Task force offers recommendations to improve services

A Connecticut task force created by legislation following the Sandy Hook Elementary School shootings released its final report featuring 47 recommendations designed to improve behavioral health services for young adults.

The Task Force to Study the Provision of Behavioral Health Services for Young Adults was created under An Act Concerning Gun Violence Prevention and Children’s Safety to analyze and make recommendations for behavioral health services for people ages 16-25. It was one of several initiatives created after the Sandy Hook shootings.

Task force member Marcy Kane, Ph.D., licensed clinical psychologist, vice president of child services at Wellmore Behavioral Health and a Connecticut Psychological Association board member, says the task force’s recommendations reinforce many themes being addressed in other initiatives since Sandy Hook.

“A lot of our recommendations talk about increasing collaboration between pediatric and primary care (physicians) and mental health, really finding more ways for behavioral health providers to be integrated into primary and pediatric offices,” Kane says.

The task force recommended mandatory screening for behavioral health problems for ages 0-25. Primary care settings are preferred over schools for the screenings, members concluded. “Some school districts have really great resources and others just don’t have enough, so just to mandate schools to do something without equalizing the playing field across the state, that recommendation wouldn’t really take off,” Kane says. “So most of the screening practices fell within primary care (in the report). We felt that might be an area where it might be the easiest reimbursement mechanism.”

The task force also emphasized the need for stronger communication and coordination across mental health and primary care providers.

Kane praised an initiative called Access Mental Health, supported by Medicaid that makes behavioral health case managers available 24 hours a day to respond to primary care physicians who have questions or need to be connected to community mental health services. Kane says that she would like to see such a program more widely used statewide.

The task force addressed ways to help families and individuals in crisis better navigate the system, such as through expansion and upgrade to the current 2-1-1 Crisis Line, which provides a mobile response for anyone seeking help for a child up to age 18 in psychiatric crisis. The report recommends increasing the scope to ages 18-24.

The report also recommended in-service training in mental health competencies for school-based social workers and psychologists, as well as administrators, teachers and resource officers, to help them identify signs and symptoms of mental illness and refer students to the appropriate supports.

The task force also addressed a need for commercial insurers to cover some of the same types of evidence-based treatments that are covered through public insurance programs. “We need to find a way to incentivize private insurance companies without mandating them,” Kane says.

State Sen. Dante Bartolomeo (D-13th District) says she supports many of the task force’s recommendations, including increased education for pediatricians about mental health.

“If (pediatricians) know enough to ask certain questions, they can then know enough to provide certain support,” she says. “Those are the types of things we are looking at and trying to establish and set up and not in an invasive and intrusive way.”

Last year, Bartolomeo co-sponsored successful legislation (An Act Concerning the Mental, Emotional, and Behavioral Health of Youths) seeking to reduce mental, emotional and behavioral health issues in children through more early identification and intervention. Bartolomeo says it’s important that children receive appropriate care starting from birth (including maternal health).

The legislation promotes improved coordination of services. “We want to make it so that there’s no wrong door,” she says. “So that if someone gets involved in a system, that providers and agencies are able to communicate across and between agencies so that it’s a natural transition and a continuum of care.”

Bartolomeo says the legislation is currently in the implementation process. Among other goals, it aims to establish processes so that children and young adults whose primary need is mental health intervention are placed into appropriate mental health treatment instead of the juvenile justice or corrections systems.