It’s been a little less than five years since Children’s Wisconsin launched an ambitious five-year plan to significantly improve access to behavioral health care for children and adolescents. Now, those efforts have culminated into a name that’s here to stay: the Craig Yabuki Mental Health Center.
The official name and designation comes on the heels of Wisconsin Department of Public Instruction releasing the results of the 2023 Youth Risk Behavior Survey last week. Educators, researchers and mental health advocates have once again sounded the alarm that the intensifying youth mental health crisis isn’t going anywhere.
Neither is the Craig Yabuki Mental Health Center.
The name may be familiar to those who have spent time at Children’s main campus in Wauwatosa in the last year and a half. Children’s Wisconsin opened the doors of the Craig Yabuki Mental Health Walk-in Clinic in March 2022, less than a year after former Fiserv Inc. CEO Jeffrey Yabuki donated $20 million to put therapists in every Children’s primary care and urgent care office in southeastern Wisconsin. It was named in memory of Jeffrey’s brother, Craig Yabuki, who died by suicide in 2017.
To better honor the gift, Children’s widened the scope of mental health services in Craig Yabuki’s name, said Amy Herbst, vice president of mental and behavioral health at Children’s. It’s also a way to acknowledge the work being done by a large team of mental health professionals at Children’s facilities across the state, Herbst said. The Craig Yabuki Mental Health Center officially opened July 31.
“The center name is a testament to all the work that we’ve been doing, in terms of care delivery, quality, services, education and outreach,” Herbst said.
In February, another new Craig Yabuki Mental Health Walk-In Clinic location opened in Kenosha, and two more clinics are in the works across the state, thanks to a $3 million donation from Kohl’s.
The arrival of the Craig Yabuki Mental Health Center comes at a critical time for young people in Wisconsin. Children’s provided mental health treatment to more than 150,000 patients in 2023, a 22% increase from just a year earlier, Herbst said. That same year, 6 out of 10 teenagers across the state self-reported in the 2023 Wisconsin Youth Risk Behavior Survey (YRBS) that they were anxious, depressed or suicidal each day.
The latest YRBS data, grim as it is, didn’t surprise Herbst. Children’s uses the data to help inform its decisions about what it’s doing — and, as important, not doing — in service of mental health care. For example, therapists from Children’s work in nearly 70 Wisconsin schools, providing mental health care and consultation to students. Students specifically voiced a need for more school-based mental health services in previous YRBS reports, which especially improves health care access for working families.
“For us, it’s a data point, and also it’s a proof point to say what we are doing continues to be needed,” Herbst said.
The need has only grown, but so have creative solutions and the donations to make them happen.
In the last five years, Children’s has bolstered its workforce
It wasn’t too long ago that Children’s announced its bold plan to significantly improve access to behavioral health care for children and adolescents. The plan, announced in 2019, came with a hefty price tag: Children’s was projected to spend $150 million over five years. One of its goals was to double the number of pediatric behavioral health professionals in its system, from 137 to 280.
Amid implementing these initiatives (not to mention the pandemic, which brought on its own surge of mental health needs), a major challenge arose, one that wasn’t unique to Wisconsin: long, frustrating wait lists to see a professional.
The $20 million donation from the Yabuki Family Foundation in 2021 helped ease some of those burdens, shrinking the outpatient waitlist by more than half over the course of nearly two years. Children’s met its goal of integrating a therapist in each of its 20 pediatric clinics and, as of today, has hired 29 therapists in primary care and two in urgent care.
Still, resolving the workforce shortage is nothing short of a Herculean task. Even with this added workforce, more children are seeking outpatient therapy services. The current outpatient waitlist is 975 kids.
Some of that is because there are so many types of jobs to fill across its system, from psychologists and psychiatrists to nurse practitioners, Herbst said. Clinical training also takes time. Once a student earns their master’s in counseling, they must complete 3,000 hours of clinical work before they can apply for a license.
But it isn’t just a numbers game. Just as the mental health crisis intensifies, so too do the symptoms. For the third consecutive year, psychologists have reported patients need more lengthy treatments and are presenting with more severe symptoms, according to the American Psychological Association’s 2023 Practitioner Pulse Survey.
