Adverse Childhood Experiences (ACEs) are potentially traumatic events that cause overwhelming stress and have lasting negative effects on physical and mental health. Such experiences include abuse and maltreatment (physical, sexual, emotional/verbal); neglect (physical and emotional/psychological); and household dysfunction (parent mental illness; domestic violence; divorce or separation; incarceration; and alcohol or drug abuse). Traumatic events in childhood can be emotionally painful or distressing and can have effects that persist for years. Factors such as the nature, frequency, and seriousness of the traumatic event, prior history of trauma, and available family and community support can shape a child's response to trauma. The ACEs Behavioral Health Collaborative will aim to improve the most critical service gap for AltaMed pediatric patients assessed for ACEs by increasing timely access to mental health/behavioral services. Long wait times to see a mental/behavioral health professional have beleaguered Los Angeles County, California, and the nation. The goal is to reduce the appointment wait time for AltaMed pediatric patients/families to strengthen the resiliency of children and youth.
Goals and Objectives:
Goal 1: Advance AltaMed's ACEs continuum of care through an interdisciplinary Care Collaboration Model of ACEs Systematic Case Review. Goal 2: Enhance trauma-informed wrap-around behavioral health services for children/families with complex acuity for ACES by providing assessments, bridge counseling, and therapeutic treatment to approximately 190 under-resourced children aged six months to 18 years and/or their parents/caregivers with identified complex co-occurring primary care and mental/behavioral health issues identified through the ACE screening tool (PEARLS).
Through the ACEs Behavioral Health Collaborative, AltaMed will: 1) Establish an interdisciplinary systematic case review process to facilitate care coordination resources for pediatric patients and their families with complex physical and behavioral health ACEs co-morbidity, as well as promote workforce development in pediatric behavioral health services through case collaboration, coaching, and mentorship in an effort to address the physical, emotional, and psychological effects of childhood trauma. This approach will bring together professionals from various disciplines, including healthcare, social work, and mental health, to develop comprehensive and personalized care plans for individuals who have experienced ACEs. 2) Host a Psychology Post-Doctoral Fellow to bridge and provide short-term psychological counseling to high-risk under-resourced children, youth, and their families.
The ACEs Behavioral Health Collaborative will create a new service point within AltaMed's Youth Services department. AltaMed's Youth Services provide case management and social support through trauma-informed principles and resiliency and strength-based methods, with rapid-response, intervention-based, in-home case management support services to meet patient/client needs. AltaMed will leverage the Collaboration of Care Model approach to employ a Systematic Case review to assess the unique needs of each individual and develop a coordinated plan of care that addresses not only their physical health but also their emotional and mental well-being. This may include medical treatment, counseling, education, and community support. This approach recognized that the effects of childhood trauma are complex and multifaceted and require a coordinated effort from various professionals to address effectively.
The project will conduct a process-based evaluation to assess the completeness and timeliness of required activities and deliverables and an outcome-based evaluation to assess access to care and care coordination using engagement of services, turnaround time, patient satisfaction surveys, and ACEs screenings as indicators.