O1126: Child Life Specialists Use Telehealth to “play” an Innovative Role in Health Enhancement and Wellbeing to Support Mental Health Needs for Complex Pediatric Patients

Background: Pandemic-related isolation and anxiety substantially impacted youth over the past 2 years, particularly those with complex diseases and from under resourced communities. Additionally, a mental and behavioral health crisis for children and youth has been declared. Friendships, connections, and social groups were some social supports that were greatly restricted. Due to increasing demand and growing needs, resources for mental health professionals became scarce, with long wait times to connect to services. Families expressed frustration and helplessness to their healthcare team. As children struggled to cope, child life specialists were in a unique position to be of help. Additionally, families were becoming more comfortable with telehealth to access care so we designed a program to capitalize on the growing use of telehealth and the availability of child life specialists in our organization.

Methods: Child life services for mental and behavioral health via telehealth were piloted with a subset of Medicaid eligible children with a chronic diagnosis. Nursing Care Navigators and the Specialty Care Team identified patients who would benefit and then the bilingual Child Life Specialist (CLS) performed phone outreach, intake, and set up initial telemedicine visits. Patients received on average 3- 4 follow-up visits for therapeutic art therapy, play therapy, normalization of disease, coping techniques, routine building, shared care planning, and connection to resources such as peer support groups. Additionally, a Family Advisory Council helped develop and vet materials prior to distribution to ensure diverse perspectives were incorporated. All visits were conducted via our EMR telehealth platform.

Results: For the past two years, the pilot enrolled 49 children with 1 Child Life Specialist who work once per week on the pilot. 47% of children referred had a positive depression screening utilizing the PHQ-9 tool and after the intervention 100% showed statistically significant improvement in depression scores upon rescreening (p < .001). Following the intervention, 78% did not need additional mental health services during the pilot period (Figure 1); 35% were proactively identified early and would otherwise not have been offered services.

Conclusion: Child life Specialists utilizing a telehealth platform have proven to be an asset to help meet the unique behavioral health needs of children with complex chronic health conditions and mental health concerns. They can serve as a bridge for mental health services while families navigate access issues and long wait times, and may even eliminate the need for more complex interventions. This novel telehealth approach is not only supported by our medical specialists but has also led to ongoing discussions for expansion of CLS staffing to scale our pilot to additional populations of children.