Massachusetts has lots to be proud of in the approach that the Commonwealth has taken to the implementation of the CBHI, with the acceptance of behavioral health screening in the pediatric office to the establishment of mobile EMH services throughout the state (nobody else is even thinking about that one!). We are innovators, on the cutting edge of high quality services for children with serious emotional disturbances.
And yet....
Why do I get a call from an intensive treatment program about one of my patients, telling me that the child's psychiatrist left in October, that they have not identified a new one for this patient, and ask that I write prescriptions for his/her three psychotropic medications. Why have I heard nothing about this patient for 8 months, while his/her psychiatrist manages his/her meds, and, upon leaving, assumes that I will continue the meds? How do I monitor the effectiveness of therapy, when I have no evidence of this child's current diagnoses? How do I monitor side effects, when I have never heard of one of the medications? This is the sort of thing that intensive case management is supposed to prevent; why did it fail my patient?
We build systems that are supposed to work. We hope that this sort of thing is happening less frequently than before. And we recognize that there are likely still a few bugs in the system.
Happy New Year!
Monday, January 9, 2012
Wednesday, December 21, 2011
Thursday, December 15, 2011
From the Boston Globe : Kinda wish I had been there.
Yesterday in the Globe- reminded me how long it takes to get anything done.
Summit focuses on children’s mental health By Patricia Wen
December 13, 2011
It was billed as the Children’s Mental Health Summit, the second in a decade, and its organizers hoped it would inspire as much passion for reform as the debut gathering did in 2001. Among the issues addressed by top officials in Boston yesterday were the high rate of psychotropic drugs consumed by the state’s foster children, poor insurance coverage of family-based services, and the relatively high percentage of substance abuse among Massachusetts teens. The keynote speaker, Pamela Hyde, an Obama appointee who heads the Substance Abuse and Mental Health Services Administration, also spoke about the growing awareness that trauma -- including domestic strife, neighborhood violence, and bullying -- undermines children’s mental well-being.…The closing talk came from US District Court Judge Michael Ponsor, who issued the 2006 landmark ruling, referred to as the Rosie D. case, which required the state to offer intensive home-based mental health services for children on Medicaid with serious emotional disturbances. “Serving the needs of children with mental health problems, especially poor children, is not for the faint of heart, or for people overly fond of cheap thrills and immediate gratification,” Ponsor said in his written remarks. “It is a very long-term commitment.”
Wednesday, December 14, 2011
Larry's Webinar is on the Web
As primary care providers incorporate adolescent mental health care into practice, Common Factors may hold solutions to successfully taking on the challenge. An approach that emphasizes provider/parent interaction over the need for diagnoses and specific treatments, Common Factors can have a powerful impact on provider training, confidence and outcomes.
Common Factors focuses on the process of care, and emphasizes the characteristics and interactions of providers, parents and others -- nurse practitioners, office staff, school health personnel -- in influencing patient behavior and improving outcomes. It challenges the need for a diagnosis and specific treatment for each patient, and instead maintains that therapies can be designed to help broad classes of people.
Common Factors expert Larry Wissow, MD, Professor, Johns Hopkins Bloomberg School of Public Health, discussed incorporating Common Factors principals into adolescent mental health care. Click here if you want to hear it.
Common Factors focuses on the process of care, and emphasizes the characteristics and interactions of providers, parents and others -- nurse practitioners, office staff, school health personnel -- in influencing patient behavior and improving outcomes. It challenges the need for a diagnosis and specific treatment for each patient, and instead maintains that therapies can be designed to help broad classes of people.
Common Factors expert Larry Wissow, MD, Professor, Johns Hopkins Bloomberg School of Public Health, discussed incorporating Common Factors principals into adolescent mental health care. Click here if you want to hear it.
Tuesday, November 29, 2011
Rethinking Adolescent Mental Health Care: Using Common Factors to Improve Your Practice Potential
A TeenScreen National Center Webinar Event
With
Professor, Johns Hopkins Bloomberg School of Public Health
Principal Investigator, NIMH-funded Center for Mental Health in Pediatric Primary Care
December 8, 2011
1:00-2:00 ET
As primary care providers incorporate adolescent mental health care into practice, Common Factors may hold solutions to successfully taking on the challenge. An approach that emphasizes provider/parent interaction over the need for diagnoses and specific treatments, Common Factors can have a powerful impact on provider training, confidence and outcomes.
Common Factors focuses on the process of care, and emphasizes the characteristics and interactions of providers, parents and others -- nurse practitioners, office staff, school health personnel -- in influencing patient behavior and improving outcomes. It challenges the need for a diagnosis and specific treatment for each patient, and instead maintains that therapies can be designed to help broad classes of people.
Join Common Factors expert Larry Wissow, MD, Professor, Johns Hopkins Bloomberg School of Public Health, for a practical discussion on incorporating Common Factors principals into adolescent mental health care.
