KU School of Medicine-Wichita

23 suicide, so the physician was like, 'I know this is serious,'" Brown said. The patient's family was distrustful of the pediatrician. But after he told them he had consulted with experts at KU Wichita, the relationship "changed enormously," Ciccolari Micaldi said, and the family took his recommendations regarding a safety plan for the patient. "He described himself as feeling like a hero, which was very nice to hear," Ciccolari Micaldi said of the physician. KSKidsMAP recognizes that "primary care physicians in this country are dealing with the task of handling the majority of mental health care," Karlsson said. "That being said, they don't receive a lot of training in psychiatry in their residency. Many times, it puts them in an unfair position." Most young patients are served indirectly by the KU Wichita team. Some patients of the enrollees in the program are referred to the KU Wichita psychiatric clinic for help, then return to primary care for ongoing care, with the ability to continue consulting with the KSKidsMAP team. "Which is great for families who have to drive a couple hours" to reach Wichita, Karlsson said. Freeman helps clinicians connect with resources in their community. But in most of those areas the resources are extremely limited or nonexistent, a key reason why the ability of enrolled participants to consult with the KU Wichita team is important. we are spread very thin, particularly in rural areas. Access is a big problem." An averted suicide? One of the medical school's first eorts launched four years ago: KSKidsMAP, which supports primary care physicians and clinicians across the state through a telehealth network. About 250 clinicians across the state are currently enrolled in the program, which enables them to consult on kids' mental health issues with a team at KU Wichita. That team includes three CAPs — Brown, Karlsson and Susanna Ciccolari Micaldi, M.D., and clinical assistant professor — plus Kari Harris, M.D., who's a pediatrician; Nicole Klaus, Ph.D., a child and adolescent psychologist, and Polly Freeman, LMSW, the program's social work coordinator. Brown, who co-founded the program with Harris, said the latter's involvement was crucial. "We thought that if we're going to try and help primary care physicians do mental health care better in their own practices, then it would help if we had someone who had walked that journey themselves," Brown said. "She'd walked the walk, if you like." ADHD, depression and anxiety, autism and development problems are the most common issues team members have been asked about over the course of 129 case consultations. One case that stood out to Brown and Ciccolari Micaldi was a rural pediatrician who contacted the team about a teen patient experiencing significant suicidal thoughts and depression. "It had touched the pediatrician because a family member of that child had died by The lack of access is why KU School of Medicine-Wichita is taking a multi-pronged approach to the problem, from starting a new fellowship program for child and adolescent psychiatrists (CAP) to providing primary care physicians and other clinicians with consults on children's mental health issues. The school is also strengthening the training pediatric residents receive in mental health treatment skills and partnering with a local school district to address attention deficit hyperactivity disorder in K-5 students. Cassie Karlsson, M.D., a CAP and clinical associate professor of psychiatry at KU Wichita, said the moves are needed. "I think Kansas hasn't really kept pace in terms of mental health services for children," Karlsson said. "Child and adolescent psychiatry is one of the most underserved specialties in all of medicine. The entire country is struggling, but Kansas is closer to the bottom than the top" in access. The American Academy of Child and Adolescent Psychiatry considers 47 CAPs per 100,000 children aged 17 and below to be sucient. With 69 CAPs, Kansas has less than 10 per 100,000, four in 100,000 below the national average. According to the academy, Kansas is one of 42 states with a severe shortage of CAPs. No state has a sucient amount, although some cities do, according to the academy. "I've never worked anywhere where there are enough resources," said Rachel Brown, MBBS, MPhil, a CAP and chair of KU Wichita's Department of Psychiatry & Behavioral Sciences. "But also in Kansas, Cassie Karlsson, M.D., clinical associate professor Psychiatry & Behavioral Sciences Susanna Ciccolari Micaldi, M.D., clinical assistant professor Psychiatry & Behavioral Sciences

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