Experts say Montefiore’s new program is a rare example of mental health services for children under 5 ... [m]any pediatricians are not trained to recognize psychological problems, and surveys show that parents often complain about physicians’ lack of support for behavioral issues.It's not only effective, but efficient:
“There is really a disconnect between the genuine needs and challenges that are facing our young children and their families and what doctors are providing,” said Dr. Dina Lieser, executive director of Docs for Tots, a nonprofit group that advocates for young children.
At the Comprehensive Family Care Center, there is a psychologist on site, and doctors — who are trained to recognize depression in parents — screen each patient for mental health concerns. Of 2,400 children screened since 2005, 1,120 have been recommended for mental health services, and 780 have participated.
The screening program currently costs the city $20,000 to $30,000 a year; therapy is generally covered by Medicaid. The Altman Foundation has covered the $150,000 yearly cost for a separate program, known as Healthy Steps, which since 2006 has screened 250 families at the family care center and provided individual and group counseling.
In Healthy Steps at Montefiore, which is part of a national program, 20 percent of the mothers are teenagers, 27 percent grew up in foster care, 37 percent have parents with mental illness, and more than 10 percent were physically or sexually abused — all risk factors for their babies’ healthy mental and social development, according to Dr. Briggs. Research shows that environmental factors like poverty, homelessness, domestic violence and drugs can lead to depression, anxiety, aggression, poor academic performance, autistic behavior and social or developmental delays.
According to doctors at Montefiore, a child enrolled in the Healthy Steps program is one-third as likely to score “at risk” for social or emotional developmental problems. Among mothers in the program, depression dropped from 30 percent at the first visit to 6 percent after two months, while 35 percent reported feeling unsupported at the first visit compared with 10 percent at two months.