Catching Mental Health Issues Early Can Change a Child's Life

Leading up to Children’s Mental Health Awareness Day Children’s Hospitals Today  published an article about the Children’s Hospital of Orange County (Calif.) and the initiatives they are undertaking to improve pediatric mental health services.

A picture of pediatric mental health

  • One in five young people in the U.S. has a diagnosable mental health disorder
  • Half of people with lifetime mental illness symptoms by age 14
  • Suicide is the second-leading cause of death in children ages 10-24

Source: Children’s Hospital of Orange County


Here's how one children's hospital launched a pediatric mental health initiative to enhance care for children.

Kimberly Cripe, president and CEO of the Children's Hospital of Orange County in California, is leading a charge to improve pediatric mental health services. In partnership with local organizations and community groups, CHOC is creating a mental health system of care for children, teens and young adults in Orange County, where 20 percent of youth report needing help for mental health problems—but less than one-third actually receive it.

Among CHOC's initiatives to address the need: the creation of the Children's Mental Health Inpatient Center, an 18-bed environment of healing for children aged three to 18 scheduled to open in 2018.

Children's Hospitals Today caught up with Cripe about CHOC's pediatric mental health initiative, and how identifying behavioral health issues early can change the entire course of a child's life.

  1. What was the moment that led you to launch the pediatric mental health initiative at CHOC?

I had been noticing an increase in the number of children and adolescents suffering from mental health disorders who were turning to the health care system when facing crises. It was on my radar because we were seeing it firsthand.

Then two families came to visit me. One lost their son to suicide. Another had a child who started exhibiting problematic behaviors at age 3. We spent about three hours listening to their stories, and what they had been through, including their struggle to find local resources. That was the big moment for me. That prompted me to dig deeper and learn more about it. There are woefully inadequate resources available for people seeking access to pediatric mental health services, and it's such a huge issue for our society and our country.

2.       Talk about the multi-pronged approach you're taking to building a pediatric mental health system of care at CHOC.

In our community, there are currently no inpatient psychiatric beds for children 0 to 12 years old — that's a significant void of services. Our first commitment was to design and build a pediatric mental health inpatient unit. Our design will provide a healing environment, featuring different spaces suitable for a range of ages and disorders.

We've also launched a co-occurring clinic, because we know there's an increased incidence of mental health problems with kids who have chronic health care problems. A lot of patients we see are three to five times more likely to have a mental health condition, such as depression and anxiety, coupled with a medical condition they are struggling with. This expansion of mental health services for CHOC patients is making a huge difference.

We're also changing our staffing models in our regular clinics and our two emergency departments to gain better recognition of the symptoms of mental health issues to enable earlier diagnosis and treatment.

3.       What impact can an earlier diagnosis and treatment have on patients and families?

When a child shows up in one of our emergency rooms despondent or having tried to commit suicide, it's a major crisis. And it's a failure of our systems to identify this behavior earlier and begin treatment.

Many very young children are affected in a significant way by mental health disorders. I have talked with families whose children were 3 or 4 years old when they started trying to harm a sibling or a parent. If we had intervened earlier, we could have changed the path that child was on—and change the trajectory.

Children's brains are still forming, their behaviors and habits are still forming, and you can redirect them into more healthy behaviors. That would have such a long-term impact on our society and on the cost of care. Then you look at the incidence of mental health disease in adults. And you think…if systems like this would have been in place 30 or 40 years ago, would we be dealing with what we are dealing with right now? I think the answer would be no. It wouldn't be as prominent.

4.       What are the biggest challenges in creating a pediatric mental health care system?

It's a very resource-intensive service line. And there is a workforce shortage in all these specialties. We're making investments to ensure we do have a workforce. Also, mental health services have poor reimbursement, and that's the main driver of why we have services that are so fragmented.

5.       What advice would you give other children's hospitals looking to enhance mental health care for children?

Jump in. It's daunting in the beginning, and it's an overwhelming problem. But there are solutions available in all of our communities. We have seen widespread community interest and a willingness of other collaborators to play an important role.

Keep in mind that most of the time, the hospital is not going to be the first place a child or parent thinks about calling. They may be talking to someone at school or pre-school or at a faith-based organization. We've reached out to help educate and create a better screening net across our whole community.

There really isn't a way that any one of us, alone, can solve this problem, but if we start to roll up our sleeves, it is remarkable how many people will express an interest and step up and help us with some facet of this.

Learn more about CHOC's pediatric mental health system of care.

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