To address the lack of integrated mental health services for children in Brooklyn, New York, BRIC will integrate mental health, primary care, and community programs to expand behavioral health access to a vulnerable population of children at risk of progression to serious emotional disturbance.
Goal 1: Implement Systematic Mental Health Screening in Primary Care and Subspecialty Clinic Settings. Objective 1: Train providers on use of validated mental health screening tools (PHQ-9-M, PSC-17) during well child visits, acute care visits and follow-up visits for children 10-13 years of age via CME-sponsored workshops in year 1. Objective 2: Implement screening in year 1. Objective 3: Provide Ongoing Support/Detailing to pediatric clinic staff to improve screening rates through weekly 'Lunch and Learn' sessions and PDSA cycles beginning in year 1. Goal 2: Systematize recruitment and enrollment of eligible Children with mild to moderate mental health problems into BRIC Program. Objective 1: Develop printed materials for eligible patients and parents with details about BRIC program, including program description, location, and key contacts in year 1. Objective 2: Develop and implement EMR and Phone-based Referral and scheduling system in year 1. Goal 3: Implement 6-week mental health intervention aimed at building coping skills/resilience for BRIC program participants Objective 1: Train BRIC social worker in evidence-based coping/resilience model in year 1. Objective 2: Implement and conduct 6-week group therapy sessions for enrolled program participants (10-13 y/o) and participant evaluation in year 2. Objective 3: Identify and connect participants who may benefit from additional community-based supports during and after program participation in year 2. Goal 4: Train primary care providers and pediatric residents in Evidence-Based Practice related to coping/resilience, community-based referrals, and principles of Trauma Informed care. Objective 1: Develop mental health curriculum and related materials in year 1. Objective 2: Implement lecture series for pediatric providers and residents. Goal 5: Develop coordinated system of referrals and communication with Community-Based Organizations providing complementary mental health and social services. Objective 1: Meet w/ prospective community partners to determine synergies with BRIC. Objective 2: Develop referral database of community partners.
Systematic mental health screening at Maimonides pediatric primary care clinics will identify children needing mental health services. Children 10-13 years old presenting to the primary care practice will complete validated screening tools (PSC-17 and PHQ-9) beginning in year 1. Pediatric subspecialists will be trained to implement screening in year 2. Children who screen positive for mild to moderate mental health problems will be referred to the co-located BRIC mental health specialist. The BRIC mental health specialist will further assess the child as follows: 1. Meet with the parent and child to explain the initial screen. 2. Administer the Child Behavior Checklist. 3. Screen for Adverse childhood experiences (ACEs) which often underlie and exacerbate emotional and behavioral issues. 4. Provide psycho-education to the parent and teen regarding the specific mental health problem. 5. Offer enrollment in the 6-week group intervention to children with moderate mental health conditions deemed appropriate for treatment in the primary care setting. 6. Arrange for follow-up psychosocial visits. 7. Link families to additional community-based services that promote resilience offered by BRIC partners. Additionally, mental health curricula and related training materials will be developed by the BRIC project team, and training via didactic presentations, workshops and webinars will be implemented with pediatrics faculty and residents beginning in year 1.
1. New York State Department of Health, Division of Family Health, Title V program- technical assistance. 2. Jewish Board for Children and Family Services- Advisory Board Member. 3. Big Brothers Big Sisters of Catholic Charities of Brooklyn & Queens- Advisory Board Member. 4. Arab American Association of New York- Advisory Board Member. 5. Maimonides Infants and Children's Hospital Family Advisory Board- Advisory Board Member. 6. Visiting Nurse Service of NY- Advisory Board Member.
Evaluating provider training and education includes examining the number and types of providers trained, and their knowledge, attitudes and practices pre and post training. Screening rates and outcomes will be assessed by examining the number of completed screens, proportion of positive screens, and BRIC/outpatient mental health referrals. The number of participants who complete BRIC group sessions, community referrals and mental health outcomes for participants will also be assessed.