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Published in CenterView on January 28, 2013
Dr. David Elkin and Dr. Susan Buttross interview a patient in the CAY Center
Dr. David Elkin and Dr. Susan Buttross interview a patient in the CAY Center

New CAY Center streamlines mental health services for children

By Jen Hospodor

Thousands of Mississippi children and adolescents coping with behavioral and mental health issues need help, and they need it quickly.

Unfortunately, they often face myriad challenges in getting the help they need, whether it is confusion about which doctor to call or months-long waits for appointments.

The newly formed Children, Adolescents and Youth Center hopes to tackle some of these challenges by acting as a central entry point into the health-care system and quickly getting these kids to the right provider fast.

“There is not easy access; there is a huge waiting period and an incredible need,” said Dr. Susan Buttross, professor of pediatrics and chief of the Division of Child Development and Behavioral Pediatrics, who will serve as medical director of the center.

This sentiment, shared by Dr. David Elkin, professor of psychiatry and executive director of the center, served as the impetus for developing the CAY Center.

For the past several years, Buttross and Elkin discussed ways to make it easier for Mississippians to access behavioral health care for their kids. 

Behavioral and mental issues encompass and often coexist with a multitude of conditions, including autism, hearing or speech difficulties, genetic anomalies, psychiatric problems, neurological disorders and many others. As a result, these children need a wide variety of health-care services.

Elkin and Buttross knew their first mission would be to create a clear point of access into the system. For families and referring physicians, the CAY Center takes the guesswork out of deciding which department to call for appointments.

“We have difficulty knowing when to call psychiatry or psychology or developmental pediatrics,” Buttross said. “Even something as simple as ‘my child has attention-deficit hyperactivity disorder,’ does that go to psychiatry, does it go to developmental pediatrics?

“So what we wanted was something where there is one track. You enter here.”

Once the child enters the CAY Center for the first time, Elkin and Buttross streamline the process of getting the child to the right provider by interviewing the child together and deciding what the first step is.

“It’s about getting to the heart of the matter and then getting them to the right place more quickly,” Buttross said. “Sometimes when they come in, we both know within 10 minutes what needs to be done.”

The “revved-up, sophisticated triage,” as they call it, discards the traditional three-hour appointment block for new patients, allows more children to be helped in a single clinic day and, ultimately, shortens the next available appointment timeframe. 

“One of our biggest frustrations is the wait period is just too long for people,” Buttross said. “They say, ‘I’m having a terrible time, I need help,’ and we have to give them an appointment in six months.”

Elkin noted that while the streamlined process makes it easier to care for the multitude of children who need it, it also proves more cost-efficient over time – something he believes is vital in light of the possible 400,000 new Medicaid enrollees in the next decade.

“We have to be prepared to deal with that number of patients and I think we are in a position to lead on that. We need to address some of those changes so care doesn’t fall off for these children,” he said.

In future plans for the center are other multidisciplinary “triage” teams that assess patients in the same manner.

“That’s what got us going and energized about this as the possibility to effect large-scale change for the state of Mississippi,” Elkin said.

“The CAY center is a great joint venture between the Departments of Pediatrics and Psychiatry that helps the children of Mississippi with behavioral, developmental and learning disabilities,” said Dr. Rick Barr, Susan B. Thames Professor and Chairman of Pediatrics. “The team approach by Dr. Buttross and Dr. Elkin is quite remarkable and will be a model of future programs for Children's Healthcare of Mississippi.”

Elkin credits Barr and Dr. Gray Norquist, professor and chair of psychiatry and human behavior, with helping to formalize the partnership between the two departments.

“This represents a novel approach to the behavioral and emotional health care of kids in that two departments – pediatrics and psychiatry – that care for kids are coming together and pooling their resources for the sake of the kids,” he said.