Selected Podcast
Perks of the PIRC - Psychiatric Intake Response Center at Children's
The PIRC (Psychiatric Intake Response Center) at Children's is one-year strong, and has helped hundreds of callers in Alabama navigate the mental health system for children and teens. Born out of the need for guidance and direction when access to care can be a challenge, the PIRC is staffed by licensed counselors trained to help triage a caller's situation and recommend the next step. The staff has access to a database of mental health professionals in a five-county area (and beyond), and is available seven days a week. While it is not a suicide or crisis hotline, the PIRC can provide support and education, safety planning for current or future crises and resources. 205.638.PIRC (7472)
Featured Speaker:
Jesse Tobias C. Martinez, Jr. MD
Dr. Jesse Tobias C. Martinez, Jr. serves as director of the Psychiatric Intake Response Center (PIRC) and Consultation-Liaison Psychiatry at Children's Hospital of Alabama. He is also Medical Director of the University of Alabama at Birmingham (UAB) Psychiatry Medical Student Clinic, and the neuroscience clinical course co-director for second-year medical students. Martinez attended medical school at the University of Texas Health Science Center in San Antonio. He then completed his residency at UAB Hospital, a teaching hospital of the UAB School of Medicine. Following residency, Martinez continued his training at UAB as a Child and Adolescent Psychiatry fellow, and joined the UAB faculty as an assistant professor in the Department of Psychiatry and Behavioral Neurobiology in July 2016. His special interests include pediatric emergency psychiatry and medical student education in behavioral health. Transcription:
Perks of the PIRC - Psychiatric Intake Response Center at Children's
Tiffany Kaczorowski (Host): Welcome to Inside Pediatrics, a podcast brought to you by Children’s Hospital of Alabama in Birmingham. I’m Tiffany Kaczorowski. Today we’re talking about the Psychiatric Intake Response Center or PIRC with Dr. Jesse Tobias Martinez. Dr. Martinez is Medical Director of the PIRC and Consultation Liaison Psychiatry at Children’s of Alabama. He is also an Assistant Professor at UAB, the University of Alabama at Birmingham. Welcome Dr. Martinez.
Jesse Tobias C. Martinez, Jr. M.D. (Guest): Thank you. Thank you for having me.
Host: So, let’s talk about PIRC. What exactly is PIRC?
Dr. Martinez: The PIRC is – it stands for the Psychiatric Intake Response Center and really, we are a telephone triage response center for patients and families to really help them better navigate the mental health system. It’s a confidential telephone response center linking adult callers to mental health resources for children and teens.
Host: And currently you guys are serving five different counties surrounding the metro area of Birmingham. Is that correct?
Dr. Martinez: Correct. Currently, we have a database with over 500 plus providers in the Jefferson, Shelby, Blount, St. Clair and Walker counties.
Host: One of the things that we try to let people know that PIRC is not is a suicide or crisis hot line. Correct? Explain to us the difference between what PIRC can do and then what those are for.
Dr. Martinez: That’s correct. So, the PIRC is really a resource center to help patients and families better navigate the complex mental health system. But we always ask callers and the community to not call the PIRC when you do have a severe crisis, if someone is suicidal. We always say call 9-1-1, call the crisis hotline or go to the nearest emergency room.
Host: Yeah, so PIRC is really more as a resource. What types of things are people calling about?
Dr. Martinez: We get telephone calls from a variety of callers whether it be teachers, nurses, other clinicians or physicians and the community social workers and patients’ families as well. And we are getting calls about children that are depressed, about bullying, anxiety, difficulty or problems in school. More recently we are getting more calls about self-harming and cutting and also, we do, even though we are not a crisis hotline; we still get telephone calls about suicidality and how to help parents navigate or how to help parents help those children.
Host: PIRC is really for adult callers of children or possibly if they are taking care of children in a scenario like a physician who may need some advice on what to do with this patient family.
Dr. Martinez: We always want to hear or speak with an adult caller because we can better help provide them resources, communicate telephone numbers to better help that adult person help that pediatric child patient.
Host: And on this side, on this end of the line; who is answering the calls in the PIRC?
Dr. Martinez: When anybody calls the Psychiatric Intake Response Center at the 638-7472; you are going to get connected with a licensed mental health professional and those licensed mental health professionals have years of education and experience in working with pediatric patients in the mental health field. That’s like one of the number one things that we require when anyone applies to work with us in our PIRC. And they are the ones that are going to provide the education and recommend the most appropriate resources.
