Family Voices of CA Health Summit Developing a Countywide Pediatric Mental Health System of Care: The Critical Role of Family Voices of CA Health Summit Mental Health for Children with Special Needs Heather Huszti, Ph.D. Department of Pediatric Psychology Children’s Hospital of Orange County

One in Five

Co-Occurring Medical-Psychological Conditions Examined prevalence of psychiatric and social adjustment in children (4 – 16 years) Children with chronic illness and disability - > 3 times risk for psychiatric and social adjustment problems Children with chronic illness and no disability – 2 times greater risk for psychiatric problems Few specialized therapists Examples: 900 kids and young adults with cancer (plus 150-200 new annually); 1500 diabetes; 700 severe GI; 3500 asthma; 4000 annually evaluated for epilepsy

Why does children’s mental health matter? Mental health is key to the overall health of children No other illnesses harm so many children so seriously Untreated mental health issues leads to: Increased health care utilization as adults Decreased school achievement Increased risk of under-employment and poverty Increased risk of incarceration Increased risk of alcohol and other drugs

Intensity of Treatment Pediatric and Young Adult System of Mental Health Care Intensity of Treatment

Task Force members today… Pediatric and Young Adult Mental Health System of Care Task Force CHOC Children's Saddleback Church OC Behavioral Health OC Dept of Education CalOptima Kaiser Permanente UCI Medical Center Regional Center OC Children & Families Commission American Academy of Pediatrics Ch. 4 St. Joseph Hoag Health OC Alliance for Children & Families Jewish Federation & Family Svcs NAMI/family Cigna Juvenile Justice

Expanding Outpatient Services 88% of surveyed physicians reported their patients had unmet need for psychological services Opening of CYS CHOC Co-Occurring Clinic September 2015 For first time, allows CHOC Psychology/Psychiatry to see children with Medi-Cal Specific focus on children with co-occurring physical and mental health disorders Provides services to children with medical diagnoses and psychological disorders – both inpatient and outpatient

Increases in Services

Emergency Department Services Pilot with Triage Funds (County partnership) Add Psychologist and Social Worker Team Add intensive family intervention Boston Children’s Hospital Intervention Add follow up to decrease return visits Hiring resource specialist to help families access services Pilot with grant funding

Integration in Primary Care With HRSA funding, able to integrate psychologist and intern in primary care clinic Provide training in Motivational Interviewing Develop materials for pediatricians on common mental health conditions Start routine depression screening 12 year old well child visits Started routine screening for anxiety and depression in all caregivers of children with Cystic Fibrosis and all teenagers with Cystic Fibrosis, with intervention

Inpatient Psychiatric Unit Corporate Presentation Speaker Notes Inpatient Psychiatric Unit Friday, February 09, 2018 18 bed unit Children 3 – 18 years Private rooms Parents stay with kids Optimal healing environment Open January 2018 © 2008 CHOC Children's. All Rights Reserved.

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