Care Coordination is Critical for Children in Mental Health Crisis

By: Allison Matthews-Wilson, LCSW, Susan Roman, RN, MPH, and Steven Rogers, MD

Children with complex medical conditions deserve strong care coordination to support their families in promoting optimal healthy development. A recent Wall Street Journal article highlighted the issue. However, in our experience, children struggling with mental health issues also require, but often fail to receive, the same level of comprehensive care coordination. Since the tragic events at Sandy Hook Elementary School in Newtown, Connecticut Children’s has seen a substantial increase in the number of children in crisis who need such services to address their mental health needs.

Families that have children who struggle with mental health issues, much like those with complex medical conditions, often fall through the cracks of an uncoordinated and confusing system.  As a result, families and schools are increasingly seeking crisis care in hospital emergency departments, including ours. Such stimulating and often over-crowded settings are typically ill-equipped to offer the necessary assessment and therapeutic services to de-escalate mental health crises. The rapid rise in the number of mental health patients cycling through emergency departments across the country is likely a result of limited access to community resources.

In an attempt to ameliorate this vicious mental health cycle, Connecticut Children’s Center for Care Coordination created a program that identifies and addresses a child’s mental health risk at the point of crisis, which is our pediatric emergency department. Upon discharge, children and their families are matched with a care coordinator who connects them to community supports including schools, primary care physicians, community mental health agencies, and other community programs in a timely and effective manner.

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Care coordinators work with the families to ensure adherence to discharge plans and to develop clinical care plans that identify key providers and supports to a family. Similar to complex medical care coordination, the program helps families create a comprehensive plan of care and will support a child, and their family, through treatment. Only through comprehensive care coordination will families of an affected child have hope of finding the path towards appropriate treatment. Treatment is the only way children and families will be able to turn their focus from mental illness to mental wellness.

Supporting the development and sustainability of models that provide coordination of care for children with mental health issues must be made a priority by the health care industry as well as local, state and federal government policy makers.