Host: Okay. What is the goal for that mental health professional as they answer that call? What is their goal, before they get off the line with that person?
Dr. Martinez: The goal of the licensed mental health professional during that telephone call is to quickly assess and triage the situation or the concern that the caller has and then connect pediatric patients to the right level of care at the right time. We really want to help families and others in the community avoid navigating the complex mental health system. And that’s one of the things that we hear a lot about that when we go out to the community, a lot of people say like they don’t really know how to get ahold of somebody or who to talk to and then when we talk to pediatricians; a lot of them say go to the nearest emergency room and if someone is depressed or having thoughts of wanting to harm themselves or are just not behaving appropriately in class, because they just don’t know who to go to.
Host: I would imagine that is often a barrier to getting help is that sometimes parents, caregivers just don’t know where to start.
Dr. Martinez: Exactly. They don’t know where to start, who to call, what insurance some agencies take, how long the wait and then they get discouraged because they hear that the wait at some places is several months out or several weeks out or they are not taking patients. So, we have our licensed mental health professionals constantly updating our database to make sure that we are giving the most accurate information to our callers.
Host: Is there a need sometimes to follow-up with these callers and ask them how things went?
Dr. Martinez: Yes. So, we do provide follow-up phone calls for families to just make sure that they were able to make that connection with that mental health professional in the community. If we have a case where we feel that really needs a follow-up phone call; we do provide that as well. And then we also encourage our callers to always give us a call back, so we give up to three resources at a time to a family. And we always tell them just give us a call back if those don’t work out for you or if you need more education. Because the reason we chose three is if we give someone a whole list, they become like overburdened or maybe confused, overwhelmed. Yes, exactly, so we give three and we tell them try these three; if that doesn’t work just give us a call back.
Host: Now let’s talk about – a little bit about the history behind the PIRC and the need for this resource center here in northern central Alabama.
Dr. Martinez: I always want to mention that suicide, a lot of people don’t really connect suicide with pediatric patients, but really the CDC reports that suicide is the second leading cause of death between individuals between the ages of 10 and 34. And so, it is out there and it’s something that we need to address. And in 2016, Children’s of Alabama engaged in a research counsel project within the state and they were identifying areas where the state of Alabama needs more assistance or can do better for our patients. And of the nine instances, mental health was one of them.
So, this lead to in March of 2018, Children’s of Alabama working with the Anne B. LaRussa Foundation to help establish our psychiatric intake response center to meet that mental health need in the community because we know that we can’t make more providers or have more child psychiatrists out there; but we can help people navigate the system and navigate and connect to those providers that are out there. Because a lot of them aren’t really known.
Host: There are not many centers like this in the country, correct?
Dr. Martinez: That’s correct. So, when we were doing research to find out what would be the best way to allocate our resources that we have here along with the Anne B. LaRussa Foundation; we did a research project and looked into the nation and we came across another psychiatric intake response center. There’s actually two other ones in the nation. They are both in Ohio. One is at Cincinnati Children’s and the other is in Akron Children’s. And so we actually went over there, paid them a visit, toured and were able to kind of look at the way they worked their psychiatric intake response center and bring that here to Children’s of Alabama.
Host: What is the goal for PIRC moving forward?
Dr. Martinez: Moving forward, right now like I mentioned, we are serving, or we have a lot of resources for the five local counties surrounding Children’s hospital; Jefferson, Shelby, Blount, St. Clair and Walker counties. And out goal in the future is to continue to expand to reach other counties within our state. Now right now, we do have people calling us from like Madison county, from Mobile Alabama calling us looking for resources and we always do a search and we always get resources for them. But we hope to further expand our database to include the surrounding counties and further out in Alabama.
Host: And then what about the mental health providers in the area when you all were in the planning stages; was there some sort of contact with them to say heh, we’re starting this database, do you want to be a part of it?
Dr. Martinez: Yes, so we did reach out to mental health providers or clinicians in the community. We had a forum. A lot of people showed up to learn about what the PIRC is and what the services we are able to offer, and the word has really spread to the point now we have people that are establishing clinics or establishing treatment centers that are calling us to ask us if they can be on our resource lists.
Host: Oh, that’s great. That’s terrific. What kind of response are you getting from those mental health providers? Are they contacting you and letting you know that things are working, any feedback from them?
