PAMF, Local Alliance Addressing Suicide Risk, Depression in Teens
Adolescence is a time of change: physiological, psychological and socio-cultural. With change comes stress and anxiety. Mood swings are common among teens and if you add depression, mental illness or substance abuse to the mix, tragedy is too often the result.
Suicide is the third leading cause of death among adolescents, according to the Centers for Disease Control and Prevention.
This fact was brought home to the local community in late 2009 and early 2010, when the City of Palo Alto experienced a series of teen suicides. The community searched for solutions, and it became obvious to the Palo Alto Medical Foundation (PAMF) that the health care providers needed to reach at-risk teens more effectively.
Mental Illness and Adolescence
According to the National Institutes of Mental Health, half of all mental illnesses manifest by age 14 and three-quarters by age 24. Despite this early onset, most people delay getting treatment for at least 10, and up to 30 years.
Meg Durbin, M.D., a PAMF primary care physician, asserts that one of the main obstacles patients encounter when getting treatment is that mental health care is often disconnected from primary care. This is due to three factors:
- “Carve-out” plans: Insurance companies “carve-out” behavioral health from general medical coverage, so while patients may get their medical coverage at PAMF, they must get their mental health care through providers outside of PAMF’s system
- Stigma of mental illness: Decades of stigmatization make families reluctant to recommend behavioral health services
- Lack of resources: Insufficient staff and tools, inadequate training for primary care to screen and treat behavioral health concerns
“Patients often must surmount many hurdles to get mental health care, at a time when they are feeling most vulnerable. They may have insurance coverage to get their medical care, but psychotherapists and psychiatrists are often outside that insurance network,” says Dr. Durbin.
Local Alliance Takes Action
Dr. Durbin is one of the doctors on the executive committee of a local consortium called the Healthcare Alliance for Response to Adolescent Depression (HEARD). HEARD’s goal is to improve collaboration between primary care providers (PCPs), mental health professionals and education professionals to better respond to adolescent depression.
PAMF and Sutter Health have been working on removing the obstacles between primary care and mental health care over the past two years, including:
- Building a $20-million state-of-the-art behavioral health facility at Sutter affiliate Mills-Peninsula Medical Center, expanding adolescent inpatient bed capacity
- Keeping an ongoing adolescent education website written by teens and PAMF providers: “We’re Talking!”
- Finalizing software improvements that will score and track depression screening test results in the patient’s electronic health record
- Working with Sutter Health to address behavioral health gaps and overcome barriers to depression screening
“We do an excellent job caring for our patients with medical problems such as heart disease,” says Dr. Durbin. “We can and must do better to care for those with broken hearts and other psychiatric problems. We need to develop our system of care to support our physicians and staff as they reach out to our patients.”
Additional Resources on the PAMF Blog: