A New Holistic Approach to Child Health



A student shares a story with board member Adrienne James

Photography by Daniel Smyth and Liam o’connell

This is the first in a three part series about how The Children's Home of Cincinnati has changed and adapted to the new healthcare landscape. The second installment will be published next Thursday, February 26, and the final installment, following up on The Children Home's plans for integrated services, will be published the following Thursday, March 5. Check out all the pieces here!

 

As part of the health care transformation that has swept the nation, The Children’s Home is changing. The organization, founded in 1864, has established a stellar reputation as a leading provider of education and mental health treatment for children facing significant social, behavioral and learning challenges. Now The Children’s Home is broadening its impact by integrating physical health care with the existing behavioral health care it already provides.

Staying ahead of the Curve

“The Children’s Home intends to stay ahead of the health care curve by being a catalyst for changes that will weave together different parts of the health care system, so children’s health care is approached in a coordinated, holistic way,” said Ellen M. Katz, president and CEO of The Children’s Home.

One of the steps the organization has taken in this direction was the 2013 addition  of Barbara Terry as the vice president of healthcare integration, a new position designed to identify and advance opportunities for The Children’s Home to build a greater presence in the health care market.

“As we all know, the Affordable Care Act brought debate and emotion to the forefront,” said Terry. “It also brought attention to the challenges inherent within our current health care delivery systems.

“Integrated care is about the organization and management of behavioral and physical health services so that people get the care they need, when they need it, in ways that are user-friendly, achieve the desired results and provide value for the money,” Terry continued. “Integrated care is not a structure or a thing. It’s about responding to needs, so that the child receives the right care at the right place at the right time. All the systems need to work together.”

An Evolution of Services 

While Terry’s role at The Children’s Home is relatively new, the concept of integrated care began to develop a several years before her arrival, when Dr. Phillip Lichtenstein, a pediatrician, was hired as The Children’s Home first medical director. The Children’s Home certainly saw the benefit of integration, but hadn’t yet acted on it in a significant way.

According to Terry, behavioral and physical disorders co-occur and need to be treated from a holistic viewpoint. “A holistic approach addresses the mind and the body,” she said. “Back in 1948, the World Health Organization defined health as a state of complete physical, mental and social wellbeing — not merely the absence of disease or infirmity. Even though we knew it made sense to look holistically, the funding streams were categorically separate and the services followed suit. Now we have the opportunity to embrace a shift from paying for volume, which was about the number of procedures, to paying for value, which is about assessing whether people are healthier. Integrated care can help make that happen.”

Terry cites two examples of why a holistic approach makes sense: asthma and obesity. “Asthma is a complex, chronic disease that affects many children and results in hospitalizations, preventable deaths and high healthcare costs,” she explained. “Research has shown that nearly 50 percent of asthma patients suffer from clinically significant depressive symptoms, which have been, in part, attributed to the stress of having a chronic illness. Similarly, emotional factors are thought to play a role in triggering asthma attacks.

“Obesity among children and adolescents is skyrocketing,” she continued. “The Centers for Disease Control reports that more than one-third of children and teens are overweight or obese. Data shows that these children tend to be at greater risk for social and psychological problems. Depression, anxiety, stress, ADHD, trauma and loss can all lead to weight gain. Researchers aren’t quite sure if obesity causes depression or if depression causes obesity, but the two are definitely linked. In fact the two conditions are so intertwined that some are calling obesity and depression a double epidemic.

“Clearly, physical health influences mental health, and mental health influences physical health,” she said. “We want to weave together different parts of the health care system so that children’s health is treated in an integrated way.”

What's the New Model? 

The ultimate goal of the service expansion is to provide services that are not disjointed and which the child’s family can easily navigate.

“We provide education and mental health treatment services, so it makes sense that we might also coordinate primary care and oral health services, for example,” she said. “This may mean offering additional services such as immunizations and dental sealants on our campus, or it may mean coordinating access so that the child’s family can easily get to the appropriate service provider in the community.”

“We want to weave together different parts of the health care system so that children’s health is treated in an integrated way.”

Adaptation is nothing new for the organization. Having long ago moved on from its roots as an orphanage during the Civil War, The Children’s Home now offers a full array of programs in special education, therapeutic treatment, focused child care, mental health counseling, family support, substance abuse counseling, home visits, parent resource groups, summer camps, preschool, a high school for children with autism spectrum disorders and more. Building confidence and self-esteem are top-priority targets here.

But “here” isn’t just on its Madison Road campus. The Children’s Home is now providing services in three states — that’s 53 counties, 59 cities and 115 neighborhoods.

Given this enormous impact, it’s little wonder that the motto of The Children’s Home is “Amazing Stories. Created Daily.” Every day, the organization’s clients are taught the skills they will need to overcome their challenges and become more.

“Our mission is to transform lives,” said Janet Burns, vice president of development for the organization. “Integrated care is important to this mission and is foundational to the concept of treating the whole child.”

 

The Children's Home of Cincinnati is located at 5050 Madison Road, Cincinnati, OH 45227. you can reach the organization at 513.272.2800 or visit www.thechildrenshomecinti.org