Wednesday, November 23, 2011
Experts Convene on Capitol Hill to Discuss Models of Integrated Care for Youth: Massachusetts Child Psychiatry Access Project Highlighted
From TeenScreen (love to be quoted)
Washington, D.C. - National experts in delivering integrated behavioral and physical health care to adolescents presented three different models of service delivery to this vulnerable population in a Capitol Hill forum. The Massachusetts Child Psychiatry Access Project (MCPAP) was highlighted as one national model that bridges the significant gap between the need for specialty mental health services and access to those services.
The TeenScreen National Center for Mental Health Checkups at Columbia University convened the forum, “Bridging the Gap through Innovation: Expanding Access to Mental Health Services,” on Nov. 16. This was the third annual Eric Trendell Health Policy Forum. Dr. David Keller described how he and his colleagues in Massachusetts have filled the behavioral health service gap through MCPAP, providing vital services to over 6,000 children in the state. “Before we started MCPAP in 2005, I had few, if any, resources for dealing with these issues. As a general pediatrician practicing in Worchester, MA, I saw perhaps 30 or 40 patients per day,” said Dr. Keller. “At least 30 percent of these children had mental health problems. Like so many of my colleagues trained in pediatrics, I was not trained extensively in child psychiatry.”
Washington, D.C. - National experts in delivering integrated behavioral and physical health care to adolescents presented three different models of service delivery to this vulnerable population in a Capitol Hill forum. The Massachusetts Child Psychiatry Access Project (MCPAP) was highlighted as one national model that bridges the significant gap between the need for specialty mental health services and access to those services.
The TeenScreen National Center for Mental Health Checkups at Columbia University convened the forum, “Bridging the Gap through Innovation: Expanding Access to Mental Health Services,” on Nov. 16. This was the third annual Eric Trendell Health Policy Forum. Dr. David Keller described how he and his colleagues in Massachusetts have filled the behavioral health service gap through MCPAP, providing vital services to over 6,000 children in the state. “Before we started MCPAP in 2005, I had few, if any, resources for dealing with these issues. As a general pediatrician practicing in Worchester, MA, I saw perhaps 30 or 40 patients per day,” said Dr. Keller. “At least 30 percent of these children had mental health problems. Like so many of my colleagues trained in pediatrics, I was not trained extensively in child psychiatry.”
“MCPAP has changed all that,” he said. “It is comprised of six centers throughout Massachusetts led by a psychiatrist and each linked to an academic health center. Individual primary care doctors and pediatricians are able to enhance their services through MCPAP tutorials in child psychiatry and consultation with specialists,” Dr. Keller said.
Through MCPAP, doctors are assured of a telephone consultation with a psychiatrist about a specific patient, usually within an hour, or immediately, if the situation demands. Dr. Keller said that 26 other states are exploring establishing a MCPAP like system to meet the growing demand for mental health care for children and adolescents.
“We have created virtual, integrated care teams so that all of the children and adolescents in Massachusetts have access to the behavioral and mental health care they may require,” said Dr. Keller.
“Integrating behavioral health into primary care is a game changer,” said A. Seiji Hayashi, MD, MPH, and Chief Medical Officer, Bureau of Primary Health Care at the Health Resources and Services Administration, and a panelist. The Centers for Medicare and Medicaid Services is working to strengthen the Medicaid and Medicare programs by looking to innovative forms of service delivery. Barbara Edwards, a director at the Centers for Medicare and Medicaid Services, and a panelist said, “The models of integrated care discussed today present important ways forward as we look to design and support methods of bringing health and mental care to children.”
TeenScreen Executive Director Laurie Flynn, said: “The movement to integrate behavioral health into primary care brings a vital benefit to adolescents. We know that up to half of all visits to pediatricians involve a behavioral, emotional or mental issue. We also know that half of all mental disorders begin by age fourteen. Innovative, integrated care models have demonstrated that we can expand mental health care to youth, bringing this vital dimension of medicine to their medical homes.”
Other forum panelists detailed their unique experiences with leading innovations such as co-located care; telepsychiatry; fostering collaboration between primary care physicians and child psychiatrists; the development of patient-centered medical homes; and the adoption of electronic medical health records.
The 2011 Eric Trendell Health Policy Forum Panel:
- Greg V. Jensen, LSCW, ACSW, Vice President for Behavioral Health Services at Lone Star Circle of Care
- Steven Adelsheim, MD, Director, Center for Rural and Community Behavioral Health and Professor of Psychiatry, Pediatrics, & Family/Community Medicine at the University of New Mexico, Department of Psychiatry
- David Keller, MD, Clinical Associate Professor of Pediatrics and Senior Analyst, Center for Health Policy and Research at the University of Massachusetts Medical School
- A.Seiji Hayashi, MD, MPH, Chief Medical Officer, Bureau of Primary Health Care at the Health Resources and Services Administration
- Barbara Edwards, Director, Disabled and Elderly Health Programs Group, Center for Medicaid, CHIP and Survey and Certification at the Centers for Medicare and Medicaid Services.
