Children's Emotional HealthLink - An Innovative Physician-Patient Communication Model
Children's Emotional Healthlink (CEHL) is a pilot project of Newton-Wellesley Hospital. Physicians, parents and the community will collaborate on improving the delivery of children’s mental health through an innovative approach to physician-patient communication. The purpose is to facilitate earlier diagnosis and treatment of emotional disorders. This one-year project serving greater Boston includes four components:
- physician training in "psychosocial pediatrics"
- a pilot screening tool
- a toolkit of resources for physicians and community advocates
- a website to disseminate information, resources and project outcomes
One in ten children in the U.S. suffers from mental illness that causes impairment, yet only one in five of those in need receives treatment. In 2000, the Surgeon General called this dichotomy a "public crisis." The local situation is critical: in Boston, one child in five at high school has considered suicide, and 8 percent attempted suicide in 1999 (Boston Health Commission, 2001). The Surgeon General reports that depression is more commonly treated in primary care than any other medical condition except hypertension.
Through physician training focused on physician-patient communication, this project will increase the number of children diagnosed with emotional disorders. In addition, through the toolkit and a network of partners, the children diagnosed will be referred to medical and social resources for treatment and support. The project's unique screening tool will also address child abuse and family violence.
Of 16 providers participating in this project, each will see about 2,000 children during one year for a total of 24,000 children and families served. Based on the research literature, an estimated 5 to 10% of these children (up to 2,400) will have emotional disorders or problems not currently diagnosed. Boston children and families served will be diverse: in Census 2000, the city was 43.2 percent minority (including 14.4 Hispanic) and 25.8 percent foreign born. Greater Boston counties outside Boston were about 15 percent minority and 14 percent foreign born.
The 16 providers will meet monthly for a year using a curriculum in "psychosocial pediatrics" developed by the Project Director. Providers will be shown reliable methods for obtaining reimbursement for psychosocial assessments and will learn how to view parents/
caregivers as partners and teachers, fostering their sense of competence. Training in cultural competence, cross-cultural mental health and how to work with interpreters will be provided. Working with interpreters and project partners, physicians will overcome language and cultural barriers to mental health.
Newton-Wellesley Hospital is committed to children in all areas of health, including their emotional development. This year, the hospital opened both a Pediatric Emergency Center and Pediatric Ambulatory Care Center. MassGeneral for Children, established here in 2002, offers subspecialty pediatric practices such as psychiatry, neurosurgery and speech and language. Michael Jellinek, MD, in addition to being the hospital's Chief Executive Officer, has served for many years as Chief of the Child Psychiatry Service at Massachusetts General Hospital.
