Funded Projects

Project videos:

Introduction video

Problem:

The Maternal and Child Health Bureau in the Delaware Division of Public Health has expressed the need for behavioral health access for pre-natal and post-partum patients. Like many other Child Psychiatry Access Programs (CPAPs) throughout the country, the Delaware Child Psychiatry Access Program (DCPAP) has agreed to partner with the Maternal and Child Health Bureau to expand the program to include psychiatry consultation, and training and education opportunities to prescribers serving this population. DCPAP will expand the resource and referral database to include maternal behavioral health resources as consultation and training sessions are instituted. Delaware has a shortage of child psychiatrists. The shortage is critically severe in the south. In northernmost New Castle County, there are 19 child psychiatrists for an under-18 population of 157,805. For Kent County, the shortage is worse with only 3 child psychiatrists for 50,830 children. Meanwhile, in Sussex County there is 1 child psychiatrist for a population of 47,032. Delaware neither has enough psychiatrists to cover its population, nor a medical school to provide more of them.

Goals and Objectives:

DCPAP's goals are:

• Increase the availability and accessibility of child and adolescent psychiatric and mental health to pediatric primary care practitioners caring for children and adolescents with behavioral disorders.
• Expand the focus of the program to include maternal health providers for pre-natal and post-partum behavioral health disorders.
• Conduct training and provide technical assistance to primary care providers to enable them to conduct early identification, diagnosis, and treatment for mothers and children with behavioral health conditions.
• Provide evidence-based methods such as web-based education and training sessions to pediatric and maternal providers on detection, assessment, treatment, and referral of patients with behavioral health disorders.
• Improve access through telehealth to treatment and referral services for pediatric and maternal health patients with identified behavioral health disorders, especially those living in rural and other underserved areas.

Methodology:

The Delaware Department of Health and Social Services, Division of Public Health, Maternal and Child Health Bureau (MCH), proposes to continue the efforts of the Delaware Department of Services for Children, Youth and Families (DSCYF), Division of Prevention and Behavioral Health Services (DPBHS), Delaware Child Psychiatry Access Program (DCPAP) by installing the program under the MCH for continuation and expansion of DCPAP to support pediatricians, family physicians, general nurse practitioners, and other primary care providers in providing prompt efficient treatment to children and mothers with mild to moderate mental health symptoms. The expectation of the program is that prompt, efficient psychiatric consultation be readily available to all pediatric and maternal serving physicians, family physicians general nurse practitioners, gynecologists and obstetricians, when treating a patient with a behavioral health concern.

Coordination:

The Department of Services for Children Youth and Families (DSCYF) will continue to support and direct the DCPAP program with existing HRSA funding while the Division of Public Health (DPH) works to get the continuation funding through the Delaware State Clearinghouse Committee process and contracts in place. Activities, staff and processes currently in place are not expected to change as the DCPAP program transitions from DSCYF to DPH. Requests for services will continue to be received through current communication methods and staff already in place with DCPAP. New contracts will be developed by DPH expecting to be implemented within the first six months of the continuation funding. There may be some overlap of contracts between the initial HRSA grants and the continuation funding to ensure services, processes, and infrastructure, transitions completely from DSCYF to DPH including the DCPAP webpage and telephone number. Consulting child psychiatrists will contract with DSCYF while DPH conducts the RFP process for these services under the continuation funding. Data collection systems will require transition from the current Qualtrics system used by the University of Delaware evaluation team, to whatever is decided to be used by the DPH evaluation team. Data for services provided will continue to be entered into the Qualtrics system through June 2024 as proposed in the DCPAP Year Five HRSA Extension Request.

Evaluation:

A new direction for evaluation will be instituted over the first six months of the first year of funding. DCPAP had previously focused only on the HRSA required data requirements for the grant, where funders are more interested in outcome measures. DCPAP will work with the MCH evaluation contractor as well as seek consultation with DPH's CDC MCH Epidemiologist for technical assistance to develop a plan for capturing both the routine and required data, as well as outcome data.