Transforming Pediatric Mental Health Care in Western New York

Author: The Tower Foundation

Child psychiatrist shortages and six-month waiting lists to access mental health services force many children to miss out on or delay critical mental health diagnoses and early psychiatric interventions. Families with Medicaid face even greater challenges, experiencing longer wait times and inadequate insurance coverage for preventive psychiatric services. Often, caregivers find that the only option to see a provider quickly is to take their child to the emergency room or an inpatient facility.

In 2005 the Tower Foundation supported the University at Buffalo’s Department of Psychiatry to create the Rapid Pediatric Psychiatric Consultation (RPPC) program to help address the growing need for psychiatric services for children and adolescents in Western New York. The aim was to improve youth access to psychiatrists and mental health outcomes by identifying psychological difficulties and addressing them before they became larger problems. The solution was to provide primary care providers with quick access to psychiatrists. With this support, pediatricians could manage their patients’ care rather than children waiting months to see a psychiatrist.

“Because of my relationship with pediatricians, I knew they were seeing more and more children with mental health issues,” said David Kaye, MD, executive director of Project TEACH. “But most pediatricians have very little mental health training, so access to a child psychiatrist is a huge benefit for them and their patients. We set out to provide fast access to psychiatrists so pediatricians could help their patients with mental health needs.

With the Tower Foundation’s help, Dr. Kaye assembled a team of psychiatrists to assist pediatricians serving Western New York children and families with Medicaid. Primary care providers could call a hotline, talk with a psychiatrist about their patient’s needs, and schedule a psychiatric consultation within two weeks. Psychiatrists provided a patient report and an action plan the pediatricians could use to manage their patient’s mental health needs within the primary care setting.

The program emerged as an invaluable resource for primary care physicians and families, facilitating timely access to crucial psychiatric assistance for children ages 3 and up. Families finally gained timely access to the help their child needed, and doctors could treat their patients in the primary care setting.

Once word spread about the program, private insurers wanted to sign on to provide the urgently needed services for their clients.

In 2009, New York State Office of Mental Health (OMH) solicited proposals for a program providing primary care physicians across the state with rapid access to child psychiatrists by phone, along with in-person consultations, referrals, and formal education.

Dr. Kaye partnered with faculty from University at Buffalo, University of Rochester, Upstate Medical University in Syracuse, Northwell/Zucker School of Medicine, and Columbia University to expand the program’s reach and capacity. Together, as Child and Adolescent Psychiatry for Primary Care (CAP PC), and based on the experience of the RPPC, they applied for and were awarded the grant to provide services to 90% of New York state.

Continuously funded by OMH since that time, the team devised an innovative system to alleviate the barriers to pediatric psychiatric assistance. Over time, their evolution, coupled with strategic partnerships, led to their rebranding as Project TEACH, a name that underscores their critical role as educators for primary care providers. Dr. Kaye emphasized that securing the state grant owed much to the Tower Foundation’s initial funding and ongoing support, enabling them to establish essential systems, accumulate vital experience, and expand their service footprint.

Since 2022 Dr. Kaye has led Project TEACH which now consists of seven teams (adding Albert Einstein College of Medicine and Albany Medical Center) providing services throughout the state, including a rapid response warmline, telehealth and in-person consultations, referrals, and formal education for pediatricians. The organization continues to help pediatricians, family physicians, nurse practitioners, and physician assistants obtain the skills and knowledge needed to engage with kids in need of mental health assistance. With the most current iteration of the grant PT also was able to expand access to reproductive psychiatrists and provide parallel services for maternal health clinicians assisting their patients with mental health needs. The program has received major national awards from the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry.

“Children and their families already have a level of trust and comfort with their primary care doctor,” said Dr. Kaye. “That’s why the program works so well. Also, by having the primary care doctor closely involved, we start to look at mental health issues just like we’d look at diabetes or another significant health concern. It helps to destigmatize mental health. There is no health without mental health.”

Project TEACH plans further growth to meet the needs of children and adolescents in New York, including expanding supports for children and adolescents with autism spectrum disorder, substance use disorders, and maternal mental health.