Mental health needs for children, already in high demand, have sky-rocketed during the pandemic. Orange County California has seen large increases in demand, such as a 41% increase in the number of children presenting to the Emergency Department in psychiatric crisis despite the opening of additional crisis stabilization resources in the county. The proposed project will allow Children’s Hospital of Orange County (CHOC) to expand capacity for several important mental health programs for the children in our county. Proposed programmatic expansion is in 3 main areas:
HOPE Clinic: A new clinic that can provide rapid appointments (within 1 to 3 days) for children in crisis who would otherwise need to go to the Emergency Department, with a goal to reduce the rise in new patients presenting to CHOC’s ED. It is based on a successful program in Ohio. Children and families receive up to 4 sessions to allow for crisis stabilization and connection with outpatient services in the community. Funding will allow the addition of a child and adolescent psychiatrist when needed to assess for medication and to monitor medication until the child is connected with community services; purchase of office furniture for staff and furniture for patients and families (such as chairs and desk); computers for office staff; tablets for the administration of screening assessments such as the PHQ-9-A; and for additional staff training in evidence based treatment for management of and intervention with children at risk of suicide and materials for families (such as books, worksheets, etc).
Young Child Clinic: CHOC recently began a Young Child Clinic to provide specialty services for children 8 years and under. Orange County has few providers with specialty services for younger children who have behavioral health symptoms/conditions and do not have autism. This clinic provides evidence- based interventions developed for younger children such as the Incredible Years and Parent Child Interaction Training (PCIT). To expand the services, we are requesting funding to allow for furniture specific for children, to provide toys and games necessary for providing PCIT in person, installation of a two-way mirror to allow for clinicians to directly observe parent interactions with their child and provide real time feedback and instructions; to purchase equipment necessary for recording of sessions and to store this information and to allow for PCIT certification for an additional staff member, with a goal towards increasing the number of children seen.
Intensive Outpatient Program: CHOC provides a Dialectical and Behavioral Therapy (DBT) adherent outpatient intensive program (IOP) for high school students with persistent suicidal ideation and/or self-injurious behavior. The program is 8 weeks in length, 3 hours of treatment each day, 4 days a week with a mix of group, family and individual therapy services. While the program is intensive, we have a high completion rate, with a fiscal year to date no show rate of under 1 percent, 3 patients not meeting graduation requirements and only 2 patients hospitalized within 6 months of program completion. Unfortunately, at this time California Medicaid does not reimburse for this level of care for mental health diagnoses (but does for substance use services). We are requesting funding to cover attendance in this program for 6 patients with Medicaid coverage with high risk of inpatient psychiatric hospitalization.