By Nanette Allison, DO, MS
This article was originally published in the July/August issue of the Tarrant County Physician. You can read find the full magazine here.
On the heels of the COVID-19 pandemic, pediatric suicide and mental health diseases are at all-time highs. According to the Centers for Disease Control and Prevention, suicide was the second leading cause of death for individuals between the ages of 10 and 34 in 2019.1 This research also noted that suicide rates have risen by 35 percent from 1999 to 2018 across the United States.1,2 With the arrival of the novel coronavirus pandemic and resulting social distancing, financial losses, and increased morbidity and mortality, we have seen an increase in the already high number of mood and anxiety disorders across all age groups. Children and adolescents have been especially impacted because of parental distress, social isolation, and difficulty adjusting to the virtual school environment. Many children with a pre-existing psychiatric diagnosis have experienced an exacerbation while others have experienced mental health symptoms for the first time, not knowing how to cope with the stress of their severely altered circumstances. Because the pandemic is currently ongoing, there is scarce research available to quantify the increase in mental health needs in the pediatric population due to COVID-19 and its restrictions.
Primary care providers and pediatricians have been on the front lines and often are the only point of contact for many patients before a suicide attempt. In 2015, researchers used National Institute of Mental Health-funded Mental Health Research Network data from 2009-2011 and found that 38 percent of patients who attempted suicide had made some type of healthcare visit within the week of the attempt, 64 percent within the month, and 95 percent within the year.3 This data shows us that primary care providers are integral in identifying and treating vulnerable patients that may not have access to psychiatric services.
Due to this urgent need for further pediatric mental health care services, the 86th Texas Legislature passed Senate Bill 11 in 2019, enacting the Child Psychiatry Access Network (CPAN), a telephone consultative service for primary care providers caring for children and adolescents with mental health needs. The caller will be greeted by a member of our team who will ask general questions about the call and can provide resources such as outpatient therapists, local partial hospitalization programs, and/or pediatric inpatient programs in the area if needed. If there are diagnostic questions or the need for support with treatment planning, consultation with a pediatric mental health provider can be arranged the same day.
Your local CPAN team wants to support you as you treat your pediatric patients’ mental health needs. The University of North Texas Health Science Center (UNTHSC) has partnered with John Peter Smith Health Network (JPS) to provide these services for Tarrant County and eight of the surrounding counties, including Parker, Wise, Cooke, Erath, Palo Pinto, Jack, Montague, and Clay. This service is free of charge with a response time of within five minutes for resourcing requests and 30 minutes for consultation with a child psychiatry provider. CPAN is ready to provide support to Texas primary care providers Monday through Friday from 8 am to 5 pm. Just call 1-888-901-CPAN, press 1 for North and North East Regions and press 1 again for the UNTHSC/JPS hub. You will be able to obtain needed resources or a consultation immediately. You can also contact the CPAN coordinator, Janet Thompson, at JThompso04@jpshealth.org to enroll, though enrollment is not required to make a call. We look forward to partnering with you to help your pediatric populations and their families.
For more information about CPAN, visit Texas Child Mental Health Care Consortium found at the JPS Health Network website: https:// www.jpshealthnet.org/medical-professionals/tcmhcc.
1“Suicide.” National Institute of Mental Health. U.S. Department of Health and Human Services. https://www.nimh.nih.gov/health/statistics/suicide.
2“Vital Signs: Trends in State Suicide Rates – United States, 1999–2016 and Circu stances Contributing to Suicide – 27 States, 2015.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, June 10, 2019. https://www.cdc.gov/mmwr/volumes/67/wr/mm6722a1.htm?s_cid=mm6722a1_w.
3Kluwer, Wolters. “High Rate of Healthcare Visits before Suicide Attempts.” High Rate of Healthcare Visits before Suicide Attempts | Wolters Kluwer, April 15, 2015. https://www.wolterskluwer.com/en/news/high-rate-of-healthcare-visits-before-suicide-attempts.