February 11, 2005

Center’s care of children in state custody lauded as among nation’s best

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Gerald Hickson, M.D.

Center’s care of children in state
custody lauded as among nation’s best

Tennessee's TennCare Centers of Excellence (COE) for Children in State Custody has been recognized by the American Psychiatric Association as one of the six most innovative programs in the country.

There are three COEs across the state, one of which is at the Monroe Carell Jr. Children's Hospital at Vanderbilt. The others are housed at the medical centers of East Tennessee State University and the University of Tennessee-Memphis.

“In recognition of their response in addressing this service gap and their ability to coordinate treatment and other services for this previously neglected population, the TennCare Centers of Excellence for Children in State Custody in Tennessee have been awarded one of APA's Silver Achievement Awards for 2004,” said Cheryl S. Al-Mateen, M.D., chair of the APA's achievement awards committee.

The committee noted that the Centers of Excellence have proven expertise in effectively identifying and addressing obstacles to treatment and services for children in state custody and their families. More than 2,170 children who are in, or at-risk of, state custody have been served statewide by the centers, with 1,018 (47 percent) of those served by the Vanderbilt Center of Excellence (COE).

The Vanderbilt COE was established in 2002, thanks to a three-year, $2.1 million state grant awarded to the Psychiatry and Pediatrics departments. The center offers early and periodic screening, diagnosis and treatment services. The program has provided consultative and clinical services for the mental and physical health care of patients under 21.

Vanderbilt's COE serves 39 counties in Middle Tennessee. It is directed by Gerald B. Hickson, M.D., professor of Pediatrics, associate dean for Clinical Affairs, and director of the Vanderbilt Center for Patient & Professional Advocacy, and Tom Catron, Ph.D., associate professor of Psychiatry, executive director of the VUMC Community Mental Health Center, and co-director of the Center for Psychotherapy Research & Policy at the Vanderbilt Institute for Public Policy Studies. Catron and Hickson worked closely with the state for nearly three years to devise the plan for the COE's role in bringing the federally required services to children in custody.

“It is such an honor to be recognized by the APA. The COEs represent the success and innovation that academic medical centers and state partnerships can accomplish in addressing children's health issues,” Catron said.

“We are dealing with children who have complex mental and physical conditions,” said Hickson. “Vanderbilt offers an overall strength at examining complex cases and providing oversight and coordination of the services they may need.”

A behavioral clinic, established out of the Psychiatry's Community Mental Health Center, provides diagnostic, treatment and placement consultations, psychological and psychiatric evaluations, and medication management for program participants. Three child psychologists, one child psychiatrist, a psychiatric nurse practitioner and a social worker staff the clinic.

In addition to providing care coordination, COE faculty and staff meet monthly with state Department of Children's Services (DCS) workers in the region to discuss cases and to streamline case management. Faculty and staff also train DCS personnel and community providers in best practice methods and evidence-based treatments.

“We're all part of the same team,” Hickson said. “We want to know what we can do to improve efficiency.”

Children in state custody often have higher rates (30 percent to 40 percent) of mental health problems than children not in custody. Problems include depression, substance abuse and behavioral problems in school.

For more information, contact the COE at 322-8701 or toll-free at 1-866-COE-VCOE (263-8263).