Dr. Martinez: So far, we are getting a lot of positive feedback that we are sending the appropriate cases to them or appropriate patients in their direction. They are grateful that we are able to kind of triage and navigate and send someone that would be a good fit for that specific therapist or counselor in the community. One of the complex things about looking for a mental health clinician or provider is insurance and who takes what insurance and so we’ve actually received feedback that from different agencies that they appreciate that we are sending them the people that are able to receive those services.
Host: So, that’s part of your database is knowing what type of insurance that mental health provider has or accepts.
Dr. Martinez: Right, what type of insurance, what type of age range, what type of diagnoses, what type of therapies. So, we are able to kind of filter out and help.
Host: I can imagine it would be hard to have a child with some mental health or behavioral issues and just not knowing where to turn.
Dr. Martinez: Right. A lot of times, people don’t know who to turn to, how to start that conversation and it goes along with the stigma surrounding mental illness. Nobody wants to say or go to somebody and say like I’m concerned because my child is saying that they no longer want to live, or I’m concerned because my child is struggling in school. Everyone wants to talk about how great their child is doing. And we’re that voice to advocate for the child and let the families know it’s okay. It’s not the end of the world. These are the next steps you need to take. This is how you need to get that help for your child and we’re always there to provide education and encourage them to call us back and let us know what we need to do to help them more.
Host: It’s a confidential call, right?
Dr. Martinez: Yeah. When anybody calls us, the telephone call is strictly confidential. We respect all of our callers’ privacy especially because a lot of people are unsure when they call us or maybe nervous when they call us and so we don’t share any information with anybody else and we only provide the resources to that family directly.
Host: Anything you’d like to share about the team and how this has fit into the landscape of menta health in this state?
Dr. Martinez: This has just been a great service and a great project to be a part of. And our team is there active, ready and willing to help those that need help navigating the mental health system. A lot of times people might feel like I don’t know if I have the – if it is appropriate to call or why should I call, how do I get in contact. Do I call or do I go to the emergency room? I mean we want to take all of that, all those pressures away from our callers and just encourage them to give us a call and let us help you and we will ultimately let us help you help that child.
Host: So, what are the goals as far as access to care for these patients?
Dr. Martinez: We really want families and adult callers to give us a call first so our licensed mental health professionals can triage the situation and really provide the resources to get that patient to the right level of care at the right time. Ultimately, we want to decrease the long waits in our emergency rooms that are already clogged with a lot of patients that may not necessarily need to come to the emergency room for an evaluation. If we can take care of this over the phone and the child can be safe in their home and go to someone in their local community; that would make everything all worth it.
Host: Okay, so remind us the hours and the phone number to call.
Dr. Martinez: All right so, the number for our Psychiatric Intake Response Center PIRC is 205-638-PIRC or 205-638-7472. We are open seven days a week from 8 a.m. to 11 p.m. and we are based here at Children’s of Alabama.
Host: Okay and that website if anyone would like more information is www.childrensal.org/pirc, P-I-R-C. Thank you so much for joining us Dr. Martinez.
Dr. Martinez: Thank you for having me.
Host: Thanks for listening to Inside Pediatrics. More podcasts like this one can be found at www.childrensal.org/insidepediatrics.
Perks of the PIRC - Psychiatric Intake Response Center at Children's
Tiffany Kaczorowski (Host): Welcome to Inside Pediatrics, a podcast brought to you by Children’s Hospital of Alabama in Birmingham. I’m Tiffany Kaczorowski. Today we’re talking about the Psychiatric Intake Response Center or PIRC with Dr. Jesse Tobias Martinez. Dr. Martinez is Medical Director of the PIRC and Consultation Liaison Psychiatry at Children’s of Alabama. He is also an Assistant Professor at UAB, the University of Alabama at Birmingham. Welcome Dr. Martinez.
Jesse Tobias C. Martinez, Jr. M.D. (Guest): Thank you. Thank you for having me.
Host: So, let’s talk about PIRC. What exactly is PIRC?
Dr. Martinez: The PIRC is – it stands for the Psychiatric Intake Response Center and really, we are a telephone triage response center for patients and families to really help them better navigate the mental health system. It’s a confidential telephone response center linking adult callers to mental health resources for children and teens.
Host: And currently you guys are serving five different counties surrounding the metro area of Birmingham. Is that correct?
Dr. Martinez: Correct. Currently, we have a database with over 500 plus providers in the Jefferson, Shelby, Blount, St. Clair and Walker counties.
Host: One of the things that we try to let people know that PIRC is not is a suicide or crisis hot line. Correct? Explain to us the difference between what PIRC can do and then what those are for.
