Funded Projects

Problem:

In 2022, Maine ranked 16th among US states for overall health of women and children according to America's Health Rankings (AHR), up from 21st in 2016. However, the report places Maine among states with the highest suicide rates at over 16.8 per 100,000 youths ages 15-19. The Child and Adolescent Health Measurement Initiative shows that in 2019-2020, close to three in 10 (29.5%) of Maine children aged three to 17 experienced a mental, emotional, developmental or behavioral (MEDB) problem. Based on recent data through the Maine Integrated Youth Survey (MIHYS), 22% of high school students have engaged in self-harm behaviors, and 18.5% have seriously considered suicide in the past year. In 2022, there were 2,654 visits to the emergency department by youth under age 19 experiencing suicidal thoughts or suicide attempts. While Maine is establishing a range of supports for pediatric behavioral health supports, the state's children remain in dire need of care.

Goals and Objectives:

Through this opportunity, Maine's goal is to continue and expand the statewide collaboration between primary care practices and psychiatric providers, including developmental pediatricians and substance use specialists, to improve knowledge of and access to behavioral health support in a child's medical home, facilitating timely access to care through reducing disparities in access to behavioral healthcare, especially in rural and underserved areas. Goal 1: Expand the Pediatric Behavioral Health Partnership to additional practices not already connected with the two health systems, with a focus on rural populations, tribal health centers, New Mainers population, emergency departments and school-based health clinics. Goal 2: Expand the practitioners participating in consultation and education/training to include substance use specialists and developmental pediatricians. Goal 3: Develop sustainability practices while enhancing the user experience of consultations by targeting Consultations to occur within 30 minutes or when the primary or specialty care provider requests as convenient.

Methodology:

Maine's health system partners will continue providing training to pediatric primary care providers on the identification, diagnosis, treatment and referral of children with behavioral health conditions. The established system for telehealth, telephone and e-consultation services will continue for nine months until the end of the State Fiscal Year, when Maine will issue an RFP to transform the program into a regional system as noted in Maine LD 231, supporting expansion of the current Pediatric Behavioral Health Partnership. Within this new model, the program will provide support across multiple domains: psychiatric consultation, substance use consultation, and developmental pediatrics. The expansion will be available to primary care practices across all Maine counties, Tribal groups, Emergency Departments, and school-based health clinics. Maine will continue to contract to support ECHO learning sessions and webinars on relevant topics to participants to increasing knowledge and confidence of practitioners to meet the needs of youth in their medical home, school, or emergency department. Software will also be put into place to centralize and allow end-to-end collaboration among participating practitioners and consultants.

Coordination:

This project will be coordinated by Dean Bugaj, Associate Director for Children's Behavioral Health in the Maine Office of Child and Family Services, DHHS.

Evaluation:

Maine will continue administering the existing evaluation plan as implemented under the first HRSA grant and will competitively re-bid the evaluation services during year one of the renewal project.