Pediatric Mental Health Care Access - The New York State Department of Health (NYSDOH)/Health Research, Inc. (HRI) proposes to use HRSA funding to expand its current Pediatric Mental Health Care Access (PMHCA) grant to 1) connect pediatric clinical providers throughout the entire state to child mental health professionals, including child psychiatrists and allied professionals, through telehealth and teleconsultation, 2) provide training and technical assistance so that the providers may initiate or expand screening, diagnosing, and treating patients with support from teleconsultation, and 3) increase the number of children and youth who access mental health services. NYSDOH will implement this grant in the Division of Family Health (DFH), which leads the state Title V Maternal and Child Health Services Block Grant (Title V). The Division Director is the Title V Director and will provide leadership and leverage the Title V grant to support the PMHCA and integrate it into the Title V State Action Plan and domain initiatives. The most recent NYS Title V Needs Assessment identified mental health as a concern for adolescent health and well-being. Of the state’s 62 counties, 22 (229,932 children) have no child-adolescent psychiatrist, 20 (957,018 children) have a severe shortage (including the Bronx with 358,404 children), and 18 counties (almost 2.5M children) have a significant shortage (including Queens and Brooklyn). NYS invests state funds in Project TEACH, which is administered by the NYS Office of Mental Health. Project TEACH is a no-cost teleconsultation, telehealth, and training resource with 7 hubs with statewide coverage. These hubs are located at medical school Departments of Psychiatry. The mission is to strengthen and support the ability of New York’s maternal health and pediatric primary care providers (PCPs) to care for children and families experiencing mild-to-moderate mental health concerns. Project TEACH is a child, adolescent, and perinatal psychiatry access program providing education/training and consultation services, allowing providers to speak directly with child and adolescent psychiatrists (CAPs) and licensed psychologists to ask questions, discuss cases, review treatment options, or obtain referral assistance. Teams consist of CAPs, including specialists in autism spectrum disorders, birth to five, and substance use, and master’s level behavioral health professionals and a coordinator. Project TEACH also offers intensive in-person and virtual training on topics such as non-suicidal self-injury, eating disorders, ADHD, anxiety and aggression, depression and suicide assessment and management, and more, as well as brief special topic webinars (ex., “Could This Be Autism?” and “OCD: Anxiety’s Sneaky Cousin”). Although Project TEACH has a statewide network, access and utilization differ by region, especially for rural areas, and a drop-off or plateau in the number of teleconsultation, referrals, and telehealth services has occurred. We propose using PMHCA funding to increase child and adolescent access to mental health care by increasing pediatric PCP knowledge through training and capacity to screen, diagnose, and clinically manage children and adolescents through teleconsultation and telehealth supports provided by Project TEACH. We will also support pediatric PCPs through referrals for evaluations as well as outpatient and inpatient services, psychology and peer supports, and other community-based services as needed. PMHCA funding will allow the state to leverage the state investment and connect services to children and adolescents and their families by using public health detailing, an evidence-based practice successfully employed in the pharmaceutical arena, that bridges public health agencies and clinical practices to engage directly with pediatric-serving practices, Community Health Centers, and Federally Qualified Health Centers, with a priority focus for rural areas and Health Profession Shortage Areas (HPSAs).