These escalating conditions have fueled longer waitlists for nearly 40% of psychologists nationwide — if psychologists can accommodate new patients at all. Psychologists who serve children, teenagers and young adults are the most in demand. On top of that, more than a third of all psychologists are reporting burnout, despite concerted efforts to maintain self-care and a positive work-life balance.
The American Psychological Association projected that by 2025, Wisconsin will have 1,520 full-time psychologists, but the state will still need 250 psychologists to meet demands. By 2030, the state is projected to close that gap by nearly 40%, but that still means it’ll be short 170 professionals.
“We are actively recruiting the workforce that we need. I am busy trying to hire more therapists. We are trying to hire more psychologists and psychiatrists,” Herbst said. “There will likely never be enough.”
One effective method at Children’s, called the Children’s Wisconsin Therapist Fellowship Program, is to hire recent psychology graduates who require 3,000 hours of clinical training, Herbst said. Following a $1 million donation from the Boldt Company in 2019, an Appleton-based construction company, graduates work full-time training under Children’s professionals, are paid a competitive salary and have the same benefits as Herbst.
This expedites the training process, which typically takes five years to complete. Training is often accomplished on a volunteer basis while graduates work other jobs to support themselves, but the Therapist Fellowship Program allows graduates to complete their clinical hours in less than two years.
So far, nearly 30 aspiring therapists have participated in the program and have supported more than 1,285 families through more than 16,000 sessions. After these trainees became licensed therapists, nearly all of them stayed with Children’s.
“It’s allowed us to retain people here in state and also to have some people come back to the state, because maybe this is where they grew up, and they do want to live here,” Herbst said.
The process has been effective enough that the Medical College of Wisconsin and the state of Wisconsin help support this training work, Herbst said.
Yet another way Children’s has bolstered its workforce is to elevate the talent already there. Families have told Herbst and others at Children’s that their trust for pediatricians extends to mental health. Kids and families feel most comfortable with their pediatricians, and they feel less of a stigma talking about mental health with pediatricians. Plus, kids with pediatricians at Children’s have immediate access to a therapist, no wait list required.
Some of the funding from the Yabuki Family Foundation has helped enhance mental health training for pediatricians. Pediatricians not only get mental health training but they’re able to work with integrated behavioral health consultants at their offices to screen patients for mental health conditions and perform treatment interventions.
“The pediatricians feel more supported and informed. The kids and families really value that care at the pediatrician office, from screening to intervention, and they want more of it,” Herbst said.
The journey of ‘treating mental health as health’
Ramping up behavioral health at Children’s puts emphasis on a growing mindset among health care workers and the community at large that mental health is health. Meaning, maintaining good mental health should be just as established in medicine as taking care of our physical bodies.
Extensive studies have shown the lasting impacts of children who go untreated for existing mental health conditions, from detrimental developmental outcomes in young adulthood, lower academic success, poorer health-related qualities of life and ongoing mental health impairments in adulthood.
Mental health interventions in early schooling years, including screenings, targeted behavioral and/or cognitive-behavioral therapy, can improve outcomes for young people, a point that Herbst continues to emphasize.
Dr. Michael Gaffrey, the first-ever endowed chair of mental and behavioral health research at the Craig Yabuki Mental Health Center, has been conducting research at Children’s to put cutting-edge science to practice in a timely manner. It can take up to a decade to get hospitals up to speed with new research, Herbst said, but under Gaffrey’s leadership, she believes implementing novel tools over a relatively shorter window will lead to better insights and results.
One such topic Gaffrey and his team are exploring, for example, is looking at the science around brain functioning in kids — and how it relates to their mental and behavioral health.
He’s also looking at internal data at Children’s to assess how effective it’s been to have integrated behavioral health consultants available to pediatricians. Herbst said it’s important to not only have these tools available, but to know whether it’s making a difference.
So far, early research shows it’s making a positive difference in children’s lives.
“Mental health is health, period. It’s just that simple. Kids are telling us that through these (YRBS) reports,” Herbst said. “We’re trying to be responsive to that truth and say, ‘Yes, mental health is health,’ and ‘Anxiety and depression and self harm (are) real,’ and ‘We are going to provide the care that you need in hopes of being part of the solution.'”
Natalie Eilbert covers mental health issues for the Milwaukee Journal Sentinel. She welcomes story tips and feedback. You can reach her at [email protected] or view her Twitter profile at @natalie_eilbert.
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