Meeting the Children’s Behavioral Health Crisis Head On

“Our community work is intentionally designed to support local providers and agencies to address more mental health conditions at less-intensive levels, then refer to us when its necessary. That increases capacity to help children at every level. We believe this comprehensive approach will ultimately reduce Emergency Department use for crisis patients and reduce readmissions to the highest levels of care.”

David Axelson, MD, Chief of Psychiatry, Medical Director, Big Lots Behavioral Health Services.

In 2020, right before the COVID-19 pandemic, we opened the largest free-standing behavioral health center of its kind — cementing our commitment to children’s mental and behavioral health. Since then, the pandemic has exacerbated the ongoing pediatric mental health crisis. But our work did not stop with the opening of a building. To address the rising need, we have developed a community-wide system of care that relies on cooperation, collaboration and innovation of hospital and community partners.

We conceptualize the community-wide system of care as a pyramid — the more intensive the level of care, the higher the level on the pyramid. Nearly all children can benefit from basic prevention programs, while only a relative few will need inpatient services. Each child, however, can receive the level of care they need.

We ensure that the various levels of care are seamlessly integrated to provide comprehensive care to children and their families over the course of their treatment. We also ensure that our care is informed by leading edge research and, in turn, supports ongoing research that will define future innovative treatments.

Leaders In Integrating Behavioral Health In Primary Care

“Integration is not just about behavioral health crises. It’s about how we develop relationships early and prevent problems later. We’re full partners in the care of the child — ready to jump in as needed to improve physical and mental health."

Whitney Raglin Bignall, PhD, Pediatric Psychologist Integrated into a Primary Care Clinic

Primary care is a front door to the mental health system. It’s the first place most parents go when they have a concern about their child’s behavior and development. That’s why Nationwide Children’s Behavioral Health and Primary Care experts have been working together in integrated practices. Project ECHO is a model that allows primary care providers to present cases to behavioral health experts at Nationwide Children’s via teleconference and receive support in managing common pediatric mental health concerns. In 2021, there were 155 ECHO sessions and 3,563 attendees.

In addition, Nationwide Children’s and its accountable care organization, Partners For Kids®, have developed a program to support community primary care practices that want to integrate behavioral health clinicians within their practice. Since launching in May 2022, 30 practices have explored, prepared for or implemented this program, and 13 practices were active within the program.

Dr. Raglin Bignall, prior to being recently named associate clinical director of On Our Sleeves, played an integral role in working with families at a Nationwide Children’s Primary Care Center, which served a primarily low-income and racially diverse community. She implemented a program to help enhance parenting skills for raising young children and built partnerships with community organizations, primary care offices and neighborhood schools.