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In 2022, 13.25% of Florida youth (ages 12 to 17) reported at least one major depressive episode.
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Economic Backbone: Pediatrics
Primary Concern
A Nemours pilot program is embedding mental health services in its primary care offices.
Your child starts missing school due to anxiety attacks. Or you start noticing more frequent and intense tantrums that you thought were things of the past.
These could be initial signs that he or she needs mental health counseling. But for too many families, that help is either out of reach or too uncomfortable to seek.
Nemours Children’s Health is expanding a pilot program that makes counseling more available and inviting by offering it at its pediatric and primary care offices in Central Florida. The Children’s Health Integrated Behavioral Health Initiative started in May 2022 with a grant from TD Bank. It has treated more than 700 kids and their families at 14 offices since, with four more sites on the way.
The needs are clear: Florida ranks 46th nationally in Mental Health America’s 2023 report that measures access to insurance and care.
“Our goal has always been to increase access and decrease barriers,” says psychologist Monica Barreto, clinical director for Nemours’ Behavioral Health for Primary Care. “We borrow the trust that the family has in their primary care physicians.”
Some people may hesitate to seek mental health counseling, but nobody thinks twice about taking their child to the doctor. Under the pilot program, behavioral health screenings take place during regular medical visits, and patients can be referred to the clinical psychology staff.
“We do treat the whole child,” says Barreto, a Miami native who earned her clinical psychology Ph.D. at Western Michigan University and completed a postdoctoral fellowship at Yale University.
Most cases Nemours has seen so far involve issues such as mild depression, anxiety or ADHD. Clinicians treat patients as young as 3 up to teenagers. The results so far are positive, Barreto says.
One Seminole County parent saw dramatic changes in her daughters, ages 10 and 16, after her primary care physician referred them to the program. She had tried to get them help before, “but the waiting list was incredible.” Both girls had anxiety about going back to school after the COVID-19 pandemic. That was exacerbated for the older girl by the “code red” active shooter drills in high school. But neither wanted to talk with a stranger.
Barreto “was so kind and so patient (with them) to the point my girls started asking, ‘When is my next appointment? When do I get to talk with her again,’” the parent says.
The pilot program is operating at primary care sites in Maitland, Winter Garden, Kissimmee and Oviedo, among others. Nearly 45% of the children treated are Hispanic, 31% white and 8% Black.
In addition to anxiety, depression and ADHD, adjustment disorders are another common diagnosis among children. Adjustment disorders are short-term conditions coping with life’s stresses that inhibit a person’s functioning.
Part of the treatment provided involves “building structures in the home” and coping skills within the patient, Barreto explains. “We can teach a child all of these skills, but if we don’t work with the parent we’re not helping the family unit,” she says.
