VHAN Behavioral Health Consult Line Helps Physicians Build their Capacity
When a teenage boy with autism and ADHD was suspended from school for creating a drawing with dark subject matter, Timothy Eidson, MD, a pediatric primary care provider at Vanderbilt Children’s Hospital, considered sending him to the emergency department (ED). The boy had also disclosed depression and passive suicidal ideation during the exam, and Dr. Eidson wanted to connect him to help as quickly as possible. Hoping to find an alternative to the ED, he reached out to the VHAN Pediatric Behavioral Consult Line for an urgent consultation.
Dr. Eidson reached Rebecca Sebastien, LCSW, MPH, a VHAN behavioral health pediatric partner and the primary clinician for the consult line. Sebastien recommended finding a partial hospitalization program for the teen.
The boy’s family had been struggling to connect him to the right therapy resources. So, his mother was relieved that, based on Sebastien’s recommendation, he was admitted to a partial hospitalization program and now has good options for ongoing therapy and medication.
The mother said that partial hospitalization is “the farthest we’ve ever gotten” in treatment for her son. She wrote in an email to Sebastien: “Thanks again for your attention and truly providing the peace of mind I was looking for! It’s people like you who truly make a difference in the lives of those who are in need.”
Real-time Phone Consultations Decrease ER Usage
VHAN offers two consult lines, one for pediatrics and one for adults. VHAN providers can have real-time phone consultations with a licensed clinical social worker to help manage patients’ mental health needs, even if patients are not covered by VHAN-managed insurance. The goal is to decrease ED utilization while giving patients and families viable, convenient resources for care without long wait lists or insurance challenges.
The consult line team also helps physicians provide urgent services before a formal treatment plan begins. Physicians can have medication consultations with a psychiatrist and even schedule a one-time psychological or psychiatric assessment for the patient.
Providers say the line offers support in an area in which many of them have not received formal training. “Overwhelmingly they say they really need help advising on behavioral health issues,” Sebastien adds. “They’re seeing more behavioral health needs in the exam room, and often they are the first person to hear about it from patients and families. We help them provide the most appropriate level of care.”
She stresses that, when clinicians reach out to the consult line, “our goal is to build their capacity, not ask them to do something outside their scope of care.”
Treating the Whole Patient
All the services provided through the consult lines help physicians treat the whole patient—not just their symptoms. Sebastien points out that symptoms like increased irritability, gastrointestinal issues, migraines and difficulty sleeping can be tied to an underlying mental health issue. “The consult line helps providers navigate care not just from a physical or mental health perspective, but in tandem,” she says.
VHAN behavioral health partners also support physicians with educational initiatives, including podcasts, webinars and more.
“I have observed providers increasing their confidence and asking more nuanced clinical questions,” Sebastien says. “They are more willing to manage complex challenges, which connects their patients to a sense of hope, lowers provider burnout and increases resiliency.”
Sebastien regularly hears two comments from providers regarding the consult line. When they first call seeking help, they often say they are “at their wits’ end,” she says. “But later, it’s ‘I don’t know what I would do without you guys.’”