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Commentary: Holistic system of care essential to achieving mental wellness for children, teens

From Modern Healthcare 

By Kimberly Chavalas Cripe, president and CEO, CHOC Children’s; and Christopher DeRosa, president of U.S. Commercial Segments, Cigna

Just before turning 3, Gavyn Bailey received a kidney transplant. Thereafter, he began to require anti-rejection medications, which create additional health concerns, including thickening of the heart muscle, necrosis of the hip, gastrointestinal issues and bacterial infections. The pain and challenges associated with his chronic condition propelled the now 21-year-old into a deep depression. To cope, Gavyn self-medicated and exhibited other forms of self-injurious behavior.

Gavyn’s case shows why it’s imperative that physical and mental health be integrated. Mental illness can produce physical illness. Physical conditions can affect mental health, as it did with Gavyn. Our healthcare system has historically been fragmented, with physical and mental health treatments being compartmentalized. When we recognize the mind-body connection, we can produce better integrated treatments that have improved outcomes.

Stories like Gavyn’s are why CHOC Children’s Health System, based in Orange, Calif., created a co-occurring clinic. This unique, publicly funded outpatient program treats children and teens who have serious or chronic physical illnesses or disabilities, as well as mental health conditions.

Not all pediatric mental health cases are as complex as Gavyn’s, but 1 in 5 young people in the U.S. have a diagnosable mental health condition. Half of people with lifetime mental illness have symptoms by age 14. And suicide is the second-leading cause of death in children and young adults ages 10 to 24. That’s why prevention, detection and early intervention are so important—to keep mental illness from advancing and becoming more complicated to treat.

For children facing mental health crises, CHOC opened an 18-bed mental health inpatient center for patients ages 3 to 17 in April 2018. With more than 600 admissions in its first year of operation, it achieved an 86% positive rating in its patient experience survey. CHOC also established a complementary intensive eight-week outpatient program for adolescents that is intended to prevent psychiatric hospitalization and readmission.

The pediatric mental health crisis is too big for any one industry or community segment to tackle on its own. That’s what led CHOC and Cigna Corp. to begin collaborating as part of countywide task force created by CHOC. The task force comprises representatives from healthcare, education, law enforcement, the faith-based community, government leaders and agencies and private sector leaders, working together on solutions. Creating new services to address the need was critical. But ensuring children and their families have access to care was equally imperative.

Providers and payers can agree that mental and physical health are intertwined and that the need to address health holistically extends to the health of children, teens and young adults. What’s more, a child’s health problem often impacts the entire family and can place additional stress on a parent who is juggling job and family responsibilities.

Employers can be part of the solution by offering benefit plans that provide access to care and resources to help families. For example, employee assistance programs can help make it easier for employees to receive counseling, referrals and advice in dealing with a child’s mental health problem that might adversely affect the employee’s well-being and job performance.

Integrated medical/behavioral health plans can work with the entire family when a child or adolescent is receiving mental health services; and mental health first-aid training can help employees learn risk factors and warning signs for mental health concerns, as well as strategies to help someone and where to seek help.

Providers, payers and employers all have a role in ensuring access to a holistic system of care. Working together, and with an increased focus on prevention, we can help young people and their families truly be their healthiest—in both mind and body.

Long Live Childhood

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