New federal funding will allow New Jersey to recruit and train nearly 2,000 more primary-care providers to better diagnose and treat mental illness and substance abuse issues in children and adolescents, groups that often lacks access to effective behavioral healthcare.
A branch of the U.S. Department of Health and Human Services has pledged to provide the state Department of Health nearly $2.3 million, over five years, to enhance primary and behavioral healthcare with new telemedicine and education programs. The Nicholson Foundation, which supports health initiatives for underserved communities, is also contributing $109,000.
The DOH said Friday the new funding will allow the state to expand an existing effort, the Pediatric Psychiatry Collaborative, which now involves nine regional hospital-based programs that seek to properly screen and diagnose children with behavioral health needs and connect them with effective treatment in the area.
In particular, the money will enable the five-year-old program — overseen by Cooper University Hospital and Hackensack Meridian Health and funded by the state Department of Children and Families — to recruit new providers, educate and train more physicians, and use new technology to reach even more young patients, the DOH said.
Roughly one in every five children in the United States suffers from some form of emotional or behavioral condition, including anxiety, depression, and attention-deficit/hyperactivity disorder, statistics show. But as few as one in nine are properly diagnosed and treated, according to experts, despite the clinical urgency. Three-quarters of serious mental illnesses develop by age 24, they note.
Complex reasons for treatment gap
The reasons for the treatment gap in young people can be complex, but many agree the problem is exacerbated by disconnects between pediatricians and mental health providers, who can be scarce in some communities. Pediatricians — often the only healthcare professionals to treat children — are not always schooled in diagnosing and caring for behavioral health issues and, in many places, it can take weeks or more to get an appointment with an adolescent psychologist or psychiatrist.
“An integrated approach to pediatric mental health care ensures New Jersey’s most vulnerable residents receive the best treatment they deserve in a coordinated way,” said state Health Commissioner Dr. Shereef Elnahal.
“Mental illness and addiction often correlate with health risk behaviors such as tobacco use and physical inactivity, which lead to other chronic illnesses such as hypertension and heart disease,” he said. “A child who is diagnosed and treated early will be on a better path toward a healthier lifestyle.”
It was these same concerns that originally drove providers and advocates, like child psychiatrist Dr. Gary Rosenberg, to push state officials to better support and empower pediatricians and other primary-care providers on the front lines. With backing from Sen. Robert Gordon (D-Bergen), advocates for the program managed to convince the state to commit $1.4 million to the effort in 2014, to fund programs that initially covered four counties.
Like similar models in other states, New Jersey’s program showed early success, benefitting close to 600 children in the first year, supporters said. Former Gov. Chris Christie included $2.3 million for the effort in fiscal year 2015, enabling it to further expand, but — in a surprise to those involved — he did not include funding for the program in his fiscal year 2016 budget. At the time, administration officials said they wanted more data on its effectiveness before making further investments.
New funding is for five years
Despite that hiccup, the initiative has continued in the years since and now includes nine hubs with services that reach all 21 counties, according to the New Jersey chapter of the American Academy of Pediatrics, a leading advocate for the program. The new funding, from the federal Health Resources and Services Administration, will be allocated at $445,000 annually for the next five years.
The collaborative program currently pays for pediatricians to learn how to better identify mental illness or drug abuse and also pays for patients to obtain follow-up care from a behavioral health specialist; it can also fund training and technology to connect pediatricians with child psychiatrists who can advise them on patients in real time.
“Our integrated approach ensures pediatricians have access to a child psychiatrist in real time — while a child is actually in their office — to get assistance with a diagnosis, recommendations, medication management and a treatment plan immediately,” said Dr. Ramon Solhkhah, chair of psychiatry at Jersey Shore University Medical Center, and a founder and leader of the collaborative.
In addition to expanding the provider network, the new funding will enable the creation of an online referral database and other efforts to make it easier for young patients and their caregivers to access the system, explained DCF Commissioner Christine Norbut Beyer. “It will go a long way toward keeping New Jersey families safe, healthy and connected,” she said.