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Project TEACH E-Newsletter

Challenging Cases: How Project TEACH Works with Pediatric Primary Care Practices to Provide Psychiatric Consultations for Your Patients

Project TEACH has been working with pediatric practices in New York State since 2010. The project, funded by the New York State Office of Mental Health, has supported and strengthened the critical role that New York State pediatric primary care providers (PCP’s) can play in the early identification and treatment of mild-to-moderate mental health concerns for children ranging in age from 0 to 21.

One component of the Project TEACH /NYS American Academy of Pediatrics partnership in 2021 is a series of monthly newsletters touching on topics of concern to pediatricians and to parents.

And now to our topic of this Project TEACH Pediatric Newsletter: "Challenging Cases: How Project TEACH Works with Pediatric Primary Care Practices to Provide Psychiatric Consultations for Your Patients”

You have been working with a family and their young adolescent for some time. As the pediatrician you are concerned that, for example, an initial diagnosis of ADHD may be evolving into a more complicated diagnosis requiring a further diagnostic evaluation, and a possible change in treatment. At this point in time you need a telephone consultation with a Project TEACH Child and Adolescent Psychiatrist (PT CAP).

You reach out to the PT CAPs for assistance, calling the warm line number in your region, or by requesting a telephone consultation on the Project TEACH website at https://projectteachny.org/wp/contact-us/. On the call, you and the PT CAP discuss the teen’s issues. You provide details describing a 13-year-old male with ADHD, worsening mood instability, and a strong family history of bipolar disorder. Following the initial phone consultation, you and PT CAP may agree that a face-to-face consultation with the family and the Project TEACH CAP is the next step to obtain sufficient information to keep this patient and family in your practice.

The Process for a Project TEACH Face-to-Face Evaluation

First, you provide the name of the patient referred for the face-to-face evaluation to Project TEACH.

Second, you are given the intake number for the family to call. As you share this information with the family, your office needs to actively encourage the family to call Project TEACH to schedule the face-to-face evaluation as soon as possible. If the family does not call to establish the visit within 2 weeks of your telephone consult, the PT CAP will call you to make you aware that the family has not yet scheduled the appointment.

Again, it is important that you follow up with the family at every point in this process. Reminding and encouraging the family to follow through with making and keeping the face-to-face evaluation appointment is crucial to determining and securing the proper treatment for your patient. Ask the family to call your office to verify that they made the appointment.

You should get back to the family once the appointment is made to encourage them to work out whatever logistics are needed to assure the appointment/evaluation actually takes place.

The face-to-face evaluation should take place within 14 days of the initial request, and may take place in-person at one of the most conveniently located Project TEACH sites, or by telehealth should the family/patient live more than one hour away from a Project TEACH site or have limited access to transportation. The face-to-face evaluation is the only time that a family/patient will have direct contact with a PT CAP.

Once the face-to-face evaluation is completed, the PT CAPS’s written report is sent to you for review within 2 days of the face-to-face evaluation. The report will include a diagnostic formulation and treatment recommendations. The treatment recommendations may include suggestions for therapy, further assessment by other healthcare professions, and suggestions regarding medications. The process anticipates that you will contact the PT CAP with any questions or concerns about how best to proceed with the written recommendations provided; typically the PT CAP will contact you following the face-to-face evaluation to discuss the written report. If there are any questions regarding the written report at any time in your ongoing relationship with the patient, you are encouraged to contact the PT CAP who conducted the evaluation for further consultation.

Consultations for families/patients experiencing mild-to-moderate mental health concerns, or for you on behalf of a patient, and/or directly for the patient and family through a face-to-face evaluation, are available to you at no cost through Project TEACH. You are encouraged to use this service when you believe it can and will help design and implement a treatment plan for children and young people, ages 0 to 22, in your practice.

As we all are acutely aware, there are not enough trained child and adolescent psychiatrists available and accessible in any part of our state. Your practice, working in partnership with Project TEACH, can help bridge the gap in services for your patients.

We encourage you to explore all the services and supports available through the Project TEACH program at https://projectteachny.org/wp/.

Overview of Project TEACH Services

Current initiatives in Medicaid and Commercial insurance and the NYS PCMH incentive project, all create an environment that encourages pediatric practices to work toward integrating children’s behavioral healthcare into pediatric primary care. Behavioral health integration has the potential to enhance the value proposition for most practices.

Project TEACH Child and Adolescent Psychiatrists are available through the Project TEACH warm lines to provide guidance on assessment of a children’s and adolescents’ mental health symptoms and evidence-based treatment following traumatic events. You can also find the Child PTSD Symptom Scale (CPSS) on the Project TEACH website: https://projectteachny.org/rating-scales/

Project TEACH can help with a variety of behavioral health concerns presented by COVID-19, including school re-entry and self-care: https://projectteachny.org/covid/

Project TEACH direct services to pediatricians include:

Accessing the educational and supportive services of Project TEACH can help your practice contract for higher payments, while also supporting you and your team in providing more comprehensive higher quality care to your patients with mild-to-moderate mental health concerns.

Funded by a grant from the New York State Office of Mental Health’s Project TEACH.

New York State American Academy of Pediatrics (NYS AAP)

A Coalition of AAP NY Chapters 1, 2, & 3

Elie Ward, MSW | Dir. of Policy, Advocacy & External Relations | eward@aap.net

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