“We need to think and do things differently”: Meadows Institute’s Kacie Kelly touts promise of pediatric collaborative care at Milken Institute’s 2023 Future of Health Summit

Even before the onset of the COVID-19 pandemic, America’s youth were experiencing a mental health crisis, moderator William Brangham said at the start of “Surviving or Thriving: Youth Mental Health in America,” a panel discussion held Nov. 6 during the Milken Institute’s 2023 Future of Health Summit in Washington, D.C.

Nearly half of all U.S. teens report that they struggle with persistent feelings of sadness and hopelessness. Eleven percent of young adults ages 16 to 24 and 20 percent of all high school students report serious thoughts of suicide.

Society must find ways to address the needs of younger generations, both outside and inside the classroom, to ensure a healthy and thriving future, said Brangham, a correspondent for the PBS NewsHour. But is our “broken down jalopy” of a mental health care system up to the task, he wondered?

(From right to left) Kacie Kelly, Amanda Grigg, staff director at the Forum for Children’s Well-Being Division of Behavioral and Social Science and Education, National Academies of Sciences, Engineering, and Medicine, and Dan Gillison, CEO of NAMI.

Sadly, the system is not even broken, said Meadows Mental Health Policy Institute Chief Innovation Officer Kacie Kelly. “We often say at the Meadows Institute that we don’t have a broken health care system; we have a system that operates exactly the way we designed it.”

Explained Kelly: Whereas most of health care is already integrated into primary care and pediatric settings, where regular screening occurs, in mental health care, “we have taken those opportunities for screening and early detection and put it over here on the side as if all mental health care needs to be treated in specialty care, and that’s not working.”

Still, Kelly stressed, “I have never been more hopeful about mental health than I am these days.”

I have never been more hopeful about mental health than I am these days.
– Kacie Kelly

That’s because support for integrating specialty behavioral health care into primary and pediatrics settings is building, thanks in part to the policy focus and on the ground implementation work of the Meadows Institute.

Through participation in the Collaborative Care Model, adults and children are able to be screened for depression, anxiety and substance use as routinely as for blood pressure or high temperature, “so that we can detect [problems] much earlier in the disease course, when most mental health conditions can actually be treated by a generalist.”

Not only are there decades of research to support the model, but “we’re thrilled that we’re getting some financing in place to have it reimbursed by Medicare, private sector insurance and Medicaid in 27 states,” Kelly said.

Meadows Institute Chief Innovation Officer Kacie Kelly (right) speaks at the Milken Institute’s 2023 Future of Health Summit in Washington, D.C.

“I’m excited that our health care community is starting to embrace that public/private partnership philosophy because historically we have not been able to leverage collective assets in a way that allows for outcomes. I’m starting to see more of a willingness to bring these resources together.”

Dan Gillison’s, NAMI’s CEO and a fellow panelist, agreed. “We need to innovate, to think and do things differently. If you do what you’ve always done, you’ll get what you’ve always gotten.”