Five Questions With: Dr. Karyn Horowitz

Dr. Karyn Horowitz was named chief medical officer of Bradley Hospital in August after serving as the hospital’s director of outpatient services for about 17 years.

Since joining Bradley’s staff in 2003, Horowitz, a practicing child psychiatrist, has helped expand its programs for children who are dealing with mental health and behavioral issues. She discusses the changes she’s witnessed at Bradley and the effect of the COVID-19 pandemic on demands for mental health treatment for children. 

PBN: What are some of your main priorities as you settle into the role of chief medical officer? 

HOROWITZ: My main priority is to ensure that Bradley Hospital provides high-quality care to as many children and families as possible while maintaining a safe and healthy work environment for our patients, families and employees.

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Bradley Hospital is focused on meeting the psychiatric needs of children and families, which requires balancing important Lifespan regulatory requirements and quality goals with our children’s psychiatric hospital and services.

We also need to continue collaborating creatively with other groups throughout R.I., such as the Department of Children, Youth & Families, the Department of Health, and other health systems to meet the significant mental health treatment needs of R.I. children and families.

PBN: How has Bradley Hospital changed since you joined the staff in 2003? 

HOROWITZ: Bradley Hospital has grown significantly since 2003, adding a range of services designed to meet the growing and varied mental health needs of children throughout R.I. These additions include several partial hospital programs for children who need significant support and structure but do not need to sleep at the hospital; an expansion of outpatient services for children and families; Bradley School programs; additional residential and acute residential services; and an outpatient program for Spanish-speaking families through our Gateway Healthcare affiliate.

PBN: As chief medical officer, are you still able to see patients? 

HOROWITZ: Yes. It was important to me to maintain my clinical practice, as I find great motivation and joy in providing care to children and their families. When families present for treatment, they are typically at a crisis in their lives. It is painful for everyone in the family when a child has a psychiatric condition. As parents gain understanding into what is happening with their child, they learn what they can do differently to support them, and [when] the child has the necessary treatment, it is a relief for everyone. There is no greater reward or motivation for me as when I hear a parent say, “I feel like I have my child back.”

PBN: We’ve seen many headlines about children suffering from stress and anxiety due to the COVID-19 health crisis. Has Bradley Hospital seen an uptick in patients who are dealing with pandemic-related mental health issues? If so, how has the hospital responded? 

HOROWITZ: As with the national trend, the rates of psychiatric illness in Rhode Island during COVID have increased dramatically. The social isolation, multiple disruptions to people’s daily structure and routines, chronic uncertainty, financial stress and loss of community connection can exacerbate existing psychiatric conditions such as anxiety and depression, and lead to the onset of these conditions. Unprecedented numbers of families are seeking services for their children who are increasingly impaired with their psychiatric symptoms.

Bradley Hospital has made virtual treatment available for those families in outpatient and partial hospitalization levels of care and provided ways for families to remain connected to their children and treatment team virtually. However, the need is increasing, and we are planning to launch new programs for school-age children and for those patients with autism/developmental disabilities who need more support in the after-school hours.

We have also been working to meet children and families “where they are” through partnerships with the R.I. Department of Education and our Pediatric Psychiatry Resource Network, a grant-funded program to support pediatric primary care providers with access to child psychiatrists to support treatment of mild to moderate mental health conditions in their practice. Unfortunately, the need is great, and we will need to continue to work to meet it through ongoing collaborations.

PBN: Is there any sort of advice that you find yourself often sharing with parents of patients? 

HOROWITZ: You know your child better than anyone else. If you notice that there is a change, in terms of their sleep, appetite, mood, energy level, social engagement or academic functioning, talk with them about it and talk with your pediatrician or another health care provider about it as well.

Listen to what your child is saying to you without judgment and validate their thoughts and feelings. Remember that all psychiatric conditions can start in childhood, they often run in families and it is usually no one’s fault that your child is suffering. There are excellent treatments available and it is important to be proactive in seeking care, especially early on.

Most importantly, be sure to be involved in your child’s treatment. It is not enough for your child to go to treatment; you must be an active participant in that treatment and be sure that your child’s providers include you in important conversations. You will all be learning new skills that will support your family in the years to come.

Elizabeth Graham is a PBN contributing writer.