Addressing Pediatric Behavioral Health Crisis: Challenges and Solutions

Transforming Child and Adolescent Behavioral Health Transforming Child and Adolescent Behavioral Health Kevin B. Churchwell, MD President & Chief Executive Officer Boston Children s Hospital

Financial Disclosure Financial Disclosure Disclaimer Disclaimer Dr. Churchwell is a member of the Massachusetts Business Roundtable, a board member of the Boston Chamber of Commerce, the Massachusetts Health and Hospital Association, the MIT Corporation, the Whitehead Institute, St. John s Preparatory School, the Children s Hospital Association, Children s Hospitals Solutions for Patient Safety, Controlled Risk Insurance Company Ltd., Risk Management Foundation of the Harvard Medical Institutions, Inc., the Advisory Board for the Boston University School of Public Health and the Boys and Girls Club of Boston. Information Purposes Only The material is offered for educational and information purposes only. The material is not meant as a substitute for independent medical judgment or the advice of a qualified physician or healthcare professional. The material is not intended to provide medical advice or clinical services to patients, to verify or approve medical information or credentials, or to make any medical referrals. Any reference in this presentation to any person, or organization, or activities, products, or services related to such person or organization, or any linkages from this web site to the web site of another party, do not constitute or imply the endorsement, recommendation, or favoring by Boston Children s Hospital.

The Pediatric Behavioral Health Crisis The Pediatric Behavioral Health Crisis The pandemic sparked an explosive increase in behavioral health disorders among children and adolescents. The impact among youth of color has been even worse. Untreated disorders result in family, social, educational and economic consequences 1 2 of young people with a psychiatric condition receive treatment < What was once a widespread and worsening problem is now a crisis 1 2 10 YEARS of US adolescents now have at least one behavioral / mental / emotional disorder The average delay between symptom onset and treatment

Where Weve Been Where We ve Been Factors Factors Access is Access is Needed Needed across the continuum of care BCH BCH In 2021, the Children s Hospital Boarding Boarding 61% increase over 4 years 30 - 40 children per day Statewide: 147 children per day in February Underlying causes poorly understood Lack of societal awareness Failure to prioritize Workforce shortages Longstanding underinvestment Association and the American Academy of Pediatrics declared the behavioral health crisis a national emergency.

Nurses: On the Front Lines of the Crisis Nurses: On the Front Lines of the Crisis Sharp rise in behavioral health patient volume and acuity Significant increase in staff-directed aggression Extended ED and inpatient behavioral health patient boarding times Multi-year behavioral health treatment gaps exacerbating workforce shortages

Nursing Workforce and Training Initiatives Nursing Workforce and Training Initiatives Increasing integration of behavioral health nurses/resources throughout all care settings Strengthening trauma-informed care, including implementing a de-escalation training program Boston Children s Key Nursing Workforce and Training Initiatives Launching a Behavioral Health Technician training program Implementing comprehensive safety measures, including electronic buttons on employee badges

Where We Are Today Where We Are Today EVERY CHILD SHOULD HAVE THE SAME ACCESS TO CARE OUR RESEARCH, WORKFORCE, CARE AND INNOVATIONS CURRENT SYSTEM LOW VULNERABLE CHILDREN CHALLENGE REIMBURSEMENT is not working for children and families How to fund and coordinate components for behavioral health services Racism and inequities exist in our behavioral health system regardless of zip code, race or gender should reflect the needs of all children

Where we need to go Where we need to go Continue to implement recent policy successes We can t solve this problem alone. American Rescue Plan Act Addressing Barriers to Care Act Roadmap for Behavioral Health Reform We need strong partnerships with federal and state governments, providers, payers, schools and communities. 2023 Create an integrated approach and invest more in: Improving access by transforming the care delivery model Research that creates new therapies Developing and retaining a diverse workforce Think differently about behavioral health 8

One Solution to the Crisis: Our Affiliation with Franciscan One Solution to the Crisis: Our Affiliation with Franciscan The Boston Children s-Franciscan Children s affiliation will create a more effective system of integrated care that will better serve children, families, communities and employees.

Together, We Will Together, We Will Increase access to our care and services for all children Expand research Strengthen our ability to jointly recruit and retain the next generation of behavioral health and rehabilitative care clinicians Modernize the Franciscan Children s campus Our affiliation is an investment in the future.

To a Better Future To a Better Future Crisis demands more integration and coordination across systems. Collaborate to harness our collective experience, expertise and commitment. Invest more in promotion, prevention, treatment and research; substantial ROI. Drive improvements that will help build a better system and a better future.