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A Novel Application of the Child Psychiatry Access Program Model to Inpatient Psychiatry: The Transitional Care
Olivia Soutullo1,2, Lael Coleman3, Samantha Hamburger3
1Children's National Hospital, Washington, DC, USA. osoutullo@childrensnational.org.
Insights
The Transitional Care Coordination Program (TCCP) successfully connected pediatric patients discharged from psychiatric care with needed mental health services. This program shows promise in preventing negative outcomes and readmissions for children.
Area of Science:
- Child and Adolescent Psychiatry
- Healthcare Management
- Public Health
Background:
- Pediatric patients discharged from psychiatric hospitalization face high risks of adverse outcomes.
- Lack of connection to outpatient mental health services exacerbates these risks.
- Existing Child Psychiatry Access Programs (CPAP) offer a potential model for post-discharge support.
Purpose of the Study:
- To describe the development and implementation of the Transitional Care Coordination Program (TCCP).
- To adapt the CPAP model for post-psychiatric hospitalization care coordination.
- To provide mental health consultation and care coordination for pediatric patients and their families.
Main Methods:
- The TCCP provided telephonic child psychiatry consultations to pediatric primary care providers.
- Three months of care coordination services were offered to patient families.
- Data collected from March 2020 to November 2021 on patient enrollment and family engagement.
Main Results:
- 163 unique pediatric patients were enrolled in the TCCP.
- 52% of patient families participated, with 25% requesting new behavioral health providers and 44% requesting other supports.
- 65% of primary care providers were reached, with no requests for psychiatric consultations.
Conclusions:
- The TCCP demonstrates initial feasibility as a post-hospitalization support program.
- This novel adaptation of the CPAP model shows promise in connecting families to mental health care.
- Further research is needed to determine the program's efficacy and broader applicability.
Abstract:
Pediatric patients who have been discharged from psychiatric hospitalizations are at high risk of negative outcomes, especially if they do not connect to outpatient mental health services. This paper describes the development and implementation of the Transitional Care Coordination Program (TCCP), a novel adaptation of the Child Psychiatry Access Program (CPAP) model, to provide mental health consultation and care coordination services after psychiatric hospitalization. The program offered discharging patients' pediatric primary care providers telephonic child psychiatry consultations and three months of care coordination for patient families over multiple timepoints. Between March 2020 and November 2021, 163 unique patients were enrolled in the TCCP from 170 admissions. Patient families from 89 admissions (52% of total) were reached and participated in the TCCP, with 22 of those (25%) requesting new behavioral health provider resources and 39 (44%) requesting other behavioral health supports. The TCCP reached out to 110 (65% of total) primary care providers, none of whom requested a psychiatric consultation. Findings support the initial feasibility of a novel adaptation of the CPAP model for preemptive support at psychiatric hospitalization discharge. This is the first program of its kind, showing promise as a way for existing CPAPs to leverage their infrastructure to help families connect to needed mental health care after discharge and potentially prevent readmissions or other adverse outcomes. More research is needed to understand its efficacy and applicability to other settings.
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