More than 2,000 children are on a waiting list for mental health help at just one center in the Cincinnati area.
The average waiting time to be seen by a professional: 98 days.
That’s more than 2,000 parents who lie half awake at night listening and worrying about their children, said Kate Schroder, president and CEO of Interact for Health, a nonprofit and health equity funder serving 20 counties in the Greater Cincinnati.
A mental health crisis among children is pushing the limits of care across the region and across the United States.
In Madisonville, the nonprofit Best Point Education and Behavioral Health is a large care provider and serves at-risk children. Only about 10,000 children with mental health needs get help there each year, said John Banchy, president and CEO. And with the severity of the mental health crisis among children, the number could grow.
There’s nothing short of calling it a crisis, Banchy said. As of June 7, Best Point had 2,079 children on the waiting list.
It’s unclear how many more children are waiting for specialized help in the region, but there’s no doubt among health experts that mental health care for children is nowhere near enough.
In January, Cincinnati Children’s Hospital Medical Center posted on its website that its emergency department was periodically receiving high volumes of mental health-related emergency visits.
The need is still high in Cincinnati and the region, said Dr. Suzanne Sampang, clinical medical director of Cincinnati Children’s Child and Adolescent Psychiatry.
«We continue to try to meet this growing need,» he said, «but the demand is outstripping the resources available in the community.»
How did we end up with too little care?
The crisis began before children in the United States, including the Cincinnati region, fell into a torrent of mental health struggles including anxiety disorders, depression, eating and other self-harm disorders, and suicidal ideation during the COVID pandemic -19. He ballooned from there.
We’re facing headwinds coming from multiple directions, Banchy said.
Between them:
- A long-term shortage of people seeking education to become therapists, psychologists, psychiatrists and other mental health specialists.
- Specialists leaving the field because Medicaid reimbursement rates are so low and that determines what we can pay folks, Banchy said.
- The severity of mental health conditions in children worsens, a crisis that continues to need to be addressed with professional help.
The pool of pediatric psychiatrists is too small for the needs of children and adolescents, data show
Psychiatrists aren’t the only specialists who can help children with mental health issues, but their numbers in Ohio, Kentucky and Indiana counties illustrate the shortage of professional care available.
The American Academy of Child and Adolescent Psychiatry estimates that the country needs 47 child and adolescent psychiatrists for every 100,000 children.
But Ohio has about 13 per 100,000. Kentucky has 14 and Indiana has 7, according to workforce data from the American Academy Child and Adolescent Psychiatry. In regional counties, the closest to that score of 47 psychiatrists is Hamilton County, with 26.
Data for counties in Cincinnati regions also shows a shortage of doctors.
Pediatricians will need to step up training to fill the gap
The shortage of specialized care providers signals the need for family care pediatricians to step in. The problem is that there is insufficient training of primary care pediatricians on how to recognize and deal with mental health care in children, experts say.
That will need to change: Accreditation for graduate medical education will require all pediatric residents to receive four weeks of mental health training by 2025.
Cincinnati Childrens specialists are already working locally and nationally to make that happen, said Dr. Sue Poynter, director of the hospital’s Pediatric Residency Training Program.
Poynter said change is essential to the health and well-being of children and adolescents.
In order to bridge the gap between mental health providers and the growing number of mental health diagnoses in pediatric patients, we need to graduate pediatricians who are comfortable with screening, diagnosing and treating common mental health problems and behaviorally, Poynter said.
Cincinnati children’s program leaders have designed a plan for a standardized online curriculum that addresses mental health topics in pediatric programs across the country, Poynter said.
The American Association of Pediatrics and other industry experts have encouraged general pediatricians to provide more mental health prevention strategies for families, regularly screen children and adolescents for mental health conditions, make personal referrals to specialists and if children are waiting or are between appointments , to help children manage their conditions as part of routine pediatric care.
Virtual training equips pediatric residents with mental health and behavioral skills
Part of Cincinnati Children’s ongoing plan involves immersing pediatric residents in environments where a virtual parent and child act out realistic scenarios that might happen during an office visit.
Dr. Joe Real, a Cincinnati children’s pediatrician, and Rachel Herbst, a pediatric psychologist, co-developed the curriculum, called Promoting Resilience and Emotional Health Through Virtual Education in Training or Prevention.
The virtual parent in the video asks questions about the new and troubling behaviors of her 3-year-old, who is «there» in the video, sitting in the room.
The resident must answer each question using evidence-based answers and stay engaged with the mom and aware of the baby, Herbst said. Even during the virtual session, the video child throws a tantrum. The resident should educate the parent on how to manage the child’s outburst and other behavioral problems.
Herbst said the virtual nature of the training gives residents a way to practice again and again, until they know how to respond and are comfortable doing so, in multiple scenarios.
Primary care pediatricians extend their resources to help now
Some pediatric groups in the Cincinnati area have a mental health professional on staff to try to meet the needs of children. Many family doctors screen children 12 and older for mental health conditions and will refer them to experts.
One example: St. Elizabeth Physicians pediatricians check every teenager for depression, every sports player in school, and, during medication checkups, every patient with ADHD. And they will check for anxiety and other mental health conditions as needed, said Dr. John La Count, a pediatrician.
The La Counts office has a social worker who is «integral in providing care and advice to families».
But the surge in children suffering from the COVID-19 pandemic has been difficult to manage with the shortage of support services,» said La Count.
He said pediatricians already have a heavy learning load and adding to it is not an easy process, and resources for further care are still lacking.
What else is being done to help?
Cincinnati-area health funders and advocacy groups are addressing the children’s mental health crisis by funding new strategies and services.
Among the current plans:
- Interact for Health is providing more than $2 million in grants for youth mental health efforts regionally, including prevention and treatment services in schools, community organizations and clinical providers.
- bi3, the health-focused funder of Bethesda, has invested $3 million to integrate mental health services into TriHealth’s pediatric practices. The goal is to help babies early on, so hospitalization and other long-term care is not needed.
- bi3 is also joining community funders, non-profits and other organizations to support a youth mental health strategy in the region.
- In 2022, the University of Miami received $5 million from the state to create a School Center of Excellence in Early Prevention and Intervention to equip schools with the tools they need to support children’s mental health.
Those funding the efforts say they know there is no quick-fix path to ending mental health care wait times for children, but they hope to make an impact as soon as possible.
«The crisis calls us to act with unprecedented urgency, and at the same time, we know results will take time,» said Schroder. «Challenges have been building up over the years and it will likely take years to reverse the trend.»
«Many families, teachers and therapists know this urge firsthand. They experience it every day and call us to share that urge and work together to help reverse the trend.»
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