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Virginia Mental Health Access Program: Expanding Mental Health Access for Children

Posted:  -  By: Ashley Everette

While improving care for children and adults with mental health needs is a top priority in Virginia, our current behavioral health system does not meet the needs of children with mental health disorders. Mental health conditions are extremely common but frequently undertreated, both nationally and within Virginia. In Virginia, 14.2% (106,922) of children with CHIP or Medicaid had a mental health diagnosis in 2017.

Mental illness is like any other disease; the earlier it is identified and treated the better the health outcomes. Untreated mental health conditions in children can disrupt development and affect school readiness and overall well-being, and these conditions can worsen later in life.

While the prevalence of mental health disorders in Virginia is similar to other states, access to behavioral health care is more limited. In fact, Virginia ranks 40th in terms of access to behavioral health care in the nation. Lack of access to specialists, like child psychiatrists, is even more pronounced. These shortages lead to decreased utilization of needed treatment, long wait times, and long distances traveled to access care.

State and national shortages of child psychiatrists exacerbate the need for pediatricians and primary care physicians to manage their patients’ mental health care. Collaborative programs like Child Psychiatry Access Programs are a promising approach to leverage our existing supply of child psychiatrists to provide mental health services to children and youth. To date, 30 states have implemented state-wide or regional child psychiatry access programs that have improved access to treatment for children by making child psychiatry services accessible to PCPS. Virginia now has the opportunity to establish its own state-wide child psychiatry access program.

Virginia Mental Health Access Program (VMAP)

In 2018, Virginia was awarded a five-year federal HRSA grant ($445,000 per yr.) to develop the Virginia Mental Health Access Program (VMAP). VMAP seeks to strengthen the ability of primary care providers (PCPs) to manage mild to moderate behavioral health needs of their pediatric patients, enabling child and adolescent psychiatrists to manage more serious and complex conditions.

Goals of VMAP include:

  1. Increase pediatric PCP knowledge, skills and confidence to manage children in primary care with mild to moderate behavioral health needs (for example, ADHD, depression, anxiety).
  2. Mitigate the shortage of child psychiatrists by promoting the rational utilization of psychiatrists for the most complex and high-risk children (for example, children with conditions that require treatment with complex or multiple psychiatric medications).
  3. Advance the integration of behavioral health and pediatric primary care.

Key objectives of VMAP include:

  1. Mental Health Training: Education/training for pediatric primary care providers, especially in underserved communities, will focus on the screening, diagnosis, management, and treatment of children. To date, over 200 pediatric providers have completed specialized mental health training through curricula such as the REACH Institute Model–Intensive”mini-fellowship” focused on anxiety, depression, and ADHD.
  2. PCP telephonic/video consults: Regional VMAP Teams (composed of child and adolescent psychiatrists, psychologist and/or social worker) in the five regions of the state will provide telephonic, video and e-consults for primary care providers who care for children.
  3. Tele-health visits with psychiatrists or psychologists. Tele-health training and services will prepare providers and extend access to our counties that do not currently have any child psychiatrists or who are severely underserved.
  4. Care Coordination: Regional care coordinators will help provide a resource to PCP practices to help them identify and obtain accessible mental health services for pediatric patients and families.

While $445,000 is a great start, additional state general fund dollars are required to build out all components of VMAP in all five regions of the state. We are pleased that Governor Northam included $1.23 million in his proposed budget to build out the first phase of VMAP in FY20.

Join us as we advocate for state investments to support the Virginia Mental Health Access Project. Please ask your legislators to support Governor Northam’s budget Item: 311 #F for $1.23 million to establish VMAP and enable it to fully expand statewide.

Check out talking points here.

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