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Two local health organizations are integrating mental health services into primary pediatric care

Renée Layman (far left)Dr. Shannon Fox-Levine Kimberly Brennan and Lauren Scirrotto sit at a table in discussion, while earing face masks. A laptop and other office supplies and cups sit on the table
Palm Beach Pediatrics
Center for Child Counseling CEO Renée Layman (far left) and Palm Beach Pediatrics and pediatrician Dr. Shannon Fox-Levine (far right) discuss their pediatric integration partnership with PBP practice administrator Kimberly Brennan and CFCC chief program officer Lauren Scirrotto.

A pediatric practice and a counseling center in Palm Beach County are teaming up to make sure their patients are physically and mentally healthy. That's especially important now, as the pandemic has worsened stress and anxiety for many children.

“As mental health professionals, we can’t do it all," said Renée Layman, CEO and president of the Center for Child Counseling in Palm Beach Gardens. “We also know that we don’t have to wait for a child to fall apart and have a mental health diagnosis before we do something."

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According to the Centers for Disease Control and Prevention, there's been a spike in children showing up at emergency rooms because of a mental health crisis. Layman says integrating mental health services into pediatrics, schools and childcare centers is an “early intervention strategy that is more important than ever.”

Layman says due to a critical staffing shortage across health care and mental health services, she has partnered with Palm Beach County Youth Services to have co-located behavioral health professionals who can handle early prevention needs and provide necessary specializations.

She is also working with Palm Beach Pediatrics on a new strategy designed to get kids the help they need before a mental health issue becomes an emergency.

Dr. Shannon Fox-Levine is president of Palm Beach Pediatrics and said there were issues brewing before the pandemic shutdown.

“The epidemic was before the pandemic. We had already been seeing a lot of anxiety and depression, and being able to try to manage that has been overwhelming for a pediatric practice,” Fox-Levine said.

Fox-Levine said the new care coordination strategy can help fill an information gap for patient care situations that are beyond her expertise.

“Recently, I [had] a teenager who had been struggling with diagnosable anxiety and depression through the pandemic. It presented mostly symptomatic through the pandemic, but even looking back, he had probably struggled,” said Fox-Levine. “And as we developed a relationship, he [revealed] to me that he is struggling with his gender identity. And that's where we struggle as a primary care medical facility is, 'How do we get this person with this particular insurance to someone who we think is going to get high quality care to help him get through something that he's struggling with?”

During the pandemic, Fox-Levine said she has seen more of her patients experiencing stress, anxiety or depression.

“We actually have about a 10 percent rate right now of diagnoses of anxiety and depression amongst our 20,000 patients, so that's 2,000 kids that we're managing right now. Some of them were before the pandemic,” said Fox-Levine. “There are definitely those kids that have been diagnosed in this past year and a half.”

She said the 10% doesn’t even include ADHD patients.

“While the pandemic may have increased numbers transiently last year, I do not believe it to be much higher, currently, than 2 years ago with everyone returning to school,” Fox-Levine said.

Incorporating mental health care into her patients' regular treatment allows health professionals to add nuance to the numbers. She said many of the children during the pandemic who were initially diagnosed with anxiety or depression turned out to be mere stress-related issues in response to the pandemic environment.

“And with just the support that we've been able to give them, whether it be with counseling and/or medication, a lot of them have improved,” she said.”

Fox-Levine partnered with Renée Layman because her primary care facility had difficulty credentialing their own licensed mental health counselors.

“We have a psychologist, we have a psychiatric nurse practitioner in our practice. But getting the insurance plans to allow us to credential the mental health professionals has been a major barrier," Fox-Levine said.

She called the situation “urgent” and that she was unwilling to wait for insurance plans to meet the demands and Layman had the resources at their fingertips.

Some of her patients will be able to access the newly available mental health services within the next few weeks.

“So even if they themselves don't have that therapist to address my patient with gender [identity] needs, they have somebody that they trust that they can send them to,” said Fox-Levine. “And so we joined Renée in trying to figure out how we can kind of help one another help the children.”

Wilkine Brutus is the Palm Beach County Reporter for WLRN. The award-winning journalist produces stories on topics surrounding local news, culture, art, politics and current affairs. Contact Wilkine at wbrutus@wlrnnews.org
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