Texas Child Mental Health Care Consortium prepares to launch Child Psychiatry Access Network

By Laurel L. Williams, DO
Co-Chair, Texas CPAN Workgroup

One in five children suffer from a mental health disorder but upwards of 50% of youth do not receive any treatment, and for many, treatment is both delayed and may not be evidence informed. There is a nationwide shortage of child and adolescent psychiatrists, or CAPs, and even then, they are often not available in rural and underserved areas.

In the U.S., 36 states have turned to a novel approach: standardizing the “curbside consultation,” in a format called Child Psychiatry Access Networks, or CPAN. The longest standing network is in the state of Massachusetts. This program has been running more than 10 years with evidence for its effectiveness in supporting primary care physicians through consultation in real time during a patient care visit.

In 2019, the Texas Legislature passed Senate Bill 10, creating the first-ever Texas Child Mental Health Care Consortium. This consortium is charged with five specific activities to increase access and improve care for youth in Texas:

• development of CPAN across Texas,
• development of urgent tele-mental health care for youth in schools,
• increased fellowship stipends for CAP training,
• improved access to quality fellowship rotations in specific community mental health care centers, and
• coordinated research across academic institutions on child mental health care topics.

CPAN will be a statewide initiative that is currently planned to deploy in spring 2020. All medical school departments of psychiatry in Texas have been assigned regions of the state with the goal of reaching and enrolling all primary care physicians who wish to participate in this free consultative service.

Once a primary care team enrolls in CPAN, the next step is calling the toll-free number for a consultation when a mental health concern is identified during a patient visit. The PCP can expect a return call from the coordinator within five minutes. If the question involves assistance in considering and locating referral options for families, the coordinator will walk the PCP through the request and provide options along with basic behavioral plans. If the question involves assessment, diagnosis, and treatment planning for which a CAP physician is needed, the PCP can expect a return call within 30 minutes to consult on the issue and provide guidance. PCPs can call as frequently as needed to assist care of the patient in their office.

Family physicians are on the forefront of helping families navigate complex mental health needs. My own father, Timothy E. Williams, MD, is a recently retired family physician who often lamented to me his continued lack of access for psychiatric consultation and care. I have him in mind when I think about the goals of CPAN to help the PCP help the family and their child. Together we can improve children’s lives. Next steps will be CPAN teams reaching out to PCPs in spring. As CPAN has finalized plans, our team will be reaching out to state family physician organizations with more detailed information on how to enroll. Stay tuned!

For more information on the Texas Child Mental Health Care Consortium, visit https://www.utsystem.edu/pophealth/tcmhcc/.