holy cow! mental health: it’s not all it’s cracked up to be…yet!
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Holy Cow! Mental Health: It’s not all it’s cracked up to be…yet!. Kristine Hobbs, LMSW – DHHS July 2011 Learning Collaborative. Remind me why we’re talking about this?. From the grant: - PowerPoint PPT PresentationTRANSCRIPT
Holy Cow! Mental Health:
It’s not all it’s cracked up to be…yet!Kristine Hobbs, LMSW – DHHS
July 2011 Learning Collaborative
Remind me why we’re talking about this?
From the grant:“Behavioral health is fully
integrated into our demonstration grant as Category C which specifically focuses on the integration of behavioral health care within the medical home…”
Remind me why we’re talking about this?
• 21% of children and adolescents in the US meet diagnostic criteria for MH disorder with impaired functioning
• 13% of school-aged, 10% of preschool children with normal functioning have parents with “concerns”
• Children with chronic medical conditions have more than 2X the likelihood of having a MH disorder
• 8 % of adolescents (2 million youths aged 12 to 17) are estimated to experience a major depressive episode each year, with only two-fifths receiving treatment.
Stats: http://www.teenscreen.org/images/stories/PDF/TS_PC_FactSheet_1.18.11.pdfhttp://gucchdtacenter.georgetown.edu/resources/Call%20Docs/2011Calls/Foy%20Earls%20Georgetown%20-%20Final.pdf
QTIP Doctor - “1/4 to 1/3 of patient visits are mental health related”
Remind me why we’re talking about this?
• 80 % of mentally ill youth are not identified and do not receive mental health services.
• The first symptoms of mental illness typically occur two to four years before the onset of a full-blown disorder, leaving an important window of opportunity for prevention.
• 90% of adolescent suicide victims have a psychiatric disorder, with 63% exhibiting symptoms identifiable by screening for at least a year before their death.
• 50% of all life-time mental health disorders start by age 14.
Stats: http://www.teenscreen.org/images/stories/PDF/TS_PC_FactSheet_1.18.11.pdfhttp://gucchdtacenter.georgetown.edu/resources/Call%20Docs/2011Calls/Foy%20Earls%20Georgetown%20-%20Final.pdf
QTIP Doctor - “1/4 to 1/3 of patient visits are mental health related”
Questions from Site Visits…
• Ultimate success?• Dismal Failure?• Realistic?• Factors Contributing to Success?• Challenges?• What are you doing already?• How can I best assist you?
Summary of Site Visits
No one feels they are meeting the needs completely – they feel the current state of mental health services for kids is the worst case scenario
Summary of Site Visits
Needs -• Effective screening, • More service providers, • Easier access to services, and • Billing issues resolved.
Summary of Site Visits
Strengths – • Some have systems in place that support having
or adding additional services in-house,• Some of you have expanded your capacity to
provide limited services,• All of you are dedicated, creative practitioners.
Summary of Site Visits
• Challenges – • Limited capacity of caregivers, • Limited resources, • Limited specialist, • Limited knowledge of resources, • Financial issues.
What You Are Doing Now…
• 18 practices• 7 of 14 practices interviewed have some form
of mental health service provider with the practice (9 total with self-report)
• Co-location ranges on-site psychologist 4 hours/week to a full-time mental health counselor– 2 have PT psychiatrist with the practice
How can I best assist you?
“Create resources out of dust”“Another form is not the answer”“I want to know what other people do”“Aren’t you a social worker? Come do
case management for us.”
Where are we going?
In the words of Dr. Rushton…
–Prevention–Skill building in the medical home–Better back up and support to front-
line medical staff
“Parties who want milk should not seat themselves on a stool in the middle of the field in hopes that the cow will back up to them.”
~Elbert Hubbard
In General
• Provide options for screening and evaluation tools,
• Figure out the fiscal issues,• Skill enhancement for pediatricians and pediatric
staff around prevention, treatment, referral,• Other training opportunities – enhance
prevention and pediatricians skills,• Sharing resources and educational opportunities,• Linkages and support to the medical home.
Resources and referrals• Identify local resources as
outlined with NCQA• Build bridges and connections
with local resources• Provide ideas for building
local networks around resource development and knowledge
• Psychometric testing• Benchmarking around
referral processes and feedback loops
Co-location & Integration
• Ways to identify staff appropriate for co-location
• Funding options• Piloting some ideas• Training opportunities for Behavioral Health
Staff• Training opportunities for Medical Staff
Psychiatry • Psychiatry Consultation with the
Pediatrician• Mini-fellowship in psychiatry• Access to more child psychiatrists
DMH 24/hr ER Telepsychiatry Consultation
You should have…
Ready to take the bull by the horns?
Using your handout, indicate your top 3 mental/behavioral health priorities for the next 6 months…