Anna Corona
Results from many Title V 2020 Needs Assessments confirmed that access to mental health care providers is a challenge for improving mental health status among the adolescent population. In fact, several state Title V programs cited mental health workforce provider shortage as a significant barrier to linking adolescents to appropriate treatment when screening positive for depression or other conditions. Given the prevalence of this shortage nationally, a recent Journal of Pediatrics[1] article discussed the promise of Child Psychiatry Access Programs (CPAP) as a tool for primary care providers to feel more comfortable providing mental health care to their patients. CPAPs provide primary care physicians with access to child psychiatrists via same-day telephone consultations that cover questions related to diagnosis, management, and care coordination for their patients. CPAPs are viewed as a promising strategy for gap-filling services while experts continue to explore ways to grow the mental health provider workforce.
The article emphasizes that the greatest challenge to the sustainability of CPAPs is a consistent funding source. Title V programs, with their flexible block grant funds, are in a unique position to directly support CPAP programs as a strategy for addressing adolescent mental health. Montana’s Title V program has done this by contracting with the state’s Billings Clinic to establish a toll-free access line for primary care providers to call and consult with the clinic’s Child and Adolescent Psychiatrists during daytime hours. Other Title V Programs also support federally-funded programs to implement their state’s CPAP, including:
- Colorado, which contracted with the Pediatric Mental Health Institute and Department of Psychiatry at the University of Colorado to implement the Colorado Pediatric Psychiatric Consultation and Access Program; and
- Kansas, which established a provider consultation line that supports primary care physicians and clinicians in treating behavioral health conditions within their practices.
Additionally, Title V Programs have been working to amplify and disseminate the message of available CPAPs to provider networks in their states, including:
- Iowa, which educates and markets their state’s 24/7 Psychiatry Consultation line to primary care providers utilizing resources enabled through the Health Resources and Services Administration’s Pediatric Mental Health Care Access Program; and
- New York, which partners with their state’s Office of Mental Health to increase awareness of the expansion of Project TEACH (NY’s model for pediatric psychiatric consultations).
Finally, Title V programs can support CPAPs by providing evaluation services to serve as an important data source for communicating the importance of this resource for improved access to mental health care. For example, the Wisconsin Title V program supports implementation and evaluation of their state’s Child Psychiatry Consultation Program in collaboration with the Medical College of Wisconsin.
For those states where a CPAP does not currently exist, the article recommends building a coalition of stakeholders who are interested in developing this for their state. Since Title V programs are well positioned to serve as conveners, this could present as an opportune starting point in such states. Once coalitions are formed, suggested next steps include contacting nearby states who have active CPAPs to learn more about how they were successfully started and implemented.
[1] Sulivan, K., George, P., and Horowitz, K. Addressing National Workforce Shortages by Funding Child Psychiatry Access Program. Pediatrics 2021;147; DOI: 10.1542/peds.2019-4012
