Cincinnati Children’s Emergency Department in Avondale is dealing with waves of children struggling with depression, anxiety, suicidal thoughts and other mental health conditions as the nation’s youth mental health crisis continues.
The children’s hospital is working to slow the rise – by adding professional support for children throughout the community to reach children and teenagers before their mental illnesses escalate to crisis levels.
“We meet the kids where they are,” said Dr. Martin Lammy, assistant chief of the Cincinnati Department of Mental Health. “We’re seeing evidence of progress.”
The emergency room saw a drop in families coming in for mental health reasons in 2023, with cases dropping from 7,500 to 7,000 this year, Lammy said, but the flow of children showing up to the emergency room remains high, she said.
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Here’s a look at the strategies the hospital system is using to reach children before mental illness takes a turn for the worse.
Center for Preschool Trauma Survivors to ‘Drastically’ Grow in 2023
Cincinnati-area toddlers ages 3 to 5 who have experienced severe trauma receive special attention to their needs at a 30-year-old Cincinnati Children’s Day Treatment program. It offers children the professional mental health care, therapies, support and treatment they need, as well as education to ensure they are ready for kindergarten, said Ann Mitchell, the program’s clinical director.
In 2023, the Therapeutic Interagency Program moved to a site with capacity for 72 children – a 50% increase from the original 48.
“It’s grown dramatically in the last year,” Mitchell said. The move tripled the program’s space from 5,000 square feet to 15,000 square feet. In September, the program, known in the community as the Council, opened a third classroom and added five new classroom positions and a new therapist.
School mental health provides ‘critical’ services
Increasing mental health professionals in schools is another strategy used to catch children’s emotional and mental health needs early.
That’s “critical,” Lammy said.
School-based mental health care is working in schools across the country, with 68 percent of public schools providing on-site mental health care in 2021-22, according to a Kaiser Family Foundation report.
The Cincinnati Children’s Psychiatry School Program began in 2012 with a partnership with a local organization called MindPeace, placing two therapists in high schools. The program now has 84 therapists and five advanced practice registered nurses who provide therapy and medication management at 57 schools in the Cincinnati area, Lammy said. Fifteen were added in the last two years.
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Developing children’s mental health care in primary care offices
The hospital is also recruiting more psychologists and master’s degree therapists in primary care and pediatric offices in the region, Lammy said.
The American Pediatric Association supports training primary care pediatricians to assess and treat the mental health needs of their primary care patients, but this time it is not a requirement, so at least for now mental health professionals must be attracted from elsewhere.
To help children in primary care offices, Cincinnati Children’s launched its integrated behavioral health program in 2019 with specialists in two community practices. “We have since rolled out the program to 12 community primary care practices in the tri-state area (Ohio, Kentucky and Indiana) spanning 19 locations,” Lammy said, “and we have plans to roll out to additional practices in early 2024.”
Internally, Cincinnati Children’s housed mental health professionals in its own pediatric practices in 2016, with one psychologist at the Hopple Street location. They have since grown that to 12 psychologists who provide care at three pediatric primary care locations, a foster care clinic and an adolescent primary care clinic, Lammy said.
Expanded Children’s Mental Health Hospital Reopens, Adds New Services
For children who require intensive or inpatient services, Cincinnati Children’s opened its remodeled and expanded mental health hospital in College Hill on October 18. The William K. Schubert, MD, Mental Health Center’s 83 private rooms for acute psychiatric primary care allow family to stay with children, which, Lammy said, can improve children’s mental health outcomes.
The hospital also offers outpatient services and space for group programming. Intensive outpatient services will open in 2024, Lammy said.
What happens if you take your child to a Cincinnati mental health emergency room?
The emergency room is still the first stop for many children. All children and teens brought there for mental health issues are evaluated by the Cincinnati Children’s Psychiatric Intake Response Center and given next steps. Children may be admitted to hospital, referred for partial hospitalization or intensive outpatient care. They can also be linked to community resources.
In the past two years, Lammy said, “We have added 23 registered nurses and 13 physicians to the psychiatric staff to expand services in the outpatient, partial inpatient and inpatient programs.”
The hospital system also offers a 24-hour crisis line at 513-636-4124, staffed by crisis social work teams.
The children’s mental health crisis will need committed, long-term attention
The mental health crisis among children began before the COVID-19 pandemic, but has grown in 2020. In December 2021, the US Surgeon General reported an “alarming” increase in youth mental illness, calling it a national crisis and issuing advice for strategies to deal with the problem problem.
That call has been answered in part through the efforts of Cincinnati Children’s and other nonprofit grants and commitments to address children’s needs locally.
While an expanded workforce is essential, Lammy said, more work needs to be done to remove the “stigma” of mental disorders — so that children can get care before their condition becomes a crisis.