At the 2023 Minnesota State of Reform Health Policy Conference, leaders in the behavioral health space met to discuss the importance of early intervention to address behavioral health conditions in children. Due to their rapid growth and development, children respond to and process traumatic events and emotional experiences in different ways than adults, which can make early diagnoses more tricky.
Simreet Khaira, MD, eastern regional medical director of Carelon Behavioral Health, explained how the first point of contact a child has for their behavioral health is with primary care physicians, who are generally expected to do as much as possible to provide them whole-person care. Khaira said it’s important to ensure that pediatric offices in particular are comfortable with screening and receiving support following screenings.
“Another thing that comes to mind is making sure that we’re all at those points where the symptoms are manifesting, and so how do we engage with our school systems and other members of the community, where some things may be seen earlier and then can be collected and used in a useful way for the treatment of it,” said Trey Sutten, co-founder and CEO of Siftwell.
Behavioral and mental health conditions cannot be detected on blood panels, and Sutten said detection comes down to trusting relationships that allow for conversations surrounding conditions to take place.
Brandon Jones, executive director of the Minnesota Association for Children’s Mental Health, added how an important piece of early intervention for behavioral health conditions is ensuring the community is informed about the availability and effectiveness of childhood early intervention, particularly due to medical mistrust.
Khaira noted Minnesota’s Children’s Intensive Behavioral Health Services, which establish policies and best practices for the certification and coverage of mental health services for children who need more intensive levels of intervention. Khaira said children up to 20 years who are identified with atypical symptoms and are marked as having a serious emotional disturbance may be eligible for services like intensive care coordination and therapeutic mentoring, among others.
“This has become an interagency effort,” Khaira said, adding that 32 community service agencies in the state deliver these services covered by Minnesota Health Care Programs.
Early interventions cannot occur without a strong workforce, which was a top-of-mind issue for panelists. People are increasingly leaving the medical workforce, which increases the caseload of others who remain in the field. Jones said the wellbeing of healthcare workers must be prioritized.
“We’re going to be in a scary place in the next few years if we don’t create pathways towards this workforce,” Jones said.
Part of the workforce issue, according to Khaira, is deciding as a society what is worth investing in and what isn’t. She said funding consultative programs would be helpful to address the workforce shortage.
“It can take a while for the workforce to catch up with the need,” Khaira said.
Investing in outcomes and having payment models that incentivize quality healthcare are important aspects of addressing the shortage.
“The fee-for-service model helps the healthiest [people], because as a provider, it is easier to work with folks who are doing a little bit better and who are going to come and see you consistently,” Khaira said. “If we really want to make a dent, we need to work with struggling families.”
Sutten said the Centers for Medicare and Medicaid Services could be creating more Medicaid flexibilities, but still believes there are many opportunities within the confines of the current system. Jones mentioned how Minnesota reservations are looking at early intervention through collaboration with nonprofits.
“How do we better support more services in rural Minnesota, because we know that they’re not as resource-rich as the metro, but the needs are in some places matching some of the needs that we have here,” Jones said.