Abstract
Problem:
In the District of Columbia, nearly 23% of children aged 0-17 experience 2 or more Adverse Childhood Experiences (ACEs) or traumas which can have a lasting impact on their overall health outcomes and well-being. ACEs can also increase the chances of a child experiencing disrupted education, legal problems and incarceration, unemployment during adulthood, serious injury, and lower life expectancy. There are several upstream policy and programmatic initiatives in the District to address ACEs and support access to behavioral health services for children and families. In addition, prior the COVID-19 pandemic, an increasing need for pediatric mental health services, as revealed through the 5-year MCH Needs Assessment and DC Community Needs Assessment was emerging. These needs have only been exacerbated as a result of the pandemic are expected to increase as children transition back to "normalcy" and return to school in the fall with already long waiting lists for mental health services.
Goals and objectives:
Telehealth expansion of existing pediatric mental health care access will aim to address the following challenges and priority areas: timely detection, assessment, treatment and referral and integration with school-based health centers (SBHCs) and providers. The overall goal of the proposed project is to have a sustained reduction in barriers to mental health treatment and follow-up in DC and metropolitan areas of neighboring states, to encourage national networking and the continued increase in the quality of telehealth mental health training and resources for PPCPs. The project aims to expand the utilization of telehealth to 80% of DC MAP pediatric primary care providers (PPCPs) by the end of the performance period. The proposed activities map to HRSA goals, in particular to improve on referrals to community-based providers, establish mechanism for monitoring access to services, and provide more tele-consultation directly to families as well as to improve the state-wide network, and provide more tele-consultation and support to PPCPs.
Methodology:
Activities proposed to accomplish the goals of this pediatric mental health care expansion project include expanding use of telehealth to more pediatric primary care providers, improving data tracking and evaluation by establishing a system within DC for better connections to care, offering enhanced clinical care coordination for a select group of families who meet criteria, expanding bridge/short-term care for families with young children through partnership with DC's Help Me Grow program and developing a referral system for patients identified in primary care to be linked to school-based mental health support. The proposed expansion will use existing telehealth technology, platforms, and tracking mechanism to deliver care and will expand the use of these technologies and improve the referral and tracking systems in use.
Coordination:
DC MAP (Mental Health Access in Pediatrics) is a program currently funded by the DC Department of Behavioral Health (DC DBH) to improve mental health (MH) integration within pediatric primary care through consultation, training and technical assistance. The DC Department of Health (DC Health) proposes to use this new grant opportunity to partner with DC DBH, expand the services of the existing DC Mental Health Access in Pediatrics (DC MAP) program through the provision of pediatric mental health care telehealth access and continuous quality improvement, and to extend collaboration with regional and national partners. Funds from this grant opportunity will be used to complement, not duplicate, the existing DC MAP activities that have been previously funded through DC DBH.
Evaluation:
The project will utilize the proposed logic model and evaluation plan, including proposed performance and outcome evaluation measures to track progress throughout the project performance period.