Abstract
Problem:
In Florida, the nation's 3rd largest state, 1 in 5 (21.7%) children ages 3-17 have one or more mental, emotional, developmental, or behavioral problems. Even as the COVID-19 pandemic has likely increased this number, only about half (52.6%) of children receive treatment or counseling. Florida's diversity in race, language, culture, geography, and regional capacity brings additional challenges in addressing pediatric mental health.
Goals and objectives:
Since 2019, the Florida Department of Health (FDOH)'s Title V program has collaborated with partners to develop a statewide network, the Florida Pediatric Mental Health Collaborative (FPMHC). The FPMHC is part of global efforts in the state to address mental health concerns facing children and their families, including the statewide initiative led by Florida's First Lady. The purpose of the FPMHC is to increase access to pediatric mental health services by building the capacity of primary care pediatric providers through technical assistance, skills-building training, and tele-consultations. The FPMHC is the organizing body for five existing regional behavioral health hubs (BHH); with this application, we are proposing to create two additional BHHs to address critical geographic gaps.
Methodology:
In each region of the state, BHHs partner with pediatric primary care practices to conduct a needs assessment, provide information and best practices to primary care providers increasing their ability to identify, diagnose, treat, and refer children with behavioral health conditions, including providing care coordination support and building referral networks. The BHHs provide telehealth consultations, with the goal of building primary care clinician capacity to work independently. Based on each region's needs and resources, the BHH has the flexibility to adapt evidenced-based models. An established quality improvement learning action network (LAN) assists BHHs with continuous tests of change using the plan, do, study, act cycle. Regional data and adaptations are shared with the larger statewide workgroup to address sustainability, scaling of services, and regulatory issues. Results will be disseminated to other state mental health efforts and national mental health organizations to improve access to pediatric mental health services.
Coordination:
The FDOH Title V program oversees the LAN and individual BHH contract activities and facilitates bimonthly FPMHC meetings to address regional and statewide challenges. Florida Medicaid and CHIP, the Florida Department of Children and Families, the Florida Chapter of the National Alliance on Mental Health, and clinicians from the BHHs constitute current workgroup membership. Expansion will include the Florida Department of Education, the Department of Juvenile Justice, private health insurers, and the Florida Chapter of the American Academy of Pediatrics.
Evaluation:
Primary outcomes of interests include the number of clients, types of services, and level of technical assistance or collaboration facilitated. Secondary outcomes of interest include identified training needs and provider self-assessment of skill development over time. Performance and outcome measures are collected on a periodic basis, with summative and formative analysis done by an external university-based evaluator allowing for comparison of regional outcomes and statewide benchmarking.