A Mental Health Block Grant supports what is known as the Pediatric Access Line (PAL) project, which is similar to projects carried out successfully first in Massachusetts and later in Washington state. A phone number to call for childhood mental health assistance is provided to physicians (not to relations of patients) who choose to use services of the mental health program when troubled youth show up at their offices. Not surprisingly, COVID-19 and its resulting isolation of children has exacerbated the need to help already struggling children.
In Nevada, the Pediatric Assistance Line, staffed from 9 a.m. - 5 p.m., is 702-553-4528. The number should be used only by physicians, nurse practitioners, and physician assistants working in primary care settings. Relatives of patients who learn about the program can ask their child’s physician whether the program could help their child.
Dr. Durette says the doctors eligible for assistance include Nevada Health Center physicians throughout the state, as well as UNLV Medicine pediatric and family care physicians. She said 183 doctors are now enrolled in the program that began last fall and has seen doctors call for assistance with a variety of issues, including advice for what to do with a depressed young patient who’s engaged in self-injurious behavior. Another consultation with a doctor dealt with what to do with a 4-year-old who has been kicked out of several preschools for behavior issues.
The call to PAL generally results in physicians getting assistance within 30 minutes, so the patient is still at the doctor’s office when a treatment plan is discussed. Dr. Durette and two fellows in her fellowship program, Colin Friendman, MD and Chau Pham, DO, are key figures in the sharing of psychiatric information, along with the two care coordinators from Chicanos por la Causa, Alba Perez and Angela Townsend.
“We talk through the case on the phone with the primary doctor like a traditional ‘curbside consult,’” she says. “If there’s a situation with a youth for whom the direction, diagnosis, or treatment options aren’t clear, we’re able to offer televideo consultations for the patient within a week, after which we send treatment recommendations back to the primary care doctor. So far, the uptake on the project has been quite positive. We’re helping support kids and clinicians in all areas of the state, keeping kids out of the ER/urgent care by providing consultative support, and helping enhance the clinical competency of the primary care doctors in addressing mild to moderate child mental health issues.”
Dr. Durette said a website has been created for the project, centers4cs.org, which includes educational materials and videos formed by fellows.
“We know there is a giant shortage of child psychiatrists and this is a way to provide more access,” said Dr. Durette. “When children show up with headaches and tummy aches and nobody can figure out why, it’s probably a good idea to call the PAL line. This program also helps us deal with stigma problems. Many parents are reluctant to take their children to a mental health professional because of the unfortunate stigma involved with mental health. This way they can keep their child in the primary care home and still get the mental health help their child needs. It’s a project that really works.”