Dr Robin Henderson on Early Intervention in Mental Health

There is no such thing as intervention for mental health that is too early—one of the most interesting early interventions Robin Henderson, PsyD, director of behavioral health services and interim director of health integration at St. Charles Health System, has been involved with is in the neonatal intensive care unit.

Transcript (slightly modified for readability)

What is the importance of early intervention for patients with mental health issues? And how best can hospitals, providers, and health systems intervene early?

One of the things that I have the most fun doing at St. Charles health system is when we started looking at the impact in our neonatal intensive care unit (NICU). Talk about early intervention—let's talk about neonatalogy, right? So we know that children who were born less than 32 weeks or may have other difficulties during their birth are at a higher risk of neurodevelopmental disorders. And many of those neurodevelopmental disorders formulate into things like autism spectrum disorders and other things that are traditionally seen in the mental health field along with the physical health field.

So we brought a psychologist into our NICU about 5 years ago, who began working with families in that early stage to teach them how to stimulate their children's brains in that very earliest of stage there in the NICU, and what cognitive markers to look at for growth and development. And then we followed those children for the first 5 years of their life. They come in every 3 months, 6 months, year, whatever, until they are 5 years old, when a team of specialists, including the psychologist, sees them to see if we can track and trend early development of neurodevelopmental disorders and other types of things. That type of intervention saves brain. That's what makes a huge difference between a child's early life costs, which can be very expensive, and their lifetime costs, which without intervention can be in the millions. That's one way we see developmental disorders and the development of that.

We put psychologists into our pediatrics clinics about 3 years ago. We've seen a lot of great ability to intervene with ADHD without medication, to intervene with other types of behavioral disorders. Because normally parents take their child to the pediatrician. That's where we see the bulk of mental health presentation in children. Parents don't go "oh, wait, my child seems to have some type of mental health disorder, so I'm going to take them to a mental health professional." No, they go to the pediatrician. So why not put mental health where parents are taking their children so we can start to intervene earlier.

And the third thing that we're doing [which we started in fall 2014] is interventions in school-based health centers. I'm really interested in what we can do in the early identification of depression and other difficulties in middle school. So if we say to everybody in 7th grade health, "you're all going to take this depression screen or you're all going to have be assessed for alcohol and drug, etc," and then put providers in the school to deal with them, I think we're going to be able to get better early identification and intervention in what is a high-risk population in middle school and early high school before we develop into some of the other types of tragic events that we've seen.