Pandemic intensified mental health crisis; Project TEACH is fighting back

The U.S. surgeon general is warning that America’s youth face a “devastating” mental health crisis. The American Academy of Pediatrics calls it “a national children’s mental health emergency.” And obstetrician/gynecologists and other primary care providers are seeing increased anxiety and depression in their pregnant and postpartum patients.

“This country has long had a critical shortage of mental health professionals and has not supported mental health treatment adequately,” says David L. Kaye, professor of psychiatry in the Jacobs School of Medicine and Biomedical Sciences at UB and a child psychiatrist with UBMD Psychiatry. “The pandemic just made it worse.”

While primary care providers see children and new parents for routine care, they typically receive minimal training in dealing with patients’ mental health needs. Understandably, Kaye notes, that makes many of them reluctant to work with their patients on these issues.

“But families trust their pediatricians and their family doctors,” he adds, “so it makes sense to try to give those providers the skills they need to successfully treat the behavioral issues facing the patients in their care.”

That’s happening in New York State. The Office of Mental Health has provided a five-year, $16.8 million grant to UBMD Psychiatry to continue and expand a statewide program called Project TEACH (Training and Education for the Advancement of Children’s Health).

“Pediatricians and family practice doctors are often the first place families go to seek help or information if they have concerns about their children’s emotional or behavioral health,” says OMH Commissioner Ann Sullivan. Project TEACH connects pediatric primary care providers with psychiatrists and other behavioral health care experts for consultation, referrals to services, and education and training on children’s social and emotional development. Our new contract with UBMD Psychiatry will help expand the services provided through Project TEACH and help more children and families address any mental health concerns they may have.”

The UBMD team is a collaboration led by UB psychiatrists and including faculty psychiatrists from the University of Rochester; Columbia University/New York State Psychiatric Institute; SUNY Upstate; Zucker School of Medicine/Northwell Health; Albany Medical Center; and Albert Einstein College of Medicine.

Since its inception in 2010, Project TEACH has provided consultation support for more than 23,000 pediatric patients throughout New York State. More than 4,400 primary care providers have registered for the program, a number that continues to grow at an annual average of 15%.

Project TEACH services are based on the principle that access to behavioral health care is essential to achieving quality health care outcomes. “Pediatricians, family medicine practitioners and obstetricians and gynecologists play a critical role in identifying and treating behavioral health problems in their patients,” says Kaye, who is also executive director of Project TEACH.

“More and more, we see the major physicians’ groups embracing the mental health agenda. This program expands mental health services to a much bigger population that has significant mental health needs.”

With the new funding, the program will expand and strengthen consultation, training and support services for obstetrician/gynecologists, family physicians and other primary care providers who work with pregnant and postpartum patients. As a result, the expansion of Project TEACH will also help combat maternal depression and other perinatal mental health disorders.

“The main target of our program is primary care providers and obstetrician/gynecologists,” Kaye explains. “Our goal is to support, train and provide consultations to primary care providers so that they improve their skills and confidence in caring for these patients.”

The pandemic turned the shortage of mental health providers into “a national crisis, and it has hit children and new mothers particularly hard,” notes Allison Brashear, vice president for health sciences at UB and dean of the Jacobs School. “Project TEACH brings mental health treatment for these vulnerable populations to every corner of New York State by bolstering the skillsets of the health care professionals these patients already know and trust.”

All Project TEACH services are provided at no cost to providers or patients. Primary care providers and OB-GYNs get immediate telephone access to psychiatrists and mental health professionals who respond to requests in real time, 9-5 Mondays through Fridays, providing information about medications, therapy, referrals and local resources.  

Kaye says they view the consultations as “curbside-style” because they’re designed to give immediate, real-time education and support to providers.

A crucial component of the program is the availability of free, live and virtual continuing medical education (CME) programs that work synergistically with the phone call support. The educational programs utilize adult learning principles and senior faculty from across the state to deliver the highest-quality educational programs to primary care providers. Many of these CME programs are available online through the Project TEACH website.

And it’s making a difference. “The Project TEACH program has been nothing less than transformative,” says Marc Lashley, a pediatrician with Northwell Health in Valley Stream. “It’s made an enormous impact on my pediatric practice and my ability to treat children and adolescents with mental health issues. I now feel comfortable and confident in diagnosing and treating most mental health issues in my patients and can recognize immediately when a referral to a psychiatrist is needed.

“I can have a qualified and trusted child psychiatrist on the phone immediately, during business hours, to discuss a case,” he says.

Diane E. Bloomfield, medical director of Family Care Center at Montefiore General Pediatrics in the Bronx, agrees. “Especially in this time of constrained mental health resources, the support of Project TEACH is a gift, as it allows me to have the ability to provide an assessment and begin treatment of a mental health condition for a child who is a member of my practice.”

Colleen Mattimore, a pediatrician with Medical Health Associates of Western New York in Orchard Park calls the training and ongoing collaborative support from the Project TEACH psychiatric team “a game-changer, especially with the impact COVID-19 has had on our young. Pediatricians know their patients; they have watched them grow up. The families trust them, and this relationship is so important when treating mental health,” Mattimore explains. “Project TEACH has allowed us to keep the care in the medical home.”

Project TEACH continues to grow through close collaboration with the New York State Department of Health, as well as with the state chapters of national organizations including the American Academy of Pediatrics, the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists.