Mental health care for children in Boone County faced two major roadblocks before 2014: a lack of access to child psychiatry and costly care for families who were underinsured or uninsured. Since the launch of the MU Bridge Program in March 2015, 394 children can access more affordable psychiatric services. Child and adolescent psychiatrist and MU Bridge Program director Laine Young-Walker says she knew there were not enough psychiatrists to go around, so she and nurse program manager Carole Schutz decided to develop a program that would help children who need affordable care.
Before the program was initiated, nurse program manager Chris Petner, along with Schutz and Young-Walker started pilot work and data collection to test its effectiveness in 2014. Additionally, the Children’s Services Fund devoted $682,770 in funding to expand the program’s research in 2017.
“One of the things we decided early on with the Bridge program is it really is a bridge,” Young-Walker says. “It’s for children who have not been able to access child psychiatry services, either because they are not insured or because their parents don’t know how to navigate the system.”
The focus of the MU Bridge program is early intervention. Peer-reviewed research from the past decade shows this leads to better outcomes for children with mental illness. Petner says the hope is that addressing mental health at an early age will help reduce the stigma long term. Another goal of the program is to improve the mental health of young children so they are more successful in school, which will help everyone in the classroom be more successful, Young-Walker says.
The program works with children ages 5 to 19 in all Columbia Public Schools and the county districts of Centralia, Hallsville, Harrisburg, Sturgeon and Southern Boone. It offers help to any school-age child who resides in Boone County, including homeschooled children.
The largest number of referrals come from school counselors, Young-Walker says. They can also come from parents and primary care providers. Petner says the program referrals from pediatricians have been great for integrating mental health and primary care.
“A lot of these primary care physicians can treat these kiddos for ADHD and things, but sometimes it gets a little more complicated,” Petner says. “We can have expert opinion on that, and they can still transition that to their primary care physicians.”
Once the child is referred to the program, they receive two to four on-site psychiatric evaluations at their school for no cost, Young-Walker says. The first evaluation determines what the child needs. If they don’t need psychiatric services, then they are referred to other appropriate medical staff.
If the child is found to need psychiatric treatment, he or she will continue to meet with the program staff. During the child’s second visit, a doctor typically determines what further treatment the child needs and will make an appointment for him or her with another provider. As the child waits for that appointment, he or she is still treated by the program.
“If they’re determined to need medication, then we provide the medication management based on the parents’ consent,” Young-Walker says. “And we follow them to get them to stability and then do a warm handoff to other agencies.”