New mental health care models in Connecticut offer ER alternative to children in crisis
A couple of refurbished, old red brick houses on Asylum Avenue in Hartford now host two new models of mental health care for teens and children.
The facilities are part of the Village for Families & Children and include an outpatient Urgent Crisis Center (UCC) which opened Thursday – it’s one of four UCCs statewide. An adjacent building will be the site of the state’s first and only sub-acute children’s mental health unit, scheduled to open in August.
Both sit in a zip code in which more than one-fourth of the population lives in poverty, where barriers to accessing health care include lack of transportation.
“We’re the only location in the state to have these beds,” said Dr. Laine Taylor, medical director at the Village. “It’s [for] ages 5 to 18, where kids who are in a crisis are not needing hospital level of care, but they can’t quite go home.”
Emergency departments at hospitals statewide are filled with kids that are waiting in the hallways, waiting long hours just to be assessed, but most of those kids don't need to be seen at the ER because they haven't had some life threatening situation “where they've either harmed themselves or someone else,” Taylor said.
“So we're hoping to have those kids be able to come to our [UCC] facility, which is a an outpatient facility, that's going to be a warm, comfortable environment where they'll get to see a clinician, they'll have a discharge plan, they'll have behavioral health supports as well as assessments in order to provide them all that they need without having to go to the emergency room so that the kids who really need acute emergency services are able to be seen there,” Taylor said.
Clinicians at the UCC will refer children that require longer-term care to the sub-acute unit next door. Up to 10 children can be admitted there at a time for up to two weeks.
“So at the Crisis Center, we’re able to come up with short-term crisis plans that include a plan for the parents on what they’re going to be able to do, and what the child will be able to do,” she said. “Sometimes you actually need several days of doing family therapy, individual therapy, and even maybe medication adjustments, in order to help the kid be able to stabilize.”
The four UCCs are attached to nonprofits that will hand over children and families for follow-on care, including psychiatric consultations.
The first to open was at Wellmore Behavioral Health in Waterbury in June, which has seen 12 children to date.
“Presenting issues have been as simple as, for the younger kids, hyperactivity,” said Kristin Pracitto, vice president of Child Services at Wellmore. “Some of the other kids have come in because of some feelings of uncertainty, family conflict, depressive symptoms.”
The other two centers are being opened at Yale New Haven Children’s Hospital in January 2024, and the Child and Family Agency (CFA) of Southeastern Connecticut in New London by the end of July, which has the capacity to see up to 12 kids in a day.
CFA is collaborating with the state’s mobile crisis unit, dispatched in response to 211 calls, to bridge care if a child seen at the CFA requires a higher level of care and hospitals have long wait times, said Erin Saylor, chief operating officer at the New London nonprofit.
Yale is in the process of building a unit next to the ER that will allow clinicians to care for families outside of the traditional ER model. “This is better for families and better for our overburdened, by volume, medical setting,” said Dr. Yann Poncin, vice chair for Clinical Affairs, Yale Child Study Center, which is collaborating for the UCC with the hospital.
“The setting allows for better therapeutic intervention. The pressures of a medical pediatric ED, including having bed availability for medical crises, will be decreased,” he said. “Time pressures will also be decreased in managing kids in mental health crisis [and] through our crisis intervention approach we can avoid an admission.”
Poncin said the UCC also allows for better continuity of care.
All four UCCs received one-time funding through the American Rescue Plan Act, a COVID-19 economic stimulus. The latest state budget does not provide funding to operate the crisis centers once the federal dollars run out.