Pediatric mental health remains of critical importance to overall child and adolescent health and wellbeing. Depression is the most common pediatric mental health disorder, affecting nearly one in eight adolescents and young adults each year. Additionally, depression and other mental health disorders are major risk factors for suicide, the second leading cause of death for 15- to 24-year-olds.

Here at CHOP, in the Emergency Department, nearly 10% of adolescents 14 and older disclose suicidal thoughts or behaviors and one-third of adolescents screen positive for severe depression through the universal behavioral health screening. The majority of these patients present with a non-psychiatric chief complaint. In CHOP primary care practices, nearly one in four adolescents reported depression symptoms that required further evaluation, and of those with depression symptoms, one in four reported suicidal thoughts or a suicide attempt.

Unfortunately, barriers can exist for healthcare providers, patients, and families around mental health care access and connection. Examples include shortages of mental health providers, long wait times for appointments, mental health stigma, family stress and adverse experiences, transportation difficulties, lack of health insurance or concerns of cost, and poor reimbursement for providers.

It is essential that health systems address barriers and are able to identify pediatric mental health needs early in order to provide patients with appropriate treatment before symptoms progress. To this end, a current CHOP project, being led by a multidisciplinary group including CVP Scholars Jeremy Esposito, MD, MSEd and Stephen Soffer, PhD and CVP co-director Joel Fein, MD, MPH, seeks to improve CHOP patients’ access to mental health services by identifying and addressing care coordination needs for mental health referrals.

The team’s approach includes:

  • Developing consensus recommendations for appropriate mental health referrals
  • Recommending and implementing electronic health record modifications
  • Providing support and resources to primary care providers, including Social Work Care Coordination for mental health referrals and provider education

This project is funded by the CHOP Department of Pediatrics through the Chair’s Initiative program. For more information on this project and other Chair’s Initiatives, click here.