Texas Children’s Hospital Announces Multifaceted Preventive Approach to the Escalating Pediatric Behavioral Health Crisis

Nation's largest children’s hospital raised more than $11 million to launch multiple community-based mental health initiatives and programs

HOUSTON (Dec. 07, 2022) —Texas Children's Hospital announces a novel, community-based approach to the escalating pediatric behavioral health crisis across the country. Thanks to the generosity of several donors, the nation’s largest children’s hospital raised more than $11 million to help launch several behavioral and mental health initiatives and programs.

Texas Children’s recently formed a dedicated Behavioral Health Task Force and multiple workgroups to develop and implement new and expanded system-wide services for patients in need of specialized care. The goal is to meet patients and families where they are and to help them address behavioral and mental health issues as early as possible at each stage of the diagnosis and treatment continuum — before they escalate to the point where inpatient hospitalization is required.

"These services are desperately needed, and we are committed to providing them because we believe that the behavioral and developmental health of children, adolescents and teens is just as important as their physical well-being," said Dr. Kirti Saxena, Chief of Psychiatry at Texas Children's Hospital and Associate Professor of Psychiatry and Behavioral Sciences at Baylor College of Medicine.

The need is greater than ever.

The U.S. Centers for Disease Control and Prevention (CDC) report a 44% increase in pediatric mental health-related emergency visits in 2020 as compared to the previous year. Major depression is among the most common health disorders in children — and in Texas, nearly three-quarters of youth with major depression did not receive treatment last year. Unfortunately, the state of Texas ranks last in the United States for access to life-changing behavioral health care.

"The demand for child and adolescent behavioral health care has exploded across the nation in the wake of the pandemic. As a national leader in pediatric health care, Texas Children's must set the bar for effective, convenient and comprehensive treatment," said Mark A. Wallace, President and CEO of Texas Children's Hospital. "Meeting this overwhelming demand requires a multidisciplinary approach and a community-wide effort. We are so grateful that generous support from our philanthropic partners enabled us to jumpstart various initiatives quickly and efficiently. This support is — and will continue to be — absolutely crucial. In addition, we are working with state government sources and with Medicaid to educate legislators and insurance providers about the importance of appropriate reimbursement."

Texas Children’s strategic Behavioral Health initiative includes the following priorities:

• Training frontline pediatricians on behavioral health care
  Texas Children's is equipping its primary care physicians with specialized training to diagnosis and treat patients with behavioral health issues while also hiring additional psychiatrists, psychologists and behavioral health specialists. To date, more than half pediatricians from Texas Children’s Pediatrics (TCP) practices completed this training and reported that they feel more comfortable treating or beginning treatment for issues of anxiety, depression and ADHD, which have continued to increase in prevalence year over year.
   
• Embedding Psychiatrists, Psychologists and Behavioral Health specialists in Texas Children's Pediatrics clinics
  Recent philanthropic support allowed Texas Children’s to hire behavioral health specialists in TCP practices in Fort Bend County. Coupled with behavioral health specialists embedded in practices around the community, Texas Children’s is on track to continue to bring behavioral healthcare support to the communities we serve throughout Houston, Austin and College Station. Benefits of this approach include:
  • Incorporating specialists into the safe and private space of a patient’s primary care office will normalize behavioral health services, help reframe them as central to primary care and reduce the stigma that, unfortunately, continues to be associated with them.
  • Families trust their primary care physicians and when a pediatrician personally introduces behavioral health specialists to patients and coordinates care within the same office, patients are more accepting of treatment and outcomes improve.
  • Interventions such as training and education, embedding of behavioral health specialists and specific screening tools will reduce the number of patients seeking help for behavioral health-related crises at emergency centers.
• Building an Intensive Outpatient Program (IOP)
  The IOP will close the gap between inpatient and outpatient behavioral health services, providing intermediary care for patients who cannot perform successfully in their current environmental support setting but who do not need inpatient psychiatric hospitalization. It will support patients through skill-based individual, group, recreational and family therapy sessions that teach strategies to reduce symptoms and improve functioning within a structure that allows patients to live at home and continue school and family activities. With locations in Bellaire and The Woodlands, Texas Children's will provide these services to patients with medical conditions and chronic illnesses, delivering a continuum of care not available elsewhere in our community.
   
• Increasing specialized Emergency Center staff and enhancing safe treatment spaces
  Demand for emergent behavioral health intervention for children and adolescents is four times higher than it was two years ago with the onset of the COVID-19 pandemic at Texas Children’s Emergency Centers. Physicians treat 400 – 500 patients seeking behavioral health services each month in the Texas Medical Center and at Texas Children's Hospital West Campus and Texas Children's Hospital The Woodlands Emergency Centers. Even more alarming is that the primary behavioral health issue for patients presenting at emergency centers used to be self-harm and now it is suicidal ideation.
  
  Texas Children's is hiring specially trained staff including physicians, nurses, technicians and security guards to care for patients in these settings. In addition, plans are underway to renovate existing spaces making them safer for patients, families and caregivers and to build new spaces where necessary.

Suicide response and prevention

Texas Children’s employees are committed to being leaders at work, at home and in the community — and often that means that people look to them for support and resources, particularly regarding the growing behavioral health crisis. In September, a Gatekeeper Training program was specially designed for employees at Texas Children's and Baylor College of Medicine to teach them how to identify warning signs of suicide and to provide tools for navigating these difficult situations. More than 5,000 team members completed this training and report feeling more comfortable about engaging in tough conversations related to suicide.

Texas Children's partnered with the Zero Suicide Institute to offer training and guidance to more than 70 clinical and administrative leaders in a two-day academy. This ongoing effort demonstrates a commitment to improving patient, family and employee safety by developing frameworks for system-wide transformation toward safer suicide care.

"Across the Texas Children’s system, we are implementing more robust patient screening, enhancing patient assessments conducted by trained behavioral health specialists and reducing the stigma surrounding behavioral health issues and treatment," said Dr. Karin Price, Chief of Psychology at Texas Children's Hospital and Associate Professor of Pediatrics at Baylor College of Medicine. "We are devising safety plans to help patients and families know what to do at various "stress levels" and what to do if someone is suicidal, developing family intervention strategies and ensuring that care coordinators are helping patients and families at every point along the care continuum. It is a tremendous undertaking, and Texas Children's is up to the task."

Donate now to help support Behavioral Health initiatives at Texas Children’s Hospital.