2012 Research Annual Report

Improving Mental Health Care for Rural Populations

Access to mental health care is a national problem, and it can be especially difficult for children in rural areas, where there are extreme shortages of providers and little or no access to child psychiatry or other mental health professionals. Cincinnati Children's Division of Psychiatry has partnered with employers to provide mental health care via teleconferencing. Evidence suggests that mental health care provided via telemedicine has comparable positive outcomes to that provided by face-to-face encounters.

Currently, we serve children in a three-state region outside of Ohio. These children have diagnoses that include ADHD, disruptive behavioral problems, mood disorders and eating disorders. We provide access to both psychotherapy and medical care, and also provide an infrastructure and access point for children needing more intensive services such as inpatient care. Groups participating in this pilot program are highly satisfied with excellent patient outcomes. The program is designated for expansion and will allow Cincinnati Children’s psychiatry physicians to provide improved care for children throughout the Midwest region.

Improving Medical Care and Safety

Children with intellectual disabilities and severe mental health challenges often struggle in medical care facilities, resulting in aggressive episodes or refusal of care. The Division of Psychiatry leads a collaborative effort at Cincinnati Children’s to improve care for these young people. We are able now to predict which children will struggle to comply with medical care and we are developing mitigation strategies and improved psychosocial outreach for better care. This program has been extremely effective in preventing aggressive episodes, as evidenced by decrease of injury rates among Cincinnati Children’s care providers. Patients and staff are now involved in interactions that are safer, more comprehensive, and able to produce outcomes of enhanced medical care and decrease staff and patient injury.

School Based Health

Access to mental health care remains a significant challenge in our region. Families often struggle in locating and transporting to providers. Studies indicate that using a collaborative approach that involves school, family, and mental health professional improves outcomes. The Division of Psychiatry has established a number of school-based mental health clinics. In these settings, in partnership with community providers, Cincinnati Children’s physicians or advanced practice nurses lead mental health teams on-site at community schools to address mental health problems of the students. Along with providing psychiatric care, preventive services are also provided. This model of a diagnostician with the ability to provide medicine and medical care, along with psychiatric social work and therapy, has served as a template for the region. On-site, school-based mental health care is seen as a strong contributor to improved school retention rates and student outcomes.