North Carolina is fortunate to have strong academic health systems – through affiliations between Duke Health and Duke School of Medicine, patients across the state benefit from academic research, grant funding and collaborative partnerships.

One example is the NC-PAL line. This free telephone consultation program helps pediatricians across the state better treat children with mental health needs with the support of Duke Health’s psychiatrists and behavioral health specialists.

This program is a much-needed resource for the state’s pediatricians, as one in five children has a diagnosable mental health condition, but many counties in North Carolina have no child psychiatrists.

How does it work?

If a child or adolescent visits their primary care pediatrician and is experiencing mental health concerns, including depression, anxiety and other conditions, the doctor can call NC-PAL and receive consultation and education about treatment, medication and referrals from board-certified child psychiatrists.

“Suicide is the second leading cause of death for the ages 10 to 24,” says Dr. Nathan Copeland, a child and adolescent psychiatrist who sees patients at Duke Autism Clinic.

 “The role of NC-PAL is, okay, we’re not going to make it to 1,000 child psychiatrists anytime soon. So how do we change the model? How do we shift the way we’re able to provide resources and expertise, and bring expertise where the kid is? That’s part of the access line and integrated care in general.”

Through this innovative and collaborative program, more children across the state are able to access the care they need. While many mental health illnesses are chronic or lifetime conditions, those diagnosed and treated earlier are often better managed and patients have a higher quality of life.

“Fifty percent of all lifetime cases of mental illness begin by the age of 14,” Copeland says. “When there is a large delay in treatment, when things have gotten really bad, a kid might be failing in school, or lost friends, or having thoughts of suicide.”

The program is all about helping pediatricians and other primary care providers identify these conditions as early as possible, so treatment can start without having to wait for a specialty care referral.  

“It’s such a wonderful experience,” Copeland says. “These are clinicians that want to provide care for their community. They just need a little guidance, but the important part is that they call, and we help them support the care of that kid.”

Telepsychiatry is one way patients in rural communities can access specialized care. Providers around the state are advocating for a bill in the NC General Assembly (HB 149) that would require insurance plans cover care provided to patients through virtual visits. Contact your local representative about expanding telehealth services in North Carolina — learn more here.