The Multiplier Effect

Pilot program for pediatric psychiatry consults includes telemedicine and education

issue 1 | winter 2012

Unidentified and untreated early-stage mental illness in children and adolescents is associated with school failure, teenage childbearing, substance use and other problems. The state of Michigan has an insufficient number of child psychiatrists to adequately treat these children. As a result, many pediatricians and family physicians are de facto mental health providers for these patients.

Sheila Marcus, M.D., child and adolescent psychiatrist at U-M is launching a pilot program to provide patients better access to child psychiatry services through primary care providers all over Michigan. "Developing relationships among the stakeholders — the PCPs, hospitals and community mental health resources — has been key to our efforts," says Marcus. "We are piloting this program in Kalamazoo, Grand Traverse, Kalkaska and Crawford counties. However, we hope this will be a statewide initiative in coming years."

According to Marcus, the goals of the pilot program are to:

  • increase access to child psychiatry evaluation via telepsychiatry for children and families with complex mental health concerns
  • increase primary care physician comfort, knowledge and abilities in treating mental health problems through:
    • "just-in-time" phone consultation by child psychiatrists to primary care physicians regarding behavioral and pharmacologic management of patients
    • ongoing educational services via webinars, case review and supplemental references

J. Lia Gaggino, M.D., a Kalamazoo pediatrician who helped create a community coalition to address these problems, was invited by Marcus to participate in the pilot. "Having that 'curbside' consult with a psychiatrist will be invaluable when I have a child with a mental health need beyond my comfort zone," explains Gaggino.

Cindy Smith, M.D., a participating pediatrician in Traverse City says, "This project will allow the expertise from a great center like U-M to be multiplied through the PCP, exponentially increasing the number of children we can help."