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Psychiatry Newsletter - B-Hipp - More Than a Stopgap for Kids

Hopkins BrainWise - Winter 2014

B-Hipp - More Than a Stopgap for Kids

Date: December 16, 2013

Dr. Joyce Harrison
One benefit surprised co-principal investigator Joyce Harrison. “I call it the Wizard of Oz effect. By saying my psychiatric consultant told me this is necessary,” she says, “practitioners use us as a prod to help keep families on track.”

Here’s a typical scenario,” says child psychiatrist Joyce Harrison. A family with a 7-year-old being treated for psychiatric illness recently moved two states away. Unfortunately, the only child psychiatrist for miles couldn’t take new patients. When little Johnny’s parents went instead to the local pediatrician for three prescription refills, that doctor confided to a colleague, I don’t even know what these medications are!

The shortage of child psychiatrists is hitting America hard, says Harrison. “More and more behaviorally or emotionally disturbed kids are showing up on primary care doorsteps, and providers can’t just send them away.”

 True, states are exploring creative alternatives, yet ad hoc measures run risks, Harrison says. “Degree courses in child psychiatry aren’t the solution for already-busy clinicians,” she adds.

Now, a new plan to help should set a standard. Behavioral Health Integration in Pediatric Primary Care (B-HIPP) pulls together experienced Johns Hopkins child psychiatrists like Harrison and Larry Wissow with colleagues at the University of Maryland in a state- and federally supported program. Its goal: Offer pediatricians and similar primary-care providers a consultative safety net, resources and encouragement.

Central to B-HIPP is its telephone consultation service. Five physicians at both institutions take clinical call-ins, with medical director Harrison having the lion’s share. “I remember thinking,” she says, “oh, pediatricians will phone us about ADHD meds. But we’re hearing cases as complex as any in our psychiatric practices.

“Our plan has providers screening kids for emotional and behavioral difficulties, and calling us for advice about the more complex cases,” explains Harrison. B-HIPP also offers consults on medication and offers tactics gleaned from seasoned pediatricians as well as evidence-based psychiatry.

She adds, “We often hear relief in our callers’ voices.”

 For more information about B-HIPP and the training and referral services it also offers practitioners: