Communities across Hampton Roads face critical shortages of child and adolescent psychiatrists, according to a new report from the Virginia Mental Health Access Project.
That’s despite efforts like the $224 million mental health hospital at The Children’s Hospital of the King’s Daughters, which opened in the fall of 2022.
The Virginia Mental Health Access Project, or VMAP, is a state initiative that’s been working to better connect kids and families with mental healthcare since 2019 — a mission which only became more critical when the pandemic hit and youth mental health needs exploded.
By the end of 2024, VMAP had helped more than 8,200 pediatric patients across the state access the limited mental healthcare available.
WHRO spoke with Victoria Cartagena, who oversees the program’s Hampton Roads operations, about provider shortages and how VMAP is bridging the gap between medical providers and mental healthcare.
WHRO: To start, how does the landscape in mental health look right now?
Victoria Cartagena: Our state as a whole has significant mental health shortages - access to child and adolescent psychiatrists, trained licensed mental health professionals, licensed clinical social workers and LPCs to treat behavioral health and mental health needs, and a shortage of those resources creates a backlog.
So we have waiting lists. We have children that are waiting for services, for assessment, for treatment of different mental health conditions, and sometimes they're on those waiting lists anywhere between six months to nine months, which creates then an increase of visits to our emergency department for mental health.
And so as we continue to have a shortage of those professionals available, we continue to see just an increase of crises that can sometimes be averted when we can increase access to care.
WHRO: Where are the needs greatest in southeastern Virginia?
VC: So, of course, we have our, you know, our rural areas outside of Hampton Roads. So if you think of Gloucester, that's part of our region here. The Eastern Shore, they're normally traveling a ways to get connected to a mental health provider.
But even in environments like Norfolk, Virginia Beach, I feel like (for) some of our more specialized care, we are seeing barriers and some wait times to get access to psychiatry services or higher levels of care.
WHRO: So how does VMAP factor into addressing those shortages?
VC: So the goal is to really support primary care physicians, family med docs, on how to be able to assess, treat and refer, so when they see those patients in the primary care setting, be able to know what screeners to utilize, what assessments to complete and then where to go once they have some information. Once you screen a child, you have more information, and then you need resources.
So we support with the education and making sure that they're aware how and when to assess and to do a screener. And then we support with consultation, so once they've assessed, if they need to consult with a psychiatrist, they're able to do that same day.
And then if they need access to resources, we also provide care navigation. So we support with collaborating with the PCP and helping the family get connected to resources in the community, whether that be continued psychiatry care, outpatient mental health therapy, speech, whatever the service may be.
WHRO: Can you walk us through an example of how VMAP does what it does?
VC: Just a few weeks ago, a mom with a 13-year-old son presented with behavioral health concerns to their provider, had already tried multiple different types of services, had already done the Googling and the research, and was really trying to get her kiddo connected to resources.
The doctor called us to ask for support with care navigation. We were able to do a consultation, you know, ‘what therapies the patient had already been in?’ and ‘what may be more effective for the family?’ And we were able to get the patient connected into services, I want to say, within four weeks.
And the reason that the story sticks out to me the most is because when I called mom to follow up, she felt like the care navigator that helped her really saved her son's life. That's what she said. She said, ‘I just want her to know that she really helped my son, and I think she really saved his life.’
When we spoke to the doc, initially, I can tell that mom was just feeling very bogged down and very overwhelmed. Just getting connected to the right resource and being able to feel like, ‘Okay, now we're heading in the right direction,’ felt like a lift for her. It felt like ‘Okay, now I don't feel as lost.’
This conversation has been edited for length and clarity.
