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Increased capacity and access in rural healthcare

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Increased capacity and access
Increased capacity and access
By Bob Anthony
Posted: 2023-04-28T16:41:00Z

Updated April, 2023

The Rotary Club of Naples, Florida increased capacity for behavioral health care, meaning increased access to prevention and treatment. Less than a year ago they facilitated self-paced training from Boston Children's Hospital and a regional phone support for rural doctors to consult with a child psychiatrist. The numerical outcomes are impressive. In one network, thirteen pediatricians in Naples compared numbers from the six months before the training with the six months after. The are:

1)  referring fewer children out to child psychiatrists

2)  writing more prescriptions for Anxiety or Depression

3)  writing fewer prescriptions for Attention Deficit Hyperactivity Disorder (ADHD)

The first point is huge because child psychiatrists are “as common as unicorns” according to one pediatrician. In other words, 18 children are already diagnosed and receiving treatment that otherwise would still be waiting for an appointment. Rotary achieved this in its local community and your club can as well. See the TOOLKITS web page about 'A LEVER'.


Before the national launch of this program in December, the fourth and final pilot of this evidence based program was completed with providers in Naples, Florida on June 30, 2022. Over 13,000 youth benefit from this new capacity for behavioral health care each year in Naples.

This program overcomes the fact that just 8,000 child and adolescent psychiatrists are available in the country by leveraging the 60,000 pediatricians and their respective staff. The training from Boston Children's Hospital is self-paced with on-demand video clips and testing. The new training builds on a 'curbside consult' by telephone with a child and adolescent psychiatrist. The Boston Children's Hospital training program is called Building Bridges of Understanding. The previous pilots were at Boston Children's Hospital, Los Angeles Children's Hospital, and Connecticut Children's Medical Center. Providers in Mexico, USA and Canada earn five AAPA Category 1 (Physician Assistant), AMA PRA Category 1 Credits™ (MD, DO, NP, PA), Contact Hours (Nurse, Nurse Practitioner).

Before this program half of youth waited, on average, 10 years between symptom onset and first treatment; the other half never got treatment. For example, the Rotary club of Naples printed bound sets of the preventive toolkits to the providers completing the training. During 2023 the District 6960 Chapter - Mental Health Initiatives Rotary Action Group will provide the manuals to participating providers in Collier County and Lee County, Florida.

Any Rotary member can replicate this program in the local community. To learn more, see the toolkit, A Lever.

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