Doctors at the Child Study Center, including Dr. Shabana Khan, use telepsychiatry to provide diagnostic assessments, medication management visits, behavioral therapies, and consultations to inpatient psychiatric units and school-based programs in five rural counties.
Photo: Karsten Moran
Modalities such as mobile applications, telepsychiatry, and digital broadcasting offer researchers and clinicians unprecedented opportunities to deepen their knowledge and broaden their impact. ٺƵ Health is a national leader in the development and adoption of these powerful tools.
Mobile Apps Give Researchers and Parents Insights into Children’s Behaviors
At ٺƵ’s WonderLab, researchers are creating a series of apps designed to help parents understand and manage their young children’s challenging behaviors, develop strategies to support their children’s mental health, and know when to seek clinical help.
The team’s first mobile health (mHealth) app, When to Wonder: Picky Eating, is a tool for parents and a research study that employs games, questionnaires, and facial recognition technology to build knowledge about food preferences and emotions around eating. The app assesses children’s behavior, offering evidence-based advice on how to address eating and feeding challenges, as well as suggestions for finding assistance, if needed. Available at no cost via the Apple App Store® and Google Play™, When to Wonder: Picky Eating has been downloaded more than 6,000 times in its inaugural year.
Future products in the When to Wonder series will include apps for tantrums, sleep problems, and anxiety. “Our mission is to give parents access in their home to actionable insights and clinically relevant knowledge,” says WonderLab founder and co-director Helen L. Egger, MD, the Arnold Simon Professor of Child and Adolescent Psychiatry and chair of the .
The lab, co-directed by Timothy L. Verduin, PhD, clinical assistant professor of child and adolescent psychiatry, brings together targeted users with specialists in children’s mental health, experts from ٺƵ’s information technology team, and outside technology partners to collaborate in the development process. “We follow the human-centered design model, which begins with the people you’re designing for and ends with solutions tailor-made to fit their needs,” Dr. Egger explains.
In addition to its utility for parents, When to Wonder is designed to provide researchers with population-level data on children’s emotions and behaviors, as well as the impact of parent–child interactions, sociodemographic elements, and other risk factors—without the complex, costly infrastructure required for conventional population studies. All information is gathered with users’ informed consent, anonymized, and securely stored.
“There are significant gaps in our knowledge surrounding children’s mental health, as well as in access to evidence-based mental healthcare for children,” notes Dr. Verduin. “We believe in the potential of digital tools to bridge both gaps.”
Bringing Telepsychiatry to Underserved Communities
Another digital tool for expanding access to care is telepsychiatry. “Large areas of this country suffer from a severe shortage of pediatric mental health professionals,” notes Shabana Khan, MD, assistant professor of child and adolescent psychiatry and director of child and adolescent telepsychiatry. “This technology enables us to bring desperately needed care to families who might otherwise never get it.”
In partnership with the New York State Office of Mental Health, the Department of Child and Adolescent Psychiatry uses telepsychiatry to provide diagnostic assessments, medication management visits, behavioral therapies, and consultations to inpatient psychiatric units and school-based programs in five rural counties.
The department offers the option of video visits at the Child Study Center, a part of Hassenfeld Children’s Hospital at ٺƵ, where patients can connect with their doctors from home using , a secure patient portal within the ٺƵ Health app on their mobile devices. Telepsychiatry is used for after-hours child psychiatry consultations in the KiDS Emergency Department at Tisch Hospital. The department also offers telepsychiatry services in two Brooklyn schools, under the leadership of Aaron O. Reliford, MD, clinical assistant professor of child and adolescent psychiatry, director of child and adolescent psychiatry at ٺƵ Hospital—Brooklyn, and director of ambulatory behavioral health services at the Family Health Centers at ٺƵ. ٺƵ has streamlined the digital experience for patients and providers.
Providing faculty and trainee education and training in the use of this modality is a priority as well. The department operates a telepsychiatry training clinic for residents and NYU Grossman School of Medicine students in partnership with the Rockland Children’s Psychiatric Center in Orangeburg, New York. In addition, Dr. Khan is collaborating with Sandra M. De Jong, MD, assistant professor of psychiatry at Harvard Medical School, and the American Academy of Child and Adolescent Psychiatry (AACAP) Telepsychiatry Committee to develop a nationally accessible online pediatric telepsychiatry curriculum for use by child psychiatry fellows, fellowship program directors, and faculty.
To help the field grow, the department is working to inform legislation, policy, and regulations at the state and federal level. “Policy makers and legislators are increasingly recognizing the power of telemedicine to expand patient access while improving quality of care and reducing cost,” explains Dr. Khan, who is co-chair of the AACAP Telepsychiatry Committee. “We’re helping translate that growing awareness into concrete change.”
In June 2019, Dr. Khan was invited by the Center for Telehealth and e-Health Law to participate in a meeting with senior White House officials on issues related to reimbursement and Centers for Medicare and Medicaid Services telemedicine policy. In July, she represented the American Telemedicine Association (ATA) at a policy briefing for national organizations about proposed changes to Drug Enforcement Agency (DEA) regulations concerning the prescribing of controlled substances through telemedicine. In August, she met with DEA officials to discuss recommendations on that issue submitted by the ATA and other professional groups. In December, Dr. Khan met with U.S. Department of Health and Human Services senior officials to discuss solutions to regulatory barriers that limit the potential of telemedicine to reach underserved communities.
Spreading Therapeutic Concepts via Satellite Radio
One of the Department of Child and Adolescent Psychiatry’s most innovative nondigital programs for disseminating evidence-based data is NYU’s . Launched in 2006 by Jess P. Shatkin, MD, MPH, professor of child and adolescent psychiatry and pediatrics and vice chair of education, the groundbreaking program began with one course of 24 students. By 2019, it encompassed more than 50 courses, with an annual enrollment of more than 5,000. Besides drawing potential recruits to the profession, CAMS aims to increase undergraduates’ awareness and understanding of mental health issues. The program’s success has spurred similar initiatives at many other colleges.
Dr. Shatkin is also known for a more technologically advanced offering: About Our Kids, the weekly show he cohosts on ٺƵ’s SiriusXM channel, Doctor Radio, with Lori K. Evans, PhD, clinical assistant professor of child and adolescent psychiatry and director of training in psychology, and Alexandra L. Barzvi, PhD.
About Our Kids was created in 2008 to give listeners access to essential information and advice about child, teen, and family mental health. Covering topics ranging from behavioral and mood issues to vaping and school shootings, the two-hour call-in show broadcasts live on Friday mornings and is repeated five times weekly; it can be streamed via the SiriusXM website or app, as well. “We get calls from across the country, from Canada and Mexico, even from Europe,” Dr. Shatkin says. “When I go to Maryland or Colorado to lecture, people say, ‘I heard you on the radio, and it was so helpful.’ I think we’re making a real contribution.”
