Scaling Pediatric Mental Health Care Through Connection

Cincinnati Children’s is accelerating and scaling up its work to address the ongoing mental and behavioral health crisis facing America’s young people.

Two years ago, it streamlined its organizational structure with the formation of the Mental and Behavioral Health Institute, strengthening connections among three divisions and enabling deeper collaboration across the health system and surrounding community. The divisions housed under the Mental and Behavioral Health Institute include:

• Behavioral Medicine and Clinical Psychology
• Child and Adolescent Psychiatry
• Developmental and Behavioral Pediatrics

By aligning these divisions’ work, Cincinnati Children’s is furthering its aspirations to lead the nation in improving child mental and behavioral health.

“This is an incredible opportunity to integrate our efforts in clinical care, research, community partnerships, and education and training, creating synergies and permitting innovations that we believe will advance care for children and adolescents,” says Laurel Leslie, MD, MPH, who joined the health system as the inaugural director of the Mental and Behavioral Health Institute this past year.

The three division leaders are relatively new in their roles and are committed to this change. Avani Modi, PhD, who served as interim director since 2023, was officially appointed director of the Division of Behavioral Medicine and Clinical Psychology in May 2025. Tanya Froehlich, MD, MS, has been director of the Division of Developmental and Behavioral Pediatrics since 2023. Suzanne Sampang, MD, now serves as interim director of the Division of Child and Adolescent Psychiatry. Jillian Burkhardt, program director, coordinates the institute’s efforts.

Also last year, Cincinnati Children’s bid a sad farewell to Michael Sorter, MD, professor and former director of the Division of Child and Adolescent Psychiatry, who had been instrumental in forming the institute before he passed away from cancer.

Highlights From Across the Divisions

Within the divisions, the creation of the Mental and Behavioral Health Institute has led to expanded programs and increased statewide impact to better support the mental and behavioral health of young people.

ECHO Autism

In the Division of Developmental and Behavioral Pediatrics, Jennifer Smith, PsyD, BCBA-D, and her colleagues have spearheaded a movement to expand Cincinnati Children’s Project ECHO program, which gives community providers training through a virtual learning community.

Smith, a clinical psychologist and board-certified behavioral analyst, specializes in treating children and adolescents with intellectual and developmental disabilities, including autism spectrum disorder (ASD). She and other leaders within the division recognized that diagnostic and treatment demands significantly exceed the capacity of specialty centers to serve children on the autism spectrum and their families, especially as the prevalence of the disorder increases.

A branch of Project ECHO, called ECHO Autism, now provides training and knowledge-sharing to primary care providers, particularly in rural communities, around treating and managing some of autism’s co-occurring conditions. Smith served as the primary author on a qualitative research study designed to demonstrate the value of ECHO Autism, publishing results in Journal of Developmental and Behavioral Pediatrics in 2025.

"A lot of times, providers view the symptoms and co-occurring conditions associated with autism as something difficult to manage, and they feel like they don’t have the skills or knowledge to help” Smith says. “Through ECHO Autism, we’re hearing that we’re helping providers feel less isolated and more confident as they support our kids and families."

Today, there are three types of ECHO Autism programs offered through the division: one for primary care providers, one for allied health professionals, such as speech and occupational therapists, and one to help primary care providers learn how to make earlier diagnoses. Additionally, Smith and her team plan to launch a new training this spring for accessibility coordinators at community organizations across Cincinnati, including the zoo, theaters, museums and parks.

Comprehensive DBT Program

A comprehensive dialectical behavior therapy (DBT) program is now officially live, after reporting successes in its pilot phase in decreased suicide-related emergency department visits, suicide attempts and psychiatric admissions.

The evidence-based psychotherapy program within the Division of Behavioral Medicine and Clinical Psychology gives children and adolescents skills to address issues like self-harm, suicidal thoughts and difficulties with emotional regulation. It includes four components—individual psychotherapy, group skills training, crisis coaching calls and a therapist consultation team.

The Division of Behavioral Medicine and Clinical Psychology’s comprehensive dialectical behavior therapy (DBT) program includes a unique and immensely valuable tool for families with teens struggling with suicidal ideation: coaching calls—brief, structured phone check-ins between therapy sessions—to help de-escalate potential crises in real time by reinforcing and generalizing skill use. Still, they’re an often-underutilized component of DBT programs, with many programs showing only 25% of participants using coaching calls. Therefore, Cincinnati Children’s DBT clinicians worked to increase their families’ use of coaching calls by normalizing, modeling and even practicing calls with families, with amazing results. 

“We think this is a huge win and illustrates why comprehensive DBT is so effective.” —Aubrey Coates, PhD, and Claire Aarnio-Peterson, program co–leads.

The six-month pilot began in December 2024 with 14 high school-aged adolescents and their families or caregivers. The official program launched this summer, and its numbers have grown to 30. It’s also now offered at three Cincinnati Children’s campuses—Burnet, Fairfield and Liberty—and includes Counseling on Access to Lethal Means (CALM) trainings. These trainings educate families on the common methods that result in death by suicide and how to reduce access to those means.

“Our hospital is innovative in this space because of the breadth of our resources,” says Aubrey Coates, PhD, a psychologist and co-leader of the dialectical behavior therapy program. “We have eight psychologists working together to help kids and families in this program. We are fortunate to have the resources to support a dialectical behavior therapy program like we can at the full-model level."

Mental and Behavioral Health Information Exchange Project

An effort to bridge information gaps between hospitals and community mental health organizations is expanding from the regional to the state level, thanks to efforts by Cincinnati Children’s Office of Population Health and a partnership with the Outcomes Acceleration for Kids (OAK) Learning Network.

“The project’s strategy was to break down information siloes and connect providers across systems to create more opportunities for collaboration, leading to better transitions and continuity of care,” says project leader Katherine Junger, PhD, a psychologist in the Division of Behavioral Medicine and Clinical Psychology and director of systems integration in the Office of Population Health. “This health information exchange helps identify overlap in the patients we serve and improve access to critical health information so we can work together to support holistic child health in a much more efficient and effective way with our community-based mental health and primary care colleagues.”

Initially, the project focused on integrating mental health into the regional health information exchange run by The Health Collaborative to improve care for youth served by Cincinnati Children’s. Partnerships with the statewide CliniSync Health Information Exchange and OAK Learning Network are supporting the spread of this strategy to all children’s hospitals in Ohio. Additionally, hospital systems in other states are now implementing this novel approach.

Although the project was originally developed within the Office of Population Health, team members across Mental and Behavioral Health Institute divisions have championed the new tools to improve crisis response  and care for patients transitioning back to a community-based care team from hospital-based care settings, including the emergency department and inpatient psychiatry.

(Published December 2025)

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