centers each month. And now, it is between 400 to 450 per month across the three campuses,” Dr. Price tells ESSENCE.
She notes that most children arriving at their centers seeking assistance are between the ages of 14 to 17 years old. But patients as young as five years old have been admitted with suicidal thoughts or behaviors.
As the largest pediatric hospital in the U.S. catering to cancer, infectious disease, and adolescent medicine, the institution is now building the foundation to implement specialized care systems and programming to identify behavioral issues before it’s too late. “We’ve launched some free pilot programs this year already. We’re looking to open our first pilot intensive outpatient program (IOP) in January,” says Dr. Price.
The hospital is also looking to increase the number of physically present behavioral health clinicians within their three emergency centers to eliminate patients experiencing long wait times for assessment once medically cleared. “They just end up waiting for a long time, and it’s not good for your mental health to be stuck sitting in the emergency center for many hours,” said Dr. Price.
“With the help of a supportive organization, we’re able to move relatively quickly to implement some of these changes that are so needed,” she continued.
Texas Children’s Hospital’s strategic behavioral health initiative includes the following priorities:
Training frontline pediatricians on behavioral health care:
The hospital is equipping its primary care physicians with specialized training to diagnose and treat patients with behavioral health issues while hiring additional psychiatrists, psychologists, and behavioral health specialists. To date, 160 pediatricians from Texas Children’s Pediatrics (TCP) practices completed this training. They reported that they feel more comfortable treating or beginning treatment for anxiety, depression, and ADHD, which recently accounted for more than half of all visits to TCP providers.
Embedding psychologists in Texas Children’s Hospital Pediatrics clinics:
Recent philanthropic support allowed Texas Children’s Hospital to hire behavioral health specialists in TCP practices in Fort Bend County. The ultimate goal is to do the same in TCP practices throughout the Greater Houston area and in Austin and College Station.
Building an Intensive Outpatient Program (IOP):
The IOP will close the gap between inpatient and outpatient behavioral health services, providing intermediary care for patients who cannot perform successfully in their current environmental support setting but do not need inpatient psychiatric hospitalization. It will support patients through skill-based individual, group, recreational, and family therapy sessions that teach strategies to reduce symptoms and improve functioning within a structure that allows patients to live at home and continue school and family activities.
Increasing specialized emergency center staff and enhancing safe treatment spaces:
Demand for emergent behavioral health intervention for children and adolescents is four times higher than two years ago with the onset of the COVID-19 pandemic at Texas Children’s Emergency Centers. Physicians treat 400 – 500 patients seeking behavioral health services each month in the Texas Medical Center and at Texas Children’s Hospital West Campus and Texas Children’s Hospital The Woodlands Emergency Centers, including suicide ideation.
Texas Children’s Hospital will hire specially trained staff, including physicians, nurses, technicians, and security guards, to care for patients in these settings. In addition, plans are underway to renovate existing spaces, making them safer for patients, families, and caregivers.
Suicide response and prevention:
Texas Children’s Hospital employees are committed to being leaders at work, at home, and in the community — which often means that people look to them for support and resources, particularly regarding the growing behavioral health crisis. In September, a Gatekeeper Training program was specially designed for employees at Texas Children’s Hospital and Baylor College of Medicine to teach them how to identify warning signs of suicide and to provide tools for navigating these difficult situations.
The hospital partnered with the Zero Suicide Institute to train and guide more than 70 clinical and administrative leaders in a two-day academy. This ongoing effort demonstrates a commitment to improving patient, family, and employee safety by developing frameworks for system-wide transformation toward safer suicide care.
“Across the Texas Children’s system, we are implementing more robust patient screening, enhancing patient assessments conducted by trained behavioral health specialists, and reducing the stigma surrounding behavioral health issues and treatment,” says Dr. Price. “We are devising safety plans to help patients and families know what to do at various “stress levels” and what to do if someone is suicidal, developing family intervention strategies and ensuring that care coordinators are helping patients and families at every point of the care continuum. It is a tremendous undertaking, and Texas Children’s is up to the task.”
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