This Clinician's View is written by Lalit Chaube, MD, medical director of pediatric and adolescent psychiatry at AdventHealth for Children.
At AdventHealth for Children, we believe in helping children and families feel whole — mind, body and spirit, and we know caring for a child’s mental health is essential to their overall health and well-being. Unfortunately, we also know that children’s mental health has been declining for more than a decade, a crisis that was exacerbated by the COVID-19 pandemic.
According to data from the Centers for Disease Control and Prevention (CDC) collected prior to the pandemic, 1 in 5 children had a mental disorder, but only about 20% of those children received care from a mental health provider. More recent findings from The State of Pediatric Mental Health in America 2023 Report reveal the current severity:
- More than 2.7 million children and adolescents are living with severe major depression.
- 16% of youth surveyed reported having at least one major depressive episode in the past year.
- 60% of youth with major depression receive no mental health treatment.
- There is a shortage of mental health providers, with just one available mental health provider for every 350 people.
Within our own system, we have experienced a significant increase in children and teenagers seeking treatment for anxiety, panic attacks, depression, suicidal thoughts and cutting behavior. As clinicians, we know that half of all lifetime mental health conditions start before age 14 and that early, effective identification and treatment of mental health concerns can help prevent more severe outcomes, including suicide or self-injury.
Bridging the Children’s Mental Health Care Gap
Today we have better medications and more effective treatments for children’s mental health conditions, but the supply of care providers has simply not been able to keep up with the soaring demand. This scarcity in services has forced too many children and families to seek care in our emergency rooms (ERs) because the wait for an initial appointment with a mental health care provider can be 3-4 months. As a father and a physician, I know we must do better.
Detecting mental health challenges and addressing them early through a collaborative, comprehensive, long-term treatment plan can make all the difference. That is why AdventHealth for Children has partnered with Dr. Phillips Charities, whose generous $6 million, five-year grant in 2021 helped create the AdventHealth for Children Mental Health Program. This first-of-its-kind, comprehensive pediatric and young adult mental and behavioral health program in Central Florida is expanding access to timely, high-quality mental health care for our community’s children and youth. In fact, our recent efforts have already helped lead to AdventHealth’s recent recognition in Becker’s Hospital Review as one of 36 hospitals and health systems with great psychiatry and mental health programs.
We are currently in the third year of our five-year grant and expansion plan, which includes the following components:
- Establishing a dedicated children’s mental health care outpatient medical practice, AdventHealth Medical Group Pediatric and Adolescent Psychiatry at Winter Park, that includes psychiatrists, psychologists, social workers and mental health counselors that operate on an “urgent care” model with appointment availability, including virtual visits, every day
- Developing and implementing a community-wide de-stigmatization/mental health education campaign
- Reducing the provider gap through recruitment of psychiatrists, nurse practitioners, mental health counselors and social workers
- Developing mental health care navigation support
- Increasing early detection and intervention through screenings and counselors at AdventHealth pediatric practices
- Partnering with Orange County Public Schools to provide mental health care navigation services to their most at-risk population
- Improving community services and resources through collaboration and partnerships
Beyond the Emergency Room — Creating a Continuum of Care
For too many years, when a child or adolescent needed urgent mental health care in Central Florida, a family’s only option was the ER, which can be a scary place for many children suffering from mental health conditions as it is designed primarily for those requiring inpatient psychiatric care. The vast majority of these patients are better served in an outpatient community setting. At AdventHealth for Children, we are committed to addressing this challenge head on. We want to be more intentional, expanding access to outpatient services and support, delivering a full continuum of care to meet each patient’s specific needs, and ultimately, achieving better outcomes:
- Through the new AdventHealth for Children Mental Health Program, we are now triaging patients to the appropriate level of care within 24-48 hours, diverting many patients from the ER, seeing them faster and in a more comfortable and appropriate environment.
- Our outpatient specialty clinic is providing an immediate step-down option from inpatient care. We know hospital discharge is the time of highest risk for patients who have been in crisis, and we are committed to connecting them with same-day or next-day support as they make this transition.
- Most recently, our expanded mental health care provider team has allowed us to transition our inpatient psychiatric consults to an in-person, hospital-based psychiatrist rather than a telehealth visit.
- We are also working on expanding the mental health support provided to medically compromised patients admitted to our pediatric units.
Helping Families Navigate Pediatric and Adolescent Mental Health Care Services
To help ensure our patients receive the right care at the right time at the right place, AdventHealth for Children has also established a Child and Adolescent Mental Health Navigation program. Our children’s mental health navigators serve as a resource for families, helping them navigate the system throughout the patient’s care journey. They also serve as a resource for our pediatric ERs, inpatient units, community pediatric practices and other pediatric specialty areas. Our mental health navigators can be reached at Call407-517-7593 or through this online form.
Removing the Stigma — “Be a Mindleader”
In partnership with Heart of Florida United Way, AdventHealth for Children also launched the “Be a Mindleader” campaign in May 2023 to help de-stigmatize mental health challenges. The goal is to get curated, expert information into the hands of kids, parents, caregivers, coaches, mentors and teachers, and help facilitate life-changing conversations about mental health between children, teens and the adults in their lives. We want to improve and save lives by breaking down the stigma of reaching out for help. This campaign includes mental health hotlines and suicide and crisis prevention resources as well as tips and advice for starting conversations with kids and handling difficult situations, such as bullying and eating disorders.
Community Outreach and Education
Prevention is a critical piece of our overall plan. Building upon the success of AdventHealth for Children’s “Mission Fit” school program and curriculum focused on social emotional learning and wellness, AdventHealth for Children also plans to host additional events to teach young children about their emotions and help them develop foundational skills for caring for their mental health. Our team plans to expand these efforts to private schools, summer camps, after-school programs, churches and early learning centers. Additionally, we are starting conversations with local business groups on the impact youth mental health has on families and how employers can ensure team members are supported.
Enhancing Suicide Prevention
Thanks to a two-year, $100,000 grant from the Cardinal Health Foundation and the Children’s Hospital Association (CHA), AdventHealth for Children is also now one of 16 children’s hospitals across the country participating in the Preventing Youth Suicide National Collaborative, allowing us to receive comprehensive training and expert consultation from the Zero Suicide Institute focused on evidence-based process improvement and care enhancement for children at risk of suicide.
It Takes a Village — Collaboration, Partnerships and Support
In addition to the tremendous generosity of Dr. Phillips Charities, Heart of Florida United Way, and Cardinal Health/CHA, AdventHealth for Children is grateful for financial and in-kind support from several other partners to help expand our comprehensive Children’s Mental Health Care program and community outreach efforts, including the following organizations:
- Orange County Government
- Central Florida Cares
- DeVos Family Foundation
- Jeff and Rita Adler Family Foundation
- 22Squared
Building Healthier Futures
The task at hand may be daunting at times, but for me, it is a calling. I love working in the children’s space and helping families. There is simply nothing more rewarding than caring for a patient and family over time, establishing trust, building relationships and ultimately, helping them achieve healthier, more whole lives. With extensive community support, AdventHealth for Children has made a significant commitment to destigmatize, prevent and more effectively treat the children’s mental health issues that exist today so that hopefully, we can prevent them for future generations.
