Connecticut’s ACCESS Mental Health is a state-funded program created to ensure that all youth under 19 years of age, irrespective of insurance coverage, have access to psychiatric and behavioral health services through contact with their primary care providers (PCP). The program is designed to increase PCPs’ behavioral health knowledge base so they can identify and treat behavioral health disorders more effectively and expand their awareness of local resources.
The vision of the ACCESS Mental Health CT program is to improve access to quality treatment for children with behavioral health or psychiatric problems while promoting productive relationships between primary care and child psychiatry providers. It supports PCPs by offering real-time telephonic consultation, including education on assessment, treatment, and access to community resources. In year two of the program, PCP satisfaction is high, with a 4.9 out of 5 rating statewide.
“Youth and families who look to their trusted PCP to provide behavioral health treatment, can now have a safety net of seasoned psychiatrists available for real-time consultation,” explains Beacon’s Statewide Program Director Elizabeth Garrigan, LPC.
Garrigan leads the Central Administrative team at Beacon’s Rocky Hill Engagement Center that provides oversight of the ACCESS Mental Health CT. Currently the program is solely funded by the Department of Children and Families, however, discussions with the state’s commercial insurance carriers have started.
The program, which started in June 2014, consists of three expert pediatric psychiatry consultation teams providing support to PCPs across the entire state of Connecticut. Each hub’s consultation team includes a board-certified child and adolescent psychiatrist(s), behavioral health clinician(s), program coordinator, and a family peer specialist. Consultations result in one of the following outcomes, depending on the needs of the child and their family:
- An answer to the PCP’s question
- Referral to the team’s program coordinator or family peer specialist to assist the family in accessing local behavioral health services
- Referral to the team’s behavioral health clinician to provide transitional (interim) face-to-face or telephonic support to the child and family
- Referral to the team’s child psychiatrist for a face-to-face diagnostic evaluation or psychopharmacological consultation
While the primary function of the program is physician-to-physician consultation, care coordination and family support are also significant program components. Navigating the behavioral health care system can be difficult. The program model requires that the Hub team work with the PCP, youth, and family to learn more about the child’s specific treatment needs in order to help support connection to care.
“As PCPs increase their knowledge and comfort on screening, diagnosing, and treating youth with behavioral health issues, through doc to doc consultations, a youth that may have previously fallen through the cracks is now seen and treated, and a youth that may have previously been sent to the emergency department due to lack of understanding or lack of support may be appropriately triaged to the right level of care,” said Garrigan.
The role of the family peer specialist is unique and fosters a connection with the family that often opens the door to a better understanding of their needs. This “warm hand-off” approach entails more than just providing phone numbers for service providers. They engage, educate, and empower youth and their families, helping to resolve barriers that might otherwise prevent the youth from connecting to care.
According to Garrigan, training is another important program component. All ACCESS Mental Health CT consultations strive to provide individualized, case-based education. The program also creates educational opportunities through traditional regionally-based didactic trainings. If a practice wants to learn more about depression or anxiety, the Hub teams conduct onsite trainings. Some of the program’s highest users have indicated they are already reducing the amount of consults because they are learning more effective behavioral health treatment protocols and applying it to their practice.
To date, the program has enrolled 86 percent of the pediatric and family care practices across the state with over 1,500 prescribing physicians. Because the program requires a formal enrollment agreement, which requires the Hub team psychiatrist to meet face-to-face with the PCP at the onset, the psychiatrist and treating provider develop a trusting relationship.
In two and a half years of programming we’ve provided over 13,700 phone consultations and have served over 2,800 unique youth and their families.
What Parents and PCPs are Saying
“For PCPs inclined to treat mental health issues, this [ACCESS Mental Health CT] will give you a level of comfort you haven’t had because you are working with a psychiatrist who answers the phone promptly, provides advice and guidance, and can provide follow up.” – Pediatrician; Glastonbury, CT
“I’m more confident with their backup not having to refer people out, being able to keep them in the practice. or alternatively, taking their psychiatric care back.” – Pediatrician; Waterbury, CT
“ACCESS Mental Health CT is so valuable! You have been extremely helpful with medication management, referrals for care. and sage advice.” – Pediatrician; New Haven, CT
“I never would have been able to find the appropriate therapy for my child unless your program was involved.” – Parent; Wheeler Hub
For more information, visit http://www.accessmhct.com.