Issue link: https://beckershealthcare.uberflip.com/i/1462389
35 QUALITY IMPROVEMENT & MEASUREMENT Children's Hospital Colorado's 1st mental health-in-chief on the now or never moment facing the US By Lauren Jensik and Alia Paavola L ast May, Children's Hospital Colorado declared a state of emergency in pediatric mental health aer seeing its emergency department and inpatient units "overrun with kids attempting suicide" and suffering from other mental health conditions. As part of the declaration, the hospital made a commitment that it would address the worsening crisis. One of the major shis included creat- ing a new leadership role, the mental health-in-chief. K. Ron-Li Liaw, MD, assumed the inaugural role at Children's Hospital Colorado in September 2021. In her role, which is on the same level as a pediatrician-in-chief or surgeon-in-chief, she is tasked with ensuring pediatric mental health is top of mind in every decision made at the hospital. Dr. Liaw, a pediatric psychiatrist, also serves as chair of the organization's Pediatric Mental Health Institute. She previously spent 14 years as a clinical associate professor for the department of child and adolescent psychiatry at NYU Langone in New York City. During her tenure, she was the director of the Sala Institute's Child-Family Services and Resilience Programs and chief of service for child and adolescent psychiatry. Here, Dr. Liaw shares with Becker's more about the inaugural mental health-in-chief role, her top goals for 2022, the biggest challenges we need to overcome and the "now or never" opportunity to create the mental health infrastructure needed to address the pediatric mental health crisis. Editor's note: Responses were edited for length and clarity. Question: The role, mental health-in-chief, is a unique C-suite role for health systems in the U.S. How did this posi- tion materialize? Dr. K. Ron-Li Liaw: Looking at how children's hospitals are struc- tured, especially the executive leadership team, you're 100 percent right that this is very unique and I think a first-of-its-kind role. I do applaud Children's Hospital Colorado's leadership under our CEO Jena Hausmann and department chair for psychiatry, C. Neill Epperson, MD, at the university's medical school. Because of the elevated awareness of the pediatric mental health crisis in Colorado and nationally, these two leaders and the executive team at Children's Hospital Colorado really raised this as a priority to make sure we have the right mental health leadership in every conversation. at meant creating a new role, the mental health-in-chief, who would sit at all of the decision-making tables for strategy, partnerships with state and local agencies, and the federal government. e role is designed to bring mental health research and discovery to our clinical continuum of care, training programs and workforce development initiatives. ose leaders really placed mental health at the center of everything that we do in children's healthcare, which I, as a child psychiatrist, am so grateful for. I am excited for the opportunity to step into this role, because there's not one like it in the country. Q: What are the main goals and priorities for you as mental health-in-chief in 2022? KL: We just kicked off an envisioning and planning process for children's mental health for both Children's Hospital Colorado as well as Colorado University Anschutz Medical Campus. Our goal is to build a best-in-class, high-quality, highly-coordinated children's mental health system for Colorado in partnership with local, state and federal agencies as well as community partners. We are obviously facing an incredible mental health crisis, partic- ularly at our emergency department and our higher levels of care. ere is a new behavioral health administration for Colorado. I'm meeting with the new director of that agency as well as other mem- bers of Governor [Jared] Polis' leadership team to really think about how we can reimagine and redesign children's mental healthcare as part of child well-being and children's healthcare at large. at redesign and the way in which we think about mental healthcare means not just investing in acute and emergency services but really thinking about prevention and early intervention. at upstream mentality is where we'll be focusing our strategic plan. Also, we have a critical shortage of mental health providers, child physiatrists and care team members nationally. I think the stat is 9.75 child psychiatrists per 100,000 kids. But what we really need is, at a minimum, 47 child psychiatrists per 100,000 kids. Even with 47, that means for me as a child psychiatrist, I would be caring for or overseeing the care of 2,000 children. It's just shocking. So another priority for me is addressing this. ere's a really diverse workforce of potential to bridge the gap. For example, we could tap masters-level clinicians, social workers, licensed professional counselors, nurse practitioners, physician assistants and community mental health folks to create a diverse mental healthcare team that represents the diversity that we see in our society. Mental health professions are different from being a cardiologist or an ophthalmologist. ere's very unique things that you have to un- derstand. People come from different backgrounds and face different challenges. It's very local, so it is important to have people who are from the community helping. So, in short, I am really focused on systems design, partnerships and building a different kind of mental health workforce that reflects the diversity in our communities. Q: What do you anticipate being your biggest challenges in trying to accomplish these things? KL: ere's the vision, and then there's the reality. I think the biggest challenge will be making sure that we are moving in the same direc- tion in the advancement of our children's mental health system with our state partners in creating this new behavioral health adminis- tration, working with child welfare and the Education Department. It'll take all of our systems working in concert and investing in concert to really change the lives and trajectories for other kids who have been dealing with a COVID-19 pandemic, increasing rates of depression, anxiety, suicide and disruptions to learning. It's going to take all of us. I think those will be some of the big chal- lenges and really getting aligned, and it will take coordination and investment. I think the workforce issue that I mentioned also poses a challenge. If I could magically wave a wand and staff all of the critical roles that we have available on our mental healthcare team, those direct-care staff as well as those working in the community, as well as our specific leadership program development, we'd be in a really great space. But we don't have that pipeline where we have