Pediatric Mental Health Care Access Program
Grant Status: Completed
Training Category: Pediatric Mental Health Care Access Program (PMHCA)
Project Director(s):
Debra Pinals, MD
Michigan Department of Health and Human Services
PO BOX 30195
Ann Arbor, MI 30195
Phone: (517) 256-4115
Email: PinalsD@michigan.gov
Problem:
There is a crisis in access to evidence-based behavioral health care in Michigan. Despite the fact that the prevalence of youth and peripartum psychiatric illness is estimated at 15-20%, 65% of counties in Michigan have no child/perinatal psychiatrists (CAPPs) and the majority of youth (55%) do not receive treatment, particularly in rural and underserved urban areas impacted by poverty and trauma. Emergency rooms report increases in youth seen for suicidality and aggression secondary to trauma, autism spectrum disorders and other social determinants of health. Primary care physicians and school-based child and adolescent health centers (CAHCs) report inability to access CAPPs for their patients, and lack of education that could assist them in assessment and treatment of children and peripartum women.
Goals and Objectives:
The Michigan Child Collaborative Care (MC3) program, developed in collaboration with Michigan Department of Health and Human Services (MDHHS), targets urban and rural disenfranchised populations through supporting local primary care providers who treat behavioral health issues in their clinics. MC3 offers same-day telephone consultation on youth from birth through 26 years and pregnant/peripartum women, telehealth evaluation for complex patients, and behavioral health consultants to coordinate care. To date, 1770 primary care providers have been enrolled in the program. The goal of MC3 Connect is to expand and enhance the MC3 program through the following objectives: Objective 1: EXPAND MC3 phone-based, telepsychiatric, group case consultations and behavioral health consultant support (BHC) to all 83 Michigan counties and to 70 CAHCs, including the frontier upper peninsula and tribal populations. Objective 2: EDUCATE providers and trainees by developing a series of culturally sensitive and content relevant webinars based on requested topics. Objective 3: LINK MC3 to other evidence-based (EB) intervention programs supported by Michigan Department of Health and Human Services (MDHHS), University of Michigan (UM) and Michigan State University (MSU) to facilitate access and coordinate follow-up care to for women/children in underserved and rural areas without specialty services. Objective 4: Integrate SCREENING AND REFERRAL with workflow processes and provide MC3 back up for positive screens. Pilot Relational Health Screening (RHS) for high-risk dyads in pediatric offices with high prevalence of intergenerational trauma and substance use.
Methodology:
MC3 Connect will build upon PCP/CAHC enrollment, consultation, education and screening methods already successfully used in the MC3 program.
Coordination:
MC3-Connect Stakeholders including HRSA, MDHHS, Advisory Committee, UM, MSU, and EB Intervention (Linkage) programs that will prioritize coordination.
Evaluation:
Providers (#s, utilization of program, satisfaction), Education (#s and modalities, provider and trainee satisfaction, pre-post confidence of the providers, cultural competency, measured through changes in knowledge, attitudes and beliefs), Patients and Families (provisional diagnostic, medication, utilization/level of care, symptom severity, social determinants of health, adherence, access), Linkage (cross referral data #s), Screening (#s, modality, referral rate); and others per HRSA/Continuous Quality Improvement (CQI).