Healthcare providers continue to transform delivery of care, changes driven largely by reimbursement policy. Mental health, in particular, is high on Orange County healthcare providers’ priority list, and Children’s Hospital of Orange County is spearheading one effort as part of a larger mission to improve children’s health and well-being.
Orange County has about one bed for every 22,000 children and none for children younger than 12, said CHOC Chief Executive Kim Cripe.
CHOC is addressing the gap with the addition of an 18-bed mental health center it announced in 2015 and scheduled to open in 2018. Now it also plans to collaborate with a network of other hospital systems, including Kaiser Permanente and St. Joseph Hoag Health, as well as community organizations, such as schools, religious institutions and county agencies, to build a stronger community system ensuring better access to mental health resources and care for children.
“It is hard to believe how a mental health problem can manifest itself at a very young age,” Cripe said. “We have seen a startling number of visits [from children with psychiatric crisis].”
One out of five children suffers from a mental health condition, according to the National Institute of Mental Health, and Cripe said that translates to more than 150,000 children in Orange County.
“The healthcare community [ought to be] thinking about mental health relating to preschools, to faith-based communities, to tech companies … and the role they can play in the next three years,” said CHOC Chief Psychologist Heather Huszti.
She stressed the importance of bringing nonhospital entities into the conversation about needs because children interact in settings beyond the home or hospital.
CHOC is working with data on children with behavioral problems who are at risk of or who’ve been expelled from preschools in order to develop a pilot program to help child care workers manage the children’s behaviors and identify treatment resources.
The hospital also is working with faith-based groups, such as Saddleback Church and Jewish Family Services, and with the department of psychiatry at the University of California-Irvine to help with education, research and training.
“[Our initiative] is really a good learning lab of what we are thinking about the health of the community, and not just healthcare for the sick.”
Mental disorders can be difficult to diagnose in children. Huszti attributed the lack of treatment for children with mental health disorders to children’s limited range of expression in speaking about their health and to medical professionals who don’t recognize that children can have mental disorders.
She has observed a range of psychiatric disorders in her role, including attention deficit disorder, depression, anxiety, suicidal behaviors and episodes of sudden rage.
“Every child throws a tantrum sometimes, but when it’s persistent and above what’s normal, there’s something to worry about,” Huszti said. She gave examples of abnormal reactions, including uncontrolled rage problems with transition, “like when being told to put down the video game and come to dinner—a lack of flexibility.”
Huszti emphasized the importance of early intervention, adding that approximately half of adults with severe and persistent mental health problems have diagnosable symptoms before age 14.
“We know even for more severe disorders like schizophrenia, early prevention can stop a psychotic episode from happening again,” Huszti said. She added that children’s brains are much more elastic, hence early treatments provide a chance to stop a mental disorder from becoming recurrent. “It’s much harder when it’s persistent.”
The planned center will provide mental health care for children between the ages of 3 and 18, as well as specialty programs for children younger than 12. All 18 beds are private rooms, making the center the only private-room facility in California.
The center will have an outdoor playground and multipurpose areas for consultation, therapy and quiet time. Huszti said CHOC is looking to create a place that’s safe and welcoming in order to promote optimum healing.
“It’s scary for the family, kids. We think it’s good for kids to be in an environment where they can calm themselves … and as we deem appropriate, [these rooms allow] for parents to stay with their kids,” Huszti said.
Construction started in September and is scheduled for completion in the first half of next year, Cripe said.
It’s funded by a state grant and private philanthropy, including a $5 million lead gift from Sandy Segerstrom Daniels. Other local donors include George and Julia Argyros.
Segerstrom Daniels is co-managing partner of South Coast Plaza and a partner in C.J. Segerstrom & Sons and HTS Management, all in Costa Mesa. The Argyroses have broad holdings in real estate and other interests.
Cripe said that approximately $20 million of the $27 million needed for the facility build-out has been largely funded. CHOC will also raise an endowment to help sustain the initiative.
The program’s annual cost is projected to reach $16 million and startup costs about $11 million, according to a CHOC spokesperson.
“People stepped up, and we raised a lot of money [through private philanthropy],” Cripe said, “but we need to make sure we have sustainable resources moving forward.”
More Beds
Orange County, on the public-sector side, is contracting with a Culver City nonprofit organization to open a 22-bed psychiatric crisis stabilization unit this year in Garden Grove to care for children ages 13 and older, and adults.
California had 6,587 psychiatric beds as of 2014, 628 of those for children and adolescents, according to data compiled by the California Hospital Association’s Center for Behavioral Health.
