Throughout the country, the pediatric mental and behavioral health crisis has been a top concern for pediatricians. It’s also one of the leading reasons they refer patients to specialists, like the ones at UVA Health Children’s.
But there are more patients needing to be seen than available specialists. And that’s left many patients without specialty care.
UVA Health Children’s Newly Opened Neurodevelopmental and Behavioral Health Center is a huge step towards correcting that imbalance. Coupled with a promise to triple the number of specialists, we’ll be able to see more children. But beyond the promise of access, the center aims to provide a first-in-class treatment facility that offers truly comprehensive care. The ribbon cutting happened December 17, 2024.
Laura Shaffer, PhD, professor and section chief of pediatric psychology at UVA Health Children’s, and Beth Ellen Davis, MD, professor and division head of neurodevelopmental and behavioral pediatrics, serve as the center’s clinic directors. “Providing wraparound service in a clinical setting is really something that we all hope for, but we don’t always get when we see children with significant developmental disabilities,” Davis says. But in the new center these patients can receive interdisciplinary care.
The Scale & Scope of the Pediatric Mental Health Crisis
The rapid increase in young people with mental health and behavioral needs has been acknowledged as a significant issue for years. “Fewer than 20% of youth needing mental healthcare receive services. It’s been a crisis since before the pandemic, and it’s only been exacerbated since then,” Shaffer says. And the numbers paint the picture very clearly:
- 3 out of 5 teenage girls report feeling persistently sad
- 37% of teenagers have experienced symptoms of depression
- 20% have seriously considered suicide
- 9% have attempted to kill themselves
Even for pediatricians on the front lines of it every day, the patient load is alarming. “We are experiencing an unprecedented mental health crisis in younger age groups,” Chris Holstege, MD, pediatric emergency doctor and director of Blue Ridge Poison Control, confirmed. When more children started showing up in UVA Health Children’s ER following attempts at self-poisoning, research showed that it wasn’t a local trend, but a national one.
The total number of suspected suicides by self-poisoning increased from 75,248 in 2015 to 93,532 in 2020.
Doctors save most of the children who present at the ER with self-inflicted poisoning or injury. But there remains significant mortality and morbidity. Suicide is the second leading cause of death amongst kids between the ages of 10 and 24. And for every child who dies, many others are left with serious injuries and health issues.
Getting help, especially early, can change the course of these children’s lives. But access has always been a challenge.
Neurodivergence & Mental Health
Not all children have an equal risk for mental health concerns. Those with neurodevelopmental differences, like autism spectrum disorder or ADHD, are at a significantly greater risk for mental illness as well as suicidal ideation and attempts.
As many as 35% percent of autistic people have considered suicide. And 25% have attempted it. That’s more than double the risk of their neurotypical peers.
Similarly, children with ADHD often struggle more with depression and anxiety. And impulsivity, a classic symptom of the disorder, can lead to additional suicide risk.
Treatment that isn’t informed by an understanding of neurodivergence is unlikely to be successful for these children. But that requires truly interdisciplinary work.
The mental health risks associated with neurodivergence decrease significantly with early intervention and diagnosis. “But fewer than half receive an autism evaluation by the age of 3,” Davis says. She’s adamant that proactive and efficient treatment can significantly improve the lives and health outcomes of these children and their families.
New Space for New Treatments
One of the new offerings the center can provide is the opportunity for parent-child interaction therapy (PCIT). For young children with behavioral concerns, like defiance or aggression, PCIT can offer treatment that lasts long after each therapy session.
Parents are taught play-therapy skills. And then, while interacting with their child in a playroom, they receive real-time coaching from a licensed therapist. In addition to limiting problematic behaviors, this therapy type also aims to improve familial attachment.
The less-medicalized environment is also helpful for relieving anxiety in patients. Many children, especially those with developmental disorders, are understandably anxious in hospitals. This limits their ability to engage in therapy. But in the warmer, more inviting space of the playroom, treatments are more likely to be successful.
Bringing in the Whole Team
Part of the appeal of the center is that it offers truly comprehensive care. Developmental pediatricians, clinical and child psychologists, child psychiatrists, and integrative medicine providers can create plans that address a child’s total wellness.
In addition to offering comprehensive medical services, the center also endeavors to provide accessibility resources to make it an asset to all in the community. “We will offer services for all children and families regardless of their ability to pay and irrespective of language and cultural background. Another asset to underserved communities is our interpreter services. People who speak many languages will use this center,” Shaffer says.
The access to many treatment options, an expanded number of providers, and accessibility features position this center to be a true asset to the community. And with better access to these resources, more of Virginia’s children will have the help they need to thrive.