Crystal Shen, MD, MPH, FAAP
Through Pediatric Transforming Clinical Practice (P-TCPi) work, my clinic (Eastgate King County Public Health) has developed an ongoing partnership with Youth Eastside Services.
In clinic, pediatricians were seeing an increasing number of youth with mental health needs, and multiple barriers to accessing care, especially with Medicaid status and with youth from non-English speaking families, where care coordination could be challenging to navigate.
Seeking ways to improve linkages with pediatric behavioral health services, we formally collaborated with Youth Eastside Services. Through regular meetings, we developed a direct referral process to help facilitate communication between primary care providers and behavioral health care providers.
This was an ongoing process that began with tracking behavioral health referrals, assessing our baseline practice with a Practice Assessment Tool, and mapping Eastgate & Youth Eastside Service processes with flowcharts (facilitated by our wonderful DOH facilitator, Christine Stalie) and led to developing a process for sharing information and working with clinic referral coordinators.
Through our regular meetings, we also developed great collaborative relationships with our Youth Eastside Services colleagues.
I personally saw how beneficial this partnership was for an adolescent patient who developed new onset psychiatric issues which led to multiple repeated psychiatric hospitalizations over a few months. The patient’s non-English speaking family members encountered significant barriers to coordinating care after discharge, including not being able to obtain psychiatric medications or to arrange outpatient mental health appointments. I received discharge communication from the inpatient psychiatrist with highly valuable information about the patient, yet realized it would be challenging for the patients’ family to relay this complex information to a new behavioral health provider. Through our connections with YES leadership, I was able to help the patient get a timely intake appointment and to also communicate necessary information from hospitalizations and discharge medications to the YES psychiatrists. Since then, the patient has had no more hospitalizations and is working and enrolled in classes. Our P-TCPi work to develop a partnership with YES helped this patient thrive while also preventing readmission.
Since then, we have continued with our partnership, where I’ve been able to connect patients with more Youth Eastside Services including:
- School-based behavioral health counselling so youth can receive mental health care at local middle and high schools. Many patients are now able to receive counselling due to eliminating transportation barriers.
- Early childhood behavioral health services with Promoting First Relationship services for children from birth to three and Parent Child Interaction Therapy for children 2 to 7 years old, equipping parents with valuable skills.
- Substance use treatment and counselling for teens, including communicating with substance use educators about the rapid rise in youth vaping locally.
I also presented at a Youth Eastside Services staff training and educated mental health providers about pediatric preventative care and the intersections with mental health. This emphasized the importance of collaboration between primary care and mental health care for the well-being of patients, and for our broader efforts towards healthcare transformation.
Due to our P-TCPi work, Eastgate’s ongoing partnership with Youth Eastside Services has been beneficial for our patients, especially for our non-English-speaking and other vulnerable families that often encounter barriers in receiving care. I look forward to continued collaboration to serve our patients.