Northwell Investing $500M in Pediatric Behavioral Health Initiative

The health system is building a 200,000-square-foot facility that will integrate behavioral health and physical health for pediatric patients.

New Hyde Park, New York-based Northwell Health is launching a $500 million initiative to boost behavioral health services for pediatric patients.

Behavioral health services for pediatric patients are in a state of crisis. Of the vast numbers of children and adolescents who have behavioral health problems nationwide, only about 20% of them are receiving appropriate care, says Jill Kalman, MD, executive vice president, chief medical officer, and deputy physician-in-chief of Northwell.

The centerpiece of Northwell's $500 million initiative is construction of the Child and Adolescent Mental Health Pavilion, which will be connected to Cohen Children's Medical Center and Zucker Hillside Hospital, Northwell's adult mental health facility in Queens, New York. The new 200,000-square-foot facility will have more than 100 inpatient beds and feature an integrated health services approach to combine behavioral health services with physical health services.

The initiative will be financed with about $350 million from the health system and about $150 million from philanthropic fundraising. The health system is not expecting a financial return on investment, says Charles Schleien, MD, senior vice president of pediatric services at Northwell.

"We are paid poorly for mental health services. This is not being done as a financial investment," he says. "There is no expectation there will be a positive return on investment until the healthcare system is changed to support mental health. This initiative is being done because Northwell feels this is part of its mission in terms of children's health. That is why we are trying to offset some of the cost philanthropically."

As is the case with children and adolescents nationwide, there is a crisis in pediatric mental healthcare, Schleien says.

"The numbers of children with behavioral health problems continue to climb dramatically—they have been climbing for years and they accelerated during the coronavirus pandemic. We are overrun with patients in our emergency departments. Schools need help addressing the problem," he says. "It is incumbent on us at Northwell to deal with the issue of behavioral health conditions in children head on as part of our mission to improve health."  

Providing integrated care is essential for pediatric patients, Schleien says.

"Many kids with major behavioral health issues are kids that have other chronic, complex disease states," he says. "So, when they are hospitalized, it is frequently true that they need other physicians beyond psychiatric care for treatment of underlying diseases. In addition, many kids with primary mental health issues get sick physically."

The new pavilion reflects the overall approach to behavioral health at Northwell, Kalman says.

"It is part of our strategy for behavioral health in general to improve access, use technology, and improve care in our communities. We want to go upstream—identify behavioral health needs earlier," she says.

Kalman says the primary goals of the new pavilion are to impact serious behavioral health outcomes, including reducing suicide among children and adolescents, which is a leading cause of death in this population.

"We want to impact the most serious outcomes in pediatric behavioral health. Another metric will be reaching our communities and bringing behavioral health services to those who have not had them in the past," she says. "Then, when you look at the most common diagnoses such as depression, anxiety, and substance abuse, we want to improve serious outcomes such as hospitalization. We want to keep children and teenagers in their homes and communities with adequate treatment."

CMO perspective

Integrated health services are part of the clinical care strategy at Northwell, and Kalman says implementing that strategy is an essential part of her responsibilities.

"I am here to align the strategy with the health system and support the clinical leadership to create the vision of integrated health services. Mental health and physical health under one roof is consistent with what we want to do at Northwell in general. We want to put the patient at the center of care and wrap all the services around them," she says.

Kalman is also responsible for filling clinical gaps.

"I make sure we have all the services we need in behavioral health, make sure we are focused on depression and anxiety, make sure we are focusing on substance abuse, and make sure behavioral health is integrated with physical health. In pediatrics, I make sure we are connecting with our schools," she says.

Kalman says she will play a pivotal role in the $500 million initiative.

"I will ensure that the initiative is implemented and that the clinical leaders of pediatrics and behavioral health have the resources they need. I will also promote the vision in outward communications to the communities we serve," she says.