Moving knowledge, not patients.
Putting more brains into a child’s case.
They’re not medical descriptions, but they encapsulate the approach of KSKidsMAP, which brings an interdisciplinary team approach to helping Kansas primary care providers deliver mental health care to children and adolescents.
KSKidsMAP is a program for primary care physicians and clinicians in Kansas through a telehealth network. It is a partnership between the Kansas Department of Health and Environment and the University of Kansas School of Medicine-Wichita Departments of Pediatrics and Psychiatry & Behavioral Sciences.
“No child is in a bubble. Their interactions at school and with peers, their genetics, their family environment, their living conditions, all that plays into their mental health. By really thinking about each child in a holistic manner, I think we serve the children better,” said Kari Harris, MD, a pediatrician on the team and associate professor at KU School of Medicine-Wichita, home to KSKidsMAP.
The need is evident, as 99 of 105 Kansas counties are short of mental health providers. That leaves primary care clinicians trying to fill a gap, especially in rural areas. Treating the children in their home communities for anxiety, depression, ADHD, and other, often complex, disorders is preferred. The reality is that mental health providers in larger communities also have an enormous waiting list.
Three years into the KSKidsMAP program, members of the team have published a study in the Journal of Clinical Pediatrics detailing the types of treatment recommendations they’ve shared with doctors and other clinicians who have signed up for the free service. The study “Expert Team in Your Back Pocket: Recommendations from a Pediatric Mental Health Access Program” covers 49 patient cases from 2020 that involved 273 recommendations. By studying and quantifying their work, Harris said, the team can help ensure what they are doing is relevant to clinicians.
The study’s recommendations on patient care include a range of themes. Psychotherapy, a thorough diagnostic evaluation (including re-evaluation), led the list, which also included accessing community resources for care and protection, use or adjustment of medications, resources, and toolkits for patients and caregivers, and education.
The cases presented by primary care clinicians often require approaches beyond medication, which may be a doctor’s first question, but once discussed, additional needs are identified.
A patient and their parents might be given toolkits to manage behavior. Parents and caregivers might be encouraged to attend therapy sessions. Schools might be pushed to create individualized education plans to help students struggling with ADHD or anxiety. A doctor might consult protective services if a patient is suffering possible neglect or abuse. Or a physician might get advice on starting a child on a psychotropic medication or tapering them off one.
“What is so beneficial about the team is you are putting multiple minds together to tackle a single case. So you’re going to have more than just medication recommendations,” Harris said. “With input from this team, you walk away with a robust plan full of resources for that child and their family.” KSKidsMAP is funded by a four-year federal grant of $2.1 million. Learn more
By: Brian Whepley, KU School of Medicine-Wichita