Children’s Hospital of Orange County’s Stance on Mental Health

True integration of mental health services into medical care may have seemed like an impossible dream even five years ago, but today an increasing number of medical systems are recognizing the need for these services. Like numerous long-practicing physicians, Dr. James Cappon, CHOC Children’s Chief Quality and Patient Safety Officer, was taught early on in his medical career that mental illnesses and eating disorders aren’t the same as other maladies; rather they were better handled by other systems of care. In the past, this lack of awareness contributed to the country’s flawed mental health system of care, including limited access to psychiatric beds, especially for children.

Dr. Cappon is glad to see the current systems of care being challenged. And he’s proud to be contributing to a shift in the way mental illness is discussed and treated, particularly among children and adolescents. He, along with Kimberly Chavalas Cripe, CHOC Children’s President and CEO; Maria Minon, MD, CHOC Children’s Chief Medical Officer and Vice President, Medical Affairs; and Heather Huszti, Ph.D, CHOC Children’s Chief Psychologist, are among a team of visionary leaders championing CHOC Children’s mental health initiative. “But it’s taken a village,” the group reports.

Their team, in collaboration with many community partners, is creating an innovative mental health system of care for all children, teens and young adults. Among the initiatives is the creation of the CHOC Children’s Mental Health Inpatient Center, the first in Orange County for children younger than 12. Set to open next year, the Center will treat children and adolescents 18 years and younger, and offer a range of services including specialty programming for children younger than 12. The program features a variety of mental health specialists including psychiatrists, psychologists, neuropsychologists, social workers and child life specialists.

In planning for the mental health system of care, including the Center and outpatient services, CHOC’s team identified several gaps and barriers to services in Orange County, including:

  • Lack of inpatient psychiatric services for children younger than 12
  • Lack of specialty inpatient medical care for children with eating disorders, a psychiatric illness with the highest rate of mortality
  • Due to a lack of inpatient psychiatric beds, suicidal children can have long waits in emergency departments
  • Fifty percent of adults who suffer from chronic mental illnesses first experienced symptoms before the age of 14. However, in many cases, it can take 10 years or longer before an accurate diagnosis, allowing the disorder to snowball for a decade due to the unfortunate stigma of shame, misunderstanding, and barriers to accessing necessary behavioral health treatments

To Minon, Huszti and their colleagues, finding solutions to these gaps and barriers inspired the creation of a mental health system of care designed to ensure children, teens and young adults in Orange County have timely access to quality mental health care services.

PSMF: What will be included in the treatment program for children?

CHOC: The program was designed with guidance from national experts and incorporates elements of several exemplary pediatric mental health programs at other children’s hospitals. The program also is based on the principles of trauma-informed care, which recognizes that children admitted to mental health units have often experienced multiple early traumas or have experienced trauma due to their mental illnesses. We plan to incorporate programming and tools for kids to learn to manage their emotions effectively.

PSMF: How many psychiatric in-patient beds will be offered?

CHOC: CHOC’s Mental Health Inpatient Center will have 18 private rooms. The private rooms will allow parents to spend the night with their children as appropriate. Individual rooms offer a chance for children experiencing psychiatric crises to have their family close to them, and for families to begin to learn new ways to help treat and support their children.

PSMF: How did CHOC determine a design layout for the center?

CHOC: We consulted with the Samueli Institute, who has worked to uncover how healing occurs in health care systems. They shared their insights on how to implement an optimal healing environments(TM) framework to enhance the patient experience. Through the combination of colors, light, and nature, we are creating an environment that fosters healing and space where children and their families can be together. We also will provide a secure outdoor area for the Center’s patients. We are hoping to incorporate exercise and physical movement, such as outdoor yoga, which can be useful in treating child and adolescent depression.

PSMF: When will the center be open and accepting patients?

CHOC: The Center is scheduled to open in 2018. CHOC recognized the hollow gap between the number of children who struggled with mental illnesses and the number of children who received treatment. CHOC’s mental health inpatient center will help to address the current pediatric mental illness crisis, and give children with mental illnesses a safe and nurturing healing environment.

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Additional Resources

For more information on Actionable Patient Safety Solutions on Mental Health, click here

To learn more about collaborative care planning in mental health, visit here!