Senator Scott Brown (R-MA), a sponsor of the forum, said, “I’m proud to support the cause of improving mental health services for our children and teens. From my own childhood, I recognize how critical it is to help our youth weather the tough circumstances that can come early in life.”
Senator Tom Udall (D-NM), a sponsor of the forum, said, “We have a moral obligation to help young people from every background and ethnicity with the support they need to overcome and deal with depression and suicidal tendencies.”
“We have created virtual, integrated care teams so that all of the children and adolescents in Massachusetts have access to the behavioral and mental health care they may require,” said Dr. Keller.
“Integrating behavioral health into primary care is a game changer,” said A. Seiji Hayashi, MD, MPH, and Chief Medical Officer, Bureau of Primary Health Care at the Health Resources and Services Administration, and a panelist. The Centers for Medicare and Medicaid Services is working to strengthen the Medicaid and Medicare programs by looking to innovative forms of service delivery. Barbara Edwards, a director at the Centers for Medicare and Medicaid Services, and a panelist said, “The models of integrated care discussed today present important ways forward as we look to design and support methods of bringing health and mental care to children.”
TeenScreen Executive Director Laurie Flynn, said: “The movement to integrate behavioral health into primary care brings a vital benefit to adolescents. We know that up to half of all visits to pediatricians involve a behavioral, emotional or mental issue. We also know that half of all mental disorders begin by age fourteen. Innovative, integrated care models have demonstrated that we can expand mental health care to youth, bringing this vital dimension of medicine to their medical homes.”
Other forum panelists detailed their unique experiences with leading innovations such as co-located care; telepsychiatry; fostering collaboration between primary care physicians and child psychiatrists; the development of patient-centered medical homes; and the adoption of electronic medical health records.
The 2011 Eric Trendell Health Policy Forum Panel:
- Greg V. Jensen, LSCW, ACSW, Vice President for Behavioral Health Services at Lone Star Circle of Care
- Steven Adelsheim, MD, Director, Center for Rural and Community Behavioral Health and Professor of Psychiatry, Pediatrics, & Family/Community Medicine at the University of New Mexico, Department of Psychiatry
- David Keller, MD, Clinical Associate Professor of Pediatrics and Senior Analyst, Center for Health Policy and Research at the University of Massachusetts Medical School
- A.Seiji Hayashi, MD, MPH, Chief Medical Officer, Bureau of Primary Health Care at the Health Resources and Services Administration
- Barbara Edwards, Director, Disabled and Elderly Health Programs Group, Center for Medicaid, CHIP and Survey and Certification at the Centers for Medicare and Medicaid Services.
Senator Scott Brown (R-MA), a sponsor of the forum, said, “I’m proud to support the cause of improving mental health services for our children and teens. From my own childhood, I recognize how critical it is to help our youth weather the tough circumstances that can come early in life.”
Senator Tom Udall (D-NM), a sponsor of the forum, said, “We have a moral obligation to help young people from every background and ethnicity with the support they need to overcome and deal with depression and suicidal tendencies.”
To view videos of remarks by the panelist, please visit:
The TeenScreen National Center for Mental Health Checkups at Columbia University is a
non-profit public health initiative and national policy center devoted to increasing youth
access to regular mental health checkups.
Friday, April 15, 2011
More Webinars: We're famous, you know...
TeenScreen National Center Upcoming Webinar
High-Performance Model: How One State Improved Youth Mental Health Care By Helping Providers
Thursday, April 27, 2011
2 p.m. - 3 p.m. Eastern Daylight Time
The issues were familiar: Mental health challenges in youth on the rise, a limited number of specialists, and a primary care community working to fill the gap.
Click here for the full event details and description.
John Straus, MD and Barry Sarvet, MD of the Massachusetts Behavioral Health Partnership will describe the MCPAP program, its role in supporting providers following the Rosie D decision, and how building and sustaining a partnership between primary care and mental health clinicians can help transform youth mental health care.
Please click here to register or copy and paste the below link:
https://event.on24.com/eventRegistration/EventLobbyServlet?target=registration.jsp&eventid=302803&sessionid=1&key=A1D6E523085B441CAFA921B2E21E113A&sourcepage=register
High-Performance Model: How One State Improved Youth Mental Health Care By Helping Providers
Thursday, April 27, 2011
2 p.m. - 3 p.m. Eastern Daylight Time
The issues were familiar: Mental health challenges in youth on the rise, a limited number of specialists, and a primary care community working to fill the gap.
Click here for the full event details and description.
John Straus, MD and Barry Sarvet, MD of the Massachusetts Behavioral Health Partnership will describe the MCPAP program, its role in supporting providers following the Rosie D decision, and how building and sustaining a partnership between primary care and mental health clinicians can help transform youth mental health care.
Please click here to register or copy and paste the below link:
https://event.on24.com/eventRegistration/EventLobbyServlet?target=registration.jsp&eventid=302803&sessionid=1&key=A1D6E523085B441CAFA921B2E21E113A&sourcepage=register
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