Programs

Charting a Path in Pediatric Mental Health Care

Posted on Jan 04, 2018

A pilot program will focus on developing and sharing techniques in pain management.

When children are fighting a chronic illness, the condition can manifest in myriad ways. Part of this may include the experience of pain symptoms. These conditions affect not only the body, but can also have substantial affects to the mental health of the child, making a child psychologist an essential part
of the care team.

Throughout Florida, mental health is a growing concern, but resources for adequate care are lacking. Johns Hopkins All Children’s Hospital is working to meet that need through recruitment of staff, developing measurable protocols and advocacy efforts.

Each year Johns Hopkins All Children’s sees nearly 2,000 children in the Emergency Center with a pain-related diagnosis that requires care by a pediatric psychologist. Of those, close to 350 are admitted to the hospital for treatment. Developing programs for quality mental health care in outpatient settings can reduce costs and has potential for better health outcomes.

To emphasize this point, leaders at Johns Hopkins All Children’s appealed to the State of Florida and secured
funding to begin a mental health pilot project. Pediatric psychologists will work in tandem with the current pain
management team to treat chronic pain patients in an outpatient setting with the goal of reducing the rate of
Emergency Center visits, hospital admissions and the corresponding costs.

“This pilot allows us to measure the benefits of integrated psychological services with medical services,” says George Jallo,M.D., medical director of the Johns Hopkins All Children’s Institute for Brain Protection Sciences. “As we quantify the benefits from both a patient and cost containment standpoint, we will be able to develop a program that we can share to allow more children to get the care they need throughout Florida and beyond.”

A key aspect of the plan involves recruitment of doctoral-level psychologists. When highly trained psychologists are involved in the treatment of children with complex medical conditions, everyone benefits through:

  • Decreased health care costs
  • Reduced hospital readmissions
  • Improved patient compliance with treatment plans and medication schedules
  • Reduced pain symptoms
  • Improvement in quality of life
  • Improved educational and vocational outcomes
  • Increased patient satisfaction

“A pain psychologist can be a valuable part of the care team,” explains Jennifer Katzenstein, Ph.D., pediatric
neuropsychologist at Johns Hopkins All Children’s. “Evidence-based treatments, such as behavioral therapy and biofeedback, can help minimize the need for medication while providing high-quality care at a lower cost.”

Beyond Medication Only

When pain treatment includes only medication for the child, the focus tends to be restricted to relieving symptoms at that moment. Psychological care adds an extra dimension, one that involves the entire family unit and may address underlying psychological aspects of pain.

“The new program follows a key component of care at Johns Hopkins All Children’s Hospital—it makes the family part of the care team,” Jallo says. “Both child and family will have the opportunity to learn how to manage pain symptoms for the long term and in a way that may reduce dependence on medication.”

Family is an important aspect of treating chronic pain symptoms, but it may not be possible for all families to get to Johns Hopkins All Children’s facility to receive services. To meet the needs of these children, the program will share its findings with the goal of improving pediatric mental health care on a broad basis.

Locally, ongoing consultation services will be available to community mental health care providers. To reach past the hospital campus and neighboring communities, the Johns Hopkins All Children’s team will work to build training modules for fellows and mini-modules for master’s level providers throughout the state. These educational building blocks will allow pediatric providers to gain insights on best practices.

Initial phases of the project kicked off in July 2017 with recruitment for doctoral-level child psychologists, psychology fellows and support staff. Once fully operational, the program will have the capability for expansion into other areas, such as diabetes, ensuring that as many children as possible can receive the care they need.

Visit hopkinsallchildrens.org/psychology to learn more about the psychology program at Johns Hopkins All Children’s Hospital.


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