Rethinking Adolescent Mental Health Care: Using Common Factors to Improve Your Practice Potential

A TeenScreen National Center Webinar Event

With

Larry Wissow, MD, MPH

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

Register

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.

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.”

“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.”

To view videos of remarks by the panelist, please visit:

http://www.teenscreen.org/policy/policy-events/trendell-forum-2011/

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.

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

From the Children's Mental Health Campaign

From my INBOX this morning:

As you know, the House Ways and Means Committee released their budget recommendations yesterday. Children’s mental health services faired well and many line items were level funded:

1. The CBHI line item was funded at $214.7 million which is the same level as the Governor’s budget.
2. The language on reporting requirements for the CBHI line item was included but not in the Governor’s budget.
3. The DMH child and adolescent mental health services line item was level funded at $71.4 million from FY11, this is a $2 million increase over the Governor’s budget.
4. The mental health consultative services line item under EEC was level funded from FY11 at $750K which also matched the Governor’s budget.

Our recommendation to include the MCPAP bill as an Outside Section was not included.
Representative Ruth Balser will file the Massachusetts Child Psychiatry Access Project (MCPAP) legislation as an outside section to the budget at the request of the CMHC.
This would act as a revenue stream for the Commonwealth during these difficult financial times as well as a workforce development program.
MCPAP is run as an “insurance blind” program and is currently funded solely by the Commonwealth. However data collected on participants includes insurance coverage. This data reveals that more than half of those served have commercial coverage.
The goal of MCPAP is to make child psychiatry services universally accessible to primary care providers (PCPs) throughout the Commonwealth who can access a team of child psychiatrists, psychologists and/or social workers via telephone consultation in order to diagnose and treat mental health disorders.
This outside section would requires commercial health insurance companies to proportionally contribute to the funding of the MCPAP at a rate equal to the participation of their membership. This will generate nearly $1.8 million per year to contribute to the cost of the program. Surplus revenue will be directed toward implementation of MCPAP in schools where administrators and teachers struggle daily to deal appropriately and effectively with children showing signs of mental health conditions.

Please CLICK HERE for more information and ask your State Representative today to sign on as a co-sponsor here.

Thank you,
Erin G. Bradley
Coordinator, CMHC

Webinars today

Why does all of the good stuff happen at once?

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From the Patient Center Primary Care Collaborative:
Please join us for a free webinar on Thursday, April 14, from 1:00 - 2:30pm, entitled: "Behavioral Health Integration in the Medical Home and Its Facilitation by Health Information Technology." This informative presentation is co-sponsored by the PCPCC Center for eHealth Information Adoption and Exchange and the Behavioral Health Task Force and will feature Drs. Rodger Kessler and Timothy Burdick from Fletcher Allen Health Care at the University of Vermont.

More info here.

From the Center for Mental Health Services in Primary Care:
"The Scope of a Federal Mandate for Providing Behavioral Health Services to Children: The Rosie D. Case"
Are children entitled under the law to mental health services?

Please join us for a free webinar on Thursday, April 14, from 1:00 - 2:30pm. Deborah Agus, JD, will discuss the Rosie D. Case and the subsequent mandate for behavioral health care for children in Massachusetts as well as the implications for other states.

Connect on the web at: http://connect.johnshopkins.edu/pediatricmentalhealth/

Contact slongway@jhsph.edu for dial-in information

A request from SAMSHA

Here's an opportunity to have input into Federal policy on mental health. Go for it.
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SAMHSA Is Seeking Comments on a New Unified Application for Mental Health and Substance Abuse Block Grants

SAMHSA announces a new approach for the Substance Abuse Prevention and Treatment Block Grant (SAPTBG) and the Community Mental Health Services Block Grant (MHSBG). Under this new approach, the grant applications will merge, providing states and territories the opportunity to use block grant dollars for prevention, recovery supports, and other services that supplement services covered by Medicaid, Medicare, and private insurance.
The block grant funds will be directed to four purposes:

• Fund priority treatment and support services for individuals without insurance or for whom coverage is terminated for short periods of time.
• Fund those priority treatment and support services that demonstrate success in improving outcomes and/or supporting recovery for low-income individuals and are not covered by Medicaid, Medicare, or private insurance.
• Fund primary prevention—universal, selective, and indicated prevention activities and services for persons not yet identified as needing treatment.
• Collect performance and outcome data to determine the ongoing effectiveness of behavioral health promotion, treatment, and recovery support services and plan the implementation of new services on a nationwide basis.

SAMHSA will work with states and territories to plan for and transition the block grants to these four purposes. In redesigning their plans, states will consider new factors: conducting a needs assessment of their behavioral health system, developing collaborative plans for health information systems, forming strategic partnerships to provide individuals better access to behavioral health services, and redesigning systems and services to increase accountability and improve the performance of services funded. SAMHSA invites your comments on the proposed grant application.

Click here to find out more.

AHRQ has much cool stuff:ASD review

Given that this is the month to think on autism, this message from AHRQ seemed worth reposting:

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The Agency for Healthcare Research and Quality (AHRQ) Effective Health Care (EHC) Program is pleased to announce that the following research review is now available:

• Therapies for Children With Autism Spectrum Disorders.

To access the research review and associated products, please visit: http://www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=651.

An article on this report has been published in the journal Pediatrics. The abstract for this article can be accessed at:http://pediatrics.aappublications.org/cgi/content/abstract/peds.2011-0426v1.

Learn how you can personalize your interactions with and share what you learn on the EHC Program Web site. Visit:http://www.effectivehealthcare.ahrq.gov/index.cfm/personalization-and-social-media-tools/.

We welcome your comments on the EHC Program Web site! Please use our “Contact Us” form available at:http://www.effectivehealthcare.ahrq.gov/index.cfm/contact-the-effective-health-care-program/.

Thank you,
Effective Health Care Program
www.effectivehealthcare.ahrq.gov