The Vermont Child Health Improvement Program (VCHIP), in collaboration with the Division of Child Psychiatry at the University of Vermont College of Medicine, Fletcher Allen Health Care, and Vermont Center for Children, Youth and Families (VCCYF), is pioneering a new program to increase access for primary care clinicians to child psychiatrists and improve mental health care in Vermont children and families.

Under the program, primary care practices that choose to participate will be assigned a UVM child psychiatrist who will be available to that practice for phone call and email questions during regular working hours regarding their patients. 

We are in the process of reaching out to the primary care practices to see who would like to participate in the program, at no cost to them.  Once the list is established, each child psychiatrist will be designated for a particular region of the state and the practices therein.   

The program provides for phone and email questions from providers of that practice as well as access to the VCCYF’s Family Wellness Coach who can help clinicians and families identify resources for treatment and health promotion activities.  In addition, all participants get a subscription to THIS BLOG! and will receive notices of other updates related to child mental health issues here in Vermont and elsewhere.

The one area that won’t change, however, is the process for in-person child psychiatry evaluations at the VCCYF.  Our clinic continues to receive many more evaluation requests than we can accommodate quickly and we feel compelled to continue to serve all the families we can on a first-come first-serve basis.

While there is no designated end point for this project, VCHIP relies on government grants to fund important programs such as this.  For those benefiting from the partnership, it would be a wonderful idea to let your elected officials know how important initiatives such as these are for Vermont youth and their families.

For questions or further information, you can contact Eliza Pillard at eliza.pillard@vtmednet.org.

Clinicians of all types who write antipsychotic medications prescriptions for children with Medicaid insurance will soon be receiving surveys to complete on each child.

The Agency of Human Services (AHS), including the Department of Vermont Health Access (DVHA), the Drug Utilization Review (DUR) Board of the DVHA, the Department of Mental Health (DMH) and the Department for Children and Families (DCF) has been interested in the use of antipsychotic medications in children and is sponsoring the survey in an effort to understand more fully the prescribing practices related to antipsychotic use for Vermont youth.  The Child and Adolescent Psychiatric Medications Trend Monitoring Group, made up of representatives from different clinical and government backgrounds (including me), has been trying to make recommendations to promote the optimal use of these medications in children and adolescents. 

Data from pharmacy insurance claims have been useful but clearly inadequate in answering basic questions about the reasons that lead to antipsychotic medication prescriptions.  The thirteen question survey can potentially go a long way towards understanding these decisions on a much more meaningful level.  Questions are focused across many areas including the origin of the prescription (such as an inpatient hospitalization), behavioral and diagnostic targets, use of other medications, and employment of nonphrmacological alternatives (such as use and availability of psychotherapy). 

A completed survey by mid-December will be mandatory for medications to be approved. 

While nobody enjoys more paperwork, the committee is hoping that clinicians will see the potential value in these data as a means towards specific and targeted measures that will improve the probability that the right youth are being prescribed the right medications at the right time.