In Victoria County, about 90 primary care physicians are the first point of contact for patients’ health.
But there are just three full-time psychiatrists, the specialists who are tasked with providing mental health care in a region that’s federally designated as not having enough psychiatrists to serve the population.
To address the shortage of mental health providers, coupled with a growing population that, by some measures, is showing increasing need for mental health treatment, the Texas legislature allocated millions toward improving mental health care for kids in the state.
That funding has created the Texas Child Mental Health Care Consortium, which finished a five-part plan to improve the treatment of Texas kids overall. Texas has historically ranked last or close to last, and data shows that 1 in 4 children suffer from a mental health condition, and that number may be growing.
Suicide is the second leading cause of death for children, after accidents, according to data from the Center for Disease Control and Prevention. In Texas, 1 in 8 high school students reported attempting suicide in 2017, according to a national school-based survey of students.
One of the consortium’s biggest initiatives is creating a network of child psychiatrists to provide real time consultation to pediatricians and family doctors who need advice in diagnosing and treating a child with a mental illness. This insight is something that primary care physicians have repeatedly sought, said Dr. Laurel Williams, the co-chair of the consortium’s working group that designed the network.
Primary care physicians, also known as family medicine doctors, are often a child’s first point of contact when they begin to show symptoms of a mental health condition. But without the specialized training of a child psychiatrist, primary care physicians might not provide adequate treatment, Williams said. Questions like how to properly dose a medication, or when a child might not even need medication, can be harder for physicians who don’t have specialized training to answer.
“Over time this allows primary care physicians to take care of kids with lower level problems such that they only send the more complex or challenging situations to the psychiatrist, given that we are a more rare resource,” Williams said.
The network, formally named the Child Psychiatry Access Network, is modeled after similar programs in other states. After Massachusetts built its statewide program, primary care providers who participated reported dramatic increases in their “ability to meet the needs of their clients with psychiatric conditions,” according to one study.
Williams said the network should be established over the next 18 months to two years, and the network would reach out to primary care providers across the state to offer the program.
Once it’s completely finished, every primary care physician in the Crossroads will have access to the insight of a trained child psychiatrist, should they want it.
A second arm of the program will offer direct services to children in the middle of a mental health crisis while at school. If and when a parent gives permission, child psychiatrists working with the consortium can offer a telehealth visit on school grounds, Williams said.
The doctor would evaluate the child and provide recommendations to the family about next steps.
This part of the consortium’s work will not be as widespread as the psychiatrists network and will not be able to reach every school district, Williams said.
“Most schools that I’ve talked with are desperate for some additional help and are glad that we’re going to be coming into school and working with them to provide this service,” Williams said.
Other components of the program will fund additional residencies and fellowships for child psychiatry programs and fund coordinated research between academic institutions across the state. The research will be completely separate from the direct services that the consortium provides to physicians and children, Williams said.