The Louisiana Department of Health (LDH) is introducing five new and additional initiatives focused on the behavioral health of children and adolescents and their families. These initiatives, titled Services from the Start: Providing Behavioral Health Support for Louisiana Families, focus on improved access to early childhood, adolescent, and family behavioral health services.

The COVID-19 pandemic has magnified the challenges facing adolescents’ and children’s mental health, causing altered experiences at home, school, and during in-person social interactions. The pandemic also highlighted the need for increased access to healthcare and social services as an alarming number of young people struggle with feelings of helplessness, depression, and thoughts of suicide. In response, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association have declared a national state of emergency in child and adolescent mental health.

“Improving and expanding mental health services for Louisianans of all ages is the culmination of years of deliberate planning and focus, and I’m proud my administration has taken on this task in a thoughtful and targeted way,” said Governor John Bel Edwards. “The Louisiana Department of Health’s work to expand crisis services, add capacity for substance use treatment, and use evidence-based treatment for other behavioral health needs will help us address the trauma and other challenges brought on by the pandemic and the many disasters Louisianans have become so accustomed to.”

“It has been our top priority over the past few years to confront the crises Louisiana residents have been facing with behavioral health strategies that improve the quality of life for our residents and hold the promise of a brighter future for Louisiana’s children,” said LDH Secretary Dr. Courtney N. Phillips. “The five initiatives we are announcing today are critical new additions to the current array of specialized behavioral health services, and I am confident that our behavioral health partners will be able to use them to increase access to services and ultimately improve health outcomes."

Recognizing the need to address the behavioral health crisis, OBH is building upon services currently available to Medicaid-eligible children and adolescents through five additional initiatives currently under development through Fiscal Year 2024.

Initiative 1: Expanding substance use residential treatment facilities for women and dependent children

Pregnant women, and women with dependent children, are among the most vulnerable of all populations in need of stable residential services for substance use disorder (SUD) treatment. Louisiana currently has 3 statewide providers. However, in order to geographically diversify and expand capacity of treatment programs that allow children up to 12 years old to accompany their mothers, OBH will identify additional providers to fill statewide gaps in services to establish additional treatment beds.

Initiative 2: Implementing Early Childhood Supports and Services (ECSS)

ECSS will provide screening, evaluation, and referral services and treatment for children from birth through age 5 and their families through evidence-based behavioral health treatment. This includes support for enhancing positive caregiving relationships and comprehensive care coordination addressing family needs, including families’ environmental risks and social determinants of health.

OBH intends to pilot ECSS with an early adopting entity, while pursuing a contractor for long-term management of the statewide program through a request for proposal (RFP), which is expected to be released in calendar year 2023.

Initiative 3: Building the foundation for statewide youth crisis services

Expanding upon the Medicaid adult crisis services continuum introduced in LDH’s Fiscal Year 2022 business plan, LDH is committed to extending Mobile Crisis Response (MCR) and Community Brief Crisis Support (CBCS) services to youth. With an anticipated launch in spring 2024, MCR is an initial intervention for individuals in a self-identified crisis; while CBCS is a face-to-face ongoing crisis intervention response, designed to provide stabilization and support.

LDH has identified start-up funding for providers and the budget proposal includes funding for Medicaid coverage of these services in late fiscal year 2024.

Initiative 4: Treating trauma through the implementation for Dialectical Behavioral Therapy (DBT) programs

DBT is an evidence-based, comprehensive intervention designed to treat adults and adolescents with severe mental disorders and out-of-control cognitive, emotional, and behavioral patterns that often result from early and/or chronic experiences of trauma, neglect, and abandonment.

LDH will begin provider DBT training in the fall with initial implementation of service delivery expected in late calendar year 2023.

Initiative 5: Cultivating Psychiatric Residential Treatment Facility (PRTF) services to treat youth with co-occurring developmental disabilities

PRTFs are non-hospital facilities offering intensive inpatient and educational services to individuals younger than age 21 who have various behavioral health issues.

OBH is currently developing this programming for a highly specialized PRTF with up to 25 beds, with treatment focusing on co-occurring mental health and developmental disabilities. This population will achieve better outcomes in a highly specialized setting tailored to their needs.