Kimberly Cripe has been a longtime advocate for pediatric mental health, and was recently appointed to the board of directors of the national Children’s Hospital Association. In 2012, Cripe was named Orange County’s “Most Trustworthy Leader,” and has been leading the formation of CHOC’s pediatric mental health task force and the creation of the 18-bed CHOC Children's Mental Health Inpatient Center, part of the hospital’s commitment to address mental health needs in Orange County. H&HN recently spoke with Cripe about the system’s mental health initiative and why behavioral health is vital to overall care.

Why is pediatric mental health an important issue for you?

CRIPE: I've been in pediatric health care now for more than two decades. I think our health care delivery system does a good job at taking care of medical illnesses in pediatrics. But recently, I’ve noticed what I consider a pretty startling increase in the number of young children and adolescents coming to our emergency departments with serious mental health disorders. I don’t think we’re unusual. I think this is the case throughout the country.

There really are woefully inadequate resources available for people suffering with mental health disorders. For me, that was a big wake-up call. Seeing the number of kids and families that were turning to us in a crisis was very alarming and concerning to me. So, I felt that it was time for someone or some organization to step up and deal with this in a more comprehensive way and to do something different from what we had been doing historically.

Can you talk about CHOC'S mental health initiative?

CRIPE: We took a recommendation to our board to build an inpatient pediatric unit because there are currently no inpatient beds for people up to 12 years old in Orange County. This is pretty common. It's overwhelming when you try to solve the problem as one institution, so we've tried to engage our community. The health care community, the faith-based community, governmental agencies and schools, and people have been extremely responsive. The inpatient unit is a major undertaking and we started construction last year and it will be complete by the end of 2017 or early 2018. But, I think one of the more important things we did was to set up a multidisciplinary mental health task force and we've worked hard to advocate on behalf of people with mental health disorders to raise awareness and deal with some of the stigma issues.

Where do you see behavioral health moving and where does children’s mental health fit into that picture?

CRIPE: I think the ultimate vision or goal should be to have parity of services. That could be government-sponsored Medicare and Medicaid covering behavioral health services, or private insurance coverage. I think the biggest underlying challenge is the fact that mental health services are reimbursed poorly and without adequate reimbursement. It's difficult to have a sustainable infrastructure to serve our patients.

In terms of pediatrics, the numbers are staggering. One in five kids has a diagnosable mental health disorder, and children with chronic conditions are three to five times more likely to have mental health disorders. If you intervene early, it doesn't really matter what it is — it could be teaching kids to read or coping with mental health problems. If you intervene while the brain is still being formed, you can make a significant impact on that person's life, not only as a child and an adolescent, but as an adult. You look at how many people are incarcerated, you look at substance abuse, you look at crime, you look at horrible events that take place where people are killed because of an untreated mental health problem and realize that there are so many important reasons why we need to do something about this as a society and as a community.