Wednesday, September 23, 2009

Technology Makes All Things Possible: Listening In on the Children's Mental Health Task Force

As I have mentioned, I am currently in Washington DC, training with the Institute of Medicine in the practical aspects of the creation of health policy (there's some active work in that area right now) through the RWJ Health Policy Fellowship. Sometimes, however, I am able to keep up on the state of Children's Mental Health in Massachusetts, and so I phoned into the Massachusetts' Chapter of the AAP's Mental Health Task Force meeting today. Sounds like the work is still going on: Today's meeting was focused on how to get services for the really young kids who are being discovered in the screening system.

The meeting opened with a presentation by the the Center for Early Relationship Support, a program of Jewish Family and Children's Services, which is an early childhood mental health program (a rare beast within the Children's Behavioral Health Initiative). They do things via home visiting, a relationship based treatment program that is very different fro the usual mental health paradigm. The cool thing is that they run an Institute to train others to do this work, and they could help expand this model so that, when we find children who "screen positive" on our behavioral screening, we would have someplace to which to send them. There is some evidence (here as well) to support this approach, and clearly it needs to be expanded to meet the needs that we are identifying in the CBHI. Training can also be found within Connected Beginnings, a program started by the United Way that trains folks in various agencies to work with families on similar issues. Both of these programs have started working with the Massachusetts Early Intervention folks (within the Department of Public Health) For their part, EI is planning to do more screening for early mental health problems. So, with the CBHI and screening within EI, we are going to be creating more demand for these services.

Progress, but slow work. Both programs spoke of the need to do the training in small groups. I suspect that this stuff will take some time to work its way out into the hinterlands like Webster. Several people spoke to the need to bring this stuff out through the Early Intervention programs, which are already understaffed and dealing with a lot of these kids, especially out in the hinterlands. Much of this work is currently funded by soft money, which makes it hard to roll this out throughout the state.

People spoke out in favor of other models; co-location/collaboration/integrated models of care seem to be more popular in other states and it is not clear why that model has not caught on in Massachusetts. It ended with more discussion of the lost of funding for MCPAP, and the need to get support from the insurance industry if we are to keep this model going.

It was fun to hear the voices of so many old friends and colleagues, continuing to do the right thing for children. Hope I can phone in again sometime.

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