Paid sponsorship by Ohio Chapter, American Academy of Pediatrics
A new resource is available now to support pediatric behavioral healthcare in Ohio—the Ohio Pediatric Psychiatry Access Line (OPPAL)!
OPPAL offers family physicians and other primary care clinicians in Ohio access to a telephone helpline for same day, convenient peer to peer consultation with child psychiatrists.
Consultation and enrollment through OPPAL is now available by calling 614.605.1511 or visiting the OPPAL website.
Child psychiatrists from across Ohio will provide consultations through OPPAL Monday through Friday between 9:30 a.m. – 4:30 p.m..
In the following Q&A, learn more about OPPAL from team members Mary Gabriel, MD, and Sarah Lytle, MD, who lead the OPPAL efforts at University Hospitals Rainbow Babies and Children’s Hospital.
Q: What do you feel is most important about having this program in Ohio?
Dr. Lytle: Data suggests that 20% of kids in the United States have some form of mental illness1 and only about 20% of those receive treatment.2 There’s a dearth of child psychiatrists overall with 10,500 child psychiatrists to cover 15 million children in the United States.3 In Ohio, most counties don’t have child psychiatrists at all.4
The limited access to child psychiatrists means kids who have mental or psychiatric disorders are going to be seen in the offices of family physicians or pediatricians. I would say that from my experience, family physicians and pediatricians historically aren’t provided with a lot of behavioral health education. I think that’s changing and has improved over time, but historically, I think that was the case. This program is basically giving pediatric clinicians direct access to consult with a child psychiatrist who’s an expert in psychiatric disorders. They can speak directly with a child and adolescent psychiatrist on questions related to diagnosis or medication management, as well as getting recommendations for services. Hopefully, that’s enhancing their training and education, and helping them be more comfortable managing and treating mental health issues that come up in their own practices.
Dr. Gabriel: I think the most important thing is clinicians feeling supported and empowered to do this kind of work. As a pediatrician, I remember that, with any condition I would start to treat, I could only go so far because of my training – so then I would call my expert friends. For example, if I saw a patient who I could not get rid of an ear infection despite all my best efforts, I’d call my friend, the pediatric ENT and I’d say, “Here’s what I’m seeing, here’s what I’ve done, this is what happened – what should I do next?” And she would coach me so I could do more before ever having to consider referring. She would give me guidelines for when to refer, what I should look for, and what I could do.
Wouldn’t it be great if we could do that for mental health? I think that’s where OPPAL comes in. I think each of the children’s hospitals in the state has tried to implement something like this within their own system, and this just upscales that. The more comfortable a clinician feels doing this kind of work, the more empowered they are and the more likely they are to do it. That saves child and adolescent psychiatrists for the really sick kids. This program also allows youth to access care earlier in their illness. They will see their family physician or pediatrician long before they ever see me. What if we can start treatment earlier? They get better sooner, and we minimize the impact these illnesses have on their development and trajectory. I think it takes down silos and it allows a patient to get the care in the way they need it.
Q: How do you feel OPPAL can best be used to be the most helpful for a family physicians’ office?
Dr. Gabriel: I think a couple of different ways. One is certainly the recommendations that Dr. Lytle and the other consulting psychiatrists provide. It’s also a clearinghouse for resources around the state. If you need something that is non-psychiatric or medication management oriented, we provide that.
I think family physicians could also use it as not only sort of a services resource, but an education resource; most of the major children’s hospitals will have ECHO programs to help educate family physicians. I think utilizing that can be really impactful; family physicians can really start changing culture in a way as they get more informed in their offices.
Dr. Lytle: I think it really goes back to what Dr. Gabriel said earlier about calling a colleague to say, “What do I do in this situation?” We’re all doing that in any field and between fields.
Q: What would you say to a clinician who’s hesitant about calling OPPAL?
Dr. Lytle: We’re all trying to collaborate and trying to provide the best health outcomes for children. If you’re not sure about something, talk to somebody who maybe knows a little bit more, has a little bit more training, or has seen that more often than you have. We all need to do that.
Dr. Gabriel: There is absolutely no shame in not knowing something. In fact, I think we should normalize not knowing in medicine because that kind of humility then allows us to seek out the answer.
Then there is the matter of discomfort. We’ve got a whole team of specialists from whom you can get that answer. Even when it’s a clinician saying “I am way out of my comfort zone, I don’t know what I should do next. Can you help?” Yes, I’d love to help! That’s what I’m here for. I think they’ll be pleasantly surprised the first time they use it, and any sort of angst about calling will very quickly dissipate once they engage. We’re here as teammates.
The Health Resources and Services Administration (HRSA), Department of Health and Human Services (HHS) provided financial support for OPPAL. The award provided 51% of total costs and totaled $1,327,033. The contents are those of the author. They may not reflect the policies of HRSA, HHS, or the U.S. Government.
- Leeb, R.T., Danielson, M.L., Claussen, A.H., Robinson, L.R., Lebrun-Harris, L.A., Ghandour, R, et al. (2024). Trends in Mental, Behavioral, and Developmental Disorders Among Children and Adolescents in the US, 2016–2021.
- Meng JF, Wiznitzer E. Factors Associated With Not Receiving Mental Health Services Among Children With A Mental Disorder in Early Childhood in the United States, 2021–2022. Prev Chronic Dis 2024;21:240126. DOI: http://dx.doi.org/10.5888/pcd21.240126
- https://www.aacap.org/AACAP/zLatest_News/Severe_Shortage_Child_Adolescent_Psychiatrists_Illustrated_AACAP_Workforce_Maps.aspx
- https://www.aacap.org/aacap/Advocacy/Federal_and_State_Initiatives/Workforce_Maps/Home.aspx