Dr. Martinez: That’s correct. So, the PIRC is really a resource center to help patients and families better navigate the complex mental health system. But we always ask callers and the community to not call the PIRC when you do have a severe crisis, if someone is suicidal. We always say call 9-1-1, call the crisis hotline or go to the nearest emergency room.
Host: Yeah, so PIRC is really more as a resource. What types of things are people calling about?
Dr. Martinez: We get telephone calls from a variety of callers whether it be teachers, nurses, other clinicians or physicians and the community social workers and patients’ families as well. And we are getting calls about children that are depressed, about bullying, anxiety, difficulty or problems in school. More recently we are getting more calls about self-harming and cutting and also, we do, even though we are not a crisis hotline; we still get telephone calls about suicidality and how to help parents navigate or how to help parents help those children.
Host: PIRC is really for adult callers of children or possibly if they are taking care of children in a scenario like a physician who may need some advice on what to do with this patient family.
Dr. Martinez: We always want to hear or speak with an adult caller because we can better help provide them resources, communicate telephone numbers to better help that adult person help that pediatric child patient.
Host: And on this side, on this end of the line; who is answering the calls in the PIRC?
Dr. Martinez: When anybody calls the Psychiatric Intake Response Center at the 638-7472; you are going to get connected with a licensed mental health professional and those licensed mental health professionals have years of education and experience in working with pediatric patients in the mental health field. That’s like one of the number one things that we require when anyone applies to work with us in our PIRC. And they are the ones that are going to provide the education and recommend the most appropriate resources.
Host: Okay. What is the goal for that mental health professional as they answer that call? What is their goal, before they get off the line with that person?
Dr. Martinez: The goal of the licensed mental health professional during that telephone call is to quickly assess and triage the situation or the concern that the caller has and then connect pediatric patients to the right level of care at the right time. We really want to help families and others in the community avoid navigating the complex mental health system. And that’s one of the things that we hear a lot about that when we go out to the community, a lot of people say like they don’t really know how to get ahold of somebody or who to talk to and then when we talk to pediatricians; a lot of them say go to the nearest emergency room and if someone is depressed or having thoughts of wanting to harm themselves or are just not behaving appropriately in class, because they just don’t know who to go to.
Host: I would imagine that is often a barrier to getting help is that sometimes parents, caregivers just don’t know where to start.
Dr. Martinez: Exactly. They don’t know where to start, who to call, what insurance some agencies take, how long the wait and then they get discouraged because they hear that the wait at some places is several months out or several weeks out or they are not taking patients. So, we have our licensed mental health professionals constantly updating our database to make sure that we are giving the most accurate information to our callers.
Host: Is there a need sometimes to follow-up with these callers and ask them how things went?
Dr. Martinez: Yes. So, we do provide follow-up phone calls for families to just make sure that they were able to make that connection with that mental health professional in the community. If we have a case where we feel that really needs a follow-up phone call; we do provide that as well. And then we also encourage our callers to always give us a call back, so we give up to three resources at a time to a family. And we always tell them just give us a call back if those don’t work out for you or if you need more education. Because the reason we chose three is if we give someone a whole list, they become like overburdened or maybe confused, overwhelmed. Yes, exactly, so we give three and we tell them try these three; if that doesn’t work just give us a call back.
Host: Now let’s talk about – a little bit about the history behind the PIRC and the need for this resource center here in northern central Alabama.
Dr. Martinez: I always want to mention that suicide, a lot of people don’t really connect suicide with pediatric patients, but really the CDC reports that suicide is the second leading cause of death between individuals between the ages of 10 and 34. And so, it is out there and it’s something that we need to address. And in 2016, Children’s of Alabama engaged in a research counsel project within the state and they were identifying areas where the state of Alabama needs more assistance or can do better for our patients. And of the nine instances, mental health was one of them.
So, this lead to in March of 2018, Children’s of Alabama working with the Anne B. LaRussa Foundation to help establish our psychiatric intake response center to meet that mental health need in the community because we know that we can’t make more providers or have more child psychiatrists out there; but we can help people navigate the system and navigate and connect to those providers that are out there. Because a lot of them aren’t really known.
Host: There are not many centers like this in the country, correct?
Dr. Martinez: That’s correct. So, when we were doing research to find out what would be the best way to allocate our resources that we have here along with the Anne B. LaRussa Foundation; we did a research project and looked into the nation and we came across another psychiatric intake response center. There’s actually two other ones in the nation. They are both in Ohio. One is at Cincinnati Children’s and the other is in Akron Children’s. And so we actually went over there, paid them a visit, toured and were able to kind of look at the way they worked their psychiatric intake response center and bring that here to Children’s of Alabama.
