From the Front Lines – A Note from Dr. Riseberg
As you know, both BCP and my perspective within it are unique: I continue to see patients while also fundraising and managing the operations of Boston Community Pediatrics (BCP). As a pediatrician, it is an incredible gift to partner with families on their child’s care and earn their trust.
This perspective provides me with the opportunity to share what I am seeing every day with donors, funders, and other community leaders. I do this to help build our mutual understanding of the challenges and opportunities that are relevant to our shared goal of pursuing equity in pediatrics. In that spirit, I will be sharing a timely update with you called From the Front Lines. It will be a raw, unfiltered snapshot of what we are seeing and learning here at BCP.
Recently, I saw a 16 year old Black teenage boy who was suicidal. As is customary in BCP’s integrated behavioral health model, his mental health clinician and I were together when he told us he didn’t feel safe. We spoke with his mom and let her know he needed to be evaluated right away. The family didn’t have transportation to the hospital so we sent them there in an Uber that BCP paid for. We knew that in this state of stress, we did not want them to have to find a ride or take public transportation (something many of us take for granted).
They sat in the emergency room for nine hours. At 4am, they were exhausted and still had not been seen by a provider. His mother asked for a cab voucher home. They were told they didn’t qualify for one since they had not yet been seen by a provider, so they walked two miles home at 4am — this is the reality of care for suicidal patients in our current system.
When I called that morning to check on him, Mom told me what had happened. I immediately called BEST (Boston Emergency Services Team) who agreed to see him over zoom. They evaluated him and said he qualified for either a CBAT or a partial program (CBAT is a short term hospitalization and a partial program is an outpatient day program patients attend five days a week usually for about two weeks). The partial program (day program) that was most likely to have space was in Brookline but he would have no transportation there everyday. When I called the BEST clinician to see what the plan was, she was shocked when I told her that BCP would pay for an Uber for him to get to and from the program for two weeks. She had never had anyone else offer to do this.
It makes no sense to me that our healthcare system would pay $500 per day for day program care but can’t (actually, won’t) pay another $50 per day to get him physically to and from this very same program.
We are in a mental health crisis. We need to change the way kids can access mental health care and routine medical care. We can do it.
BCP is leading the way with integrated mental health care: we give providers and mental health clinicians enough time to spend with patients to more fully evaluate their mental health and dedicated time to coordinate care outside of visits. And, as you can see from the above example: BCP is willing to do whatever it takes to match our patients with the care they need and make sure that they have the additional support needed to actually participate in that care.
There are innovative, out of the box solutions to change the way mental healthcare is delivered to all children. They exist at BCP. More systems just have to step outside of the box and do it.
Now it’s time for me to go back to the front lines…thanks for reading along.