January 15, 2014
Here’s a typical
scenario,” says child psychiatrist Joyce
Harrison. A family with a 7-year-old being treated for psychiatric illness
recently moved two states away. Unfortunately, the only child psychiatrist for
miles couldn’t take new patients. When little Johnny’s parents went instead to
the local pediatrician for three prescription refills, that doctor confided to a
colleague, I don’t even know what these medications are!
The shortage of
child psychiatrists is hitting America hard, says Harrison. “More and more
behaviorally or emotionally disturbed kids are showing up on primary care
doorsteps, and providers can’t just send them away.”
True, states are
exploring creative alternatives, yet ad hoc measures run risks, Harrison says.
“Degree courses in child psychiatry aren’t the solution for already-busy
clinicians,” she adds.
Now, a new plan to help should set a standard.
Behavioral Health Integration in Pediatric Primary Care (B-HIPP) pulls together
experienced Johns Hopkins child psychiatrists like Harrison and Larry Wissow
with colleagues at the University of Maryland in a state- and federally
supported program. Its goal: Offer pediatricians and similar primary-care
providers a consultative safety net, resources and encouragement.
Central to B-HIPP is its telephone consultation service. Five physicians at
both institutions take clinical call-ins, with medical director Harrison having
the lion’s share.
“I remember thinking, ‘Oh, pediatricians will phone us
about ADHD meds.’ But we’re hearing cases as complex as any in our psychiatric
practices, Harrison says. “Our plan has providers screening kids for emotional
and behavioral difficulties, and calling us for advice about the more complex
B-HIPP also offers consults on medication and offers tactics
gleaned from seasoned pediatricians as well as evidence-based psychiatry.
Harrison adds, “We often hear relief in our callers’ voices.”
for more information about B-HIPP and the training and referral services it also
This article first appeared in
Hopkins Brain Wise, Winter 2014; reprinted with permission.