Host: What is the goal for PIRC moving forward?
Dr. Martinez: Moving forward, right now like I mentioned, we are serving, or we have a lot of resources for the five local counties surrounding Children’s hospital; Jefferson, Shelby, Blount, St. Clair and Walker counties. And out goal in the future is to continue to expand to reach other counties within our state. Now right now, we do have people calling us from like Madison county, from Mobile Alabama calling us looking for resources and we always do a search and we always get resources for them. But we hope to further expand our database to include the surrounding counties and further out in Alabama.
Host: And then what about the mental health providers in the area when you all were in the planning stages; was there some sort of contact with them to say heh, we’re starting this database, do you want to be a part of it?
Dr. Martinez: Yes, so we did reach out to mental health providers or clinicians in the community. We had a forum. A lot of people showed up to learn about what the PIRC is and what the services we are able to offer, and the word has really spread to the point now we have people that are establishing clinics or establishing treatment centers that are calling us to ask us if they can be on our resource lists.
Host: Oh, that’s great. That’s terrific. What kind of response are you getting from those mental health providers? Are they contacting you and letting you know that things are working, any feedback from them?
Dr. Martinez: So far, we are getting a lot of positive feedback that we are sending the appropriate cases to them or appropriate patients in their direction. They are grateful that we are able to kind of triage and navigate and send someone that would be a good fit for that specific therapist or counselor in the community. One of the complex things about looking for a mental health clinician or provider is insurance and who takes what insurance and so we’ve actually received feedback that from different agencies that they appreciate that we are sending them the people that are able to receive those services.
Host: So, that’s part of your database is knowing what type of insurance that mental health provider has or accepts.
Dr. Martinez: Right, what type of insurance, what type of age range, what type of diagnoses, what type of therapies. So, we are able to kind of filter out and help.
Host: I can imagine it would be hard to have a child with some mental health or behavioral issues and just not knowing where to turn.
Dr. Martinez: Right. A lot of times, people don’t know who to turn to, how to start that conversation and it goes along with the stigma surrounding mental illness. Nobody wants to say or go to somebody and say like I’m concerned because my child is saying that they no longer want to live, or I’m concerned because my child is struggling in school. Everyone wants to talk about how great their child is doing. And we’re that voice to advocate for the child and let the families know it’s okay. It’s not the end of the world. These are the next steps you need to take. This is how you need to get that help for your child and we’re always there to provide education and encourage them to call us back and let us know what we need to do to help them more.
Host: It’s a confidential call, right?
Dr. Martinez: Yeah. When anybody calls us, the telephone call is strictly confidential. We respect all of our callers’ privacy especially because a lot of people are unsure when they call us or maybe nervous when they call us and so we don’t share any information with anybody else and we only provide the resources to that family directly.
Host: Anything you’d like to share about the team and how this has fit into the landscape of menta health in this state?
Dr. Martinez: This has just been a great service and a great project to be a part of. And our team is there active, ready and willing to help those that need help navigating the mental health system. A lot of times people might feel like I don’t know if I have the – if it is appropriate to call or why should I call, how do I get in contact. Do I call or do I go to the emergency room? I mean we want to take all of that, all those pressures away from our callers and just encourage them to give us a call and let us help you and we will ultimately let us help you help that child.
Host: So, what are the goals as far as access to care for these patients?
Dr. Martinez: We really want families and adult callers to give us a call first so our licensed mental health professionals can triage the situation and really provide the resources to get that patient to the right level of care at the right time. Ultimately, we want to decrease the long waits in our emergency rooms that are already clogged with a lot of patients that may not necessarily need to come to the emergency room for an evaluation. If we can take care of this over the phone and the child can be safe in their home and go to someone in their local community; that would make everything all worth it.
Host: Okay, so remind us the hours and the phone number to call.
Dr. Martinez: All right so, the number for our Psychiatric Intake Response Center PIRC is 205-638-PIRC or 205-638-7472. We are open seven days a week from 8 a.m. to 11 p.m. and we are based here at Children’s of Alabama.
Host: Okay and that website if anyone would like more information is www.childrensal.org/pirc, P-I-R-C. Thank you so much for joining us Dr. Martinez.
Dr. Martinez: Thank you for having me.
Host: Thanks for listening to Inside Pediatrics. More podcasts like this one can be found at www.childrensal.org/insidepediatrics.