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Rhode Island news

New hotline offers mental-health help for children, families

01:00 AM EST on Thursday, January 11, 2007

By Felice J. Freyer

Journal Medical Writer

PAWTUCKET — Parents and other caregivers of children who are in emotional crisis — such as crying inconsolably or hurting themselves or others — have a new way to get help fast.

A state-run hotline (866) 429-3979 can put parents in touch with a clinician trained in children’s mental health and related family issues. The rules require a return call within 15 minutes, and if a face-to-face interview is warranted, the clinician should be available within two hours. The family can also arrange a meeting for the next morning. These clinicians should then locate the appropriate type of care for the distressed child.

Prompted by a new state law, this mental health clearinghouse — called Kid’s Link — has been operating quietly since Nov. 1 on a pilot basis. On Tuesday, Governor Carcieri joined state and mental health officials at Gateway Healthcare to announce that Kid’s Link is ready for prime time and will start an advertising campaign.

Carcieri said Kid’s Link gives families, for the first time, a single point of entry into the mental-health system.

“The sooner we can pick up youngsters in crisis and get them plugged into the care they need, the better they will do,” he said.

But Kid’s Link goes beyond helping individual families. It is intended to also ease problems throughout the health care system, which until now has dealt haphazardly with children’s behavioral and emotional troubles.

Rep. Steven Costantino, D-Providence, who sponsored the legislation, said, “I asked the simple question: ‘How does someone get into a psychiatric hospital in this state?’ There were about 10 different answers.”

To create Kid’s Link, the state Department of Children, Youth and Families teamed with Gateway Healthcare, a nonprofit provider of mental-health and substance-abuse care, to coordinate and track the care of children seeking mental health treatment. The DCYF is using money already in its budget to offer this service, by reorganizing its relationship with the community mental-health centers around the state.

Before Kid’s Link, children in crisis often were taken to a hospital emergency room, where the person assessing him or her may not have had expertise in children’s mental health and family issues. If a doctor decided that the child needed to be hospitalized but there were no psychiatric beds available, the child became a “boarder” at a medical hospital — kept safe in a hospital bed, but not receiving care for mental illness.

It is hoped that Kid’s Link will provide an alternative to the emergency room, as well as backup for emergency room staff when a mentally ill child does show up there. And it is hoped that the new system will reduce children’s hospitalizations for psychiatric care by finding alternative services in times of crisis and also by intervening earlier in a child’s illness to avert those crises.

When Kid’s Link was proposed, hospital officials regarded it with some skepticism. They questioned whether hospitalizations could really be cut, saying they never admit children who don’t truly need it. And they worried that the state program would create a troublesome new layer of bureaucracy.

But Dr. Gregory Fritz, director of child and family psychiatry at Hasbro Children’s Hospital, said in a phone interview that Kid’s Link so far has proven to be “terrific” and that Gateway has been “very easy to collaborate with.”

Although he emphasized that many possible factors could be responsible, Fritz said the number of boarders — children with psychiatric needs being held in medical beds — declined “noticeably” in November and December after Kid’s Link started. “I’m very hopeful that this has made an impact on the boarders,” Fritz said.

Gateway obtained privileges at Hasbro Children’s Hospital so the agency’s clinicians can work there.

“That is a huge breakthrough,” said Janet Anderson, the DCYF’s assistant director for children’s behavioral health, “for the hospital and community mental health centers to be working together in this way.”

Kid’s Link is intended for children who receive their mental health care through the state, although people with private insurance will not be turned away. The DCYF estimates that it will serve 250 publicly funded children each month. In November, the program served 120, without any advertising.

Patricia Martinez, DCYF director, acknowledged that easing access could attract more youngsters than the system can serve. But, she said, Kid’s Link will count how many seek care and why — for the first time developing a picture of children’s mental health needs that can inform future programs.

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