Youth Mental Health Crisis: A pioneer seeks to rebuild a broken system

This article is part of The Recorder’s ongoing series examining the child and adolescent mental health crisis through the perspectives of parents, teens, educators and mental health professionals.

Dr. Vera Feuer is director of pediatric emergency psychiatry at Northwell Health. FRANCES F. DENNY PHOTO

By MELISSA WHITWORTH

What if there was an entirely new way to address the adolescent mental health crisis? One where parents, educators and providers were all connected? 

 What if there were no long wait times to see psychiatrists, psychologists and social workers? What if the place for adolescents in crisis was no longer the emergency room? What if parents of children struggling no longer felt overwhelmed and alone as they navigated a fractured system of mental health care? 

This new way requires dramatic systemic change, and Dr. Vera Feuer is spearheading that overhaul in our community.

Feuer, director of pediatric emergency psychiatry at Northwell Health, has been described in turns by colleagues, parents and teachers as a pioneer and visionary, someone who is relentless in her pursuit of a better way for children and parents to not only navigate a broken system, but to help rebuild it.

Originally from Budapest, Hungary, Feuer moved to the U.S. in 1995 to attend Case Western Reserve University in Ohio. She went on to study at the State University of New York Buffalo, and completed her residency at Drexel University, Philadelphia, Pa., followed by a fellowship at Northwell.

“The issue in Westchester and in many other places, is that the care system is very fragmented and it’s missing a lot of pieces,” she told The Recorder. “At the very bottom — the prevention — and at the very top —  the crisis, the immediate access — those are the areas where we’re missing the most pieces.”

What is the solution? First, Feuer and her team partner with school districts. Then, they take the haphazard and often overwhelming task of accessing providers and close the gaps.

Extending school teams

“In partnership and in collaboration, we really truly mean to be an extension of a school team. Where their scope ends, ours begin,” she said. “We are the connector and the bridge to this complicated mental health care system that families need help navigating. And that is truly the secret sauce needed behind the program.”

Parents can expect to start hearing about this new programming soon through their schools and pediatricians. As part of our continuing coverage, The Recorder also will share details and progress reports on the rollout with the community. 

“Our hope is to come and enhance that further for mental health with professional development and more support for parents,” Feuer said. “Workshops, support groups, parenting resources, self-directed resources, guiding parents to resources online that are appropriate or can help self-support, learning and care for those that are again in that bottom level. So one component of our programming is all about awareness, community engagement, education, mental health literacy, and doing that work.”

The results of Feuer’s Long Island pilot program through Northwell Health, which she started seven years ago, have been dramatic. Officials reported a 60 percent decrease in the number of students going to the emergency room. Further, 98 percent of children and adolescents seen at Feuer and her team’s behavioral health center are discharged and only 2 percent are hospitalized.

“The medical metrics speak for themselves,” said Lisa Schwartz, board member of Northern Westchester Hospital and co-chair of the community health committee. 

“For decades, we’ve come to realize that solving complex challenges requires a systems approach. And yet to make things manageable we tend to break down what’s needed into manageable bites which often leads to piecemeal and ineffective solutions,” she continued. 

Nine area school districts including Katonah-Lewisboro and Bedford Central are in talks to sign on to the program. Each district would contract with their local BOCES to receive mental health support services made available through the program.

By summer, officials expect there will be an urgent care center for mental health, modeled on the one in Long Island, set up on the same street as Northern Westchester Hospital.

More access to care

“Our overarching goal and plan is to bring more access and more child mental health care to Westchester and to recognize that different families access care differently and they need different things,” Feuer said. 

For kids in crisis, “care needs to be accessible immediately,” she said.  Waiting three months to see a provider is not acceptable, she stressed. 

Feuer said the new model aims to connect families to appropriate providers — or, at a minimum, bridge the gap in care until those providers are found and booked.  

The Long Island project was a huge undertaking. There, she manages connections with 54 school districts, which includes about 300 schools and over 200,000 students. Then she connects those students in those districts with the behavioral health teams of Northwell, Cohen Children’s Medical Center and the Children’s Hospital in New Hyde Park. 

“That is no small scope,” said Derek Anderson, executive director of Northern Westchester Hospital, part of Northwell.

“As soon as we got connected with Vera,” Anderson said, it was evident “she has such a passion for all of this, not only as an expert psychiatrist but in building programs that have such reach. For a clinician to pursue an area of medicine that is not always the simplest or the best working hours or the best pay — we could name many other specialties that pay more — she chose to go into a field that’s highly complex and, even more so, to do it with children.”

“So I think that in and of itself speaks to who she is,” Anderson said. “It takes a special person to pursue that area of medicine.”

Seeking solutions post-pandemic

Anderson said that as the community emerged out of the pandemic, “everything ‘mental health’ was just amplified and especially with our teens and young people. We were seeking solutions. We looked at each other and we said, ‘Where are we doing this? What can we bring? How can we replicate, build upon, amplify the work that’s happening in Long Island and how do we bring it here locally?’ It took us a matter of days to find Dr. Feuer.”

The pinnacle of this initiative will be the bricks and mortar mental health urgent care facility for adolescents. Northwell signed the lease for this space near the hospital in Mount Kisco in October 2024. The center will work to support families by providing immediate access, and short-term stabilization. 

The next component of the model is outpatient care. 

“We recognize that in that middle, where maybe there is not the biggest gap in care, there’s still a big need,” Feuer said. 

Within the urgent care facility there will also be an outpatient child and adolescent psychiatry clinic that works on medication management and evidence-based treatments. — “all the things that outpatient mental health therapy clinics offer,” Feuer said.

“We have also started embedding behavioral health providers, mental health providers, social workers, psychologists, counselors into pediatric offices to help pediatricians screen and provide short-term support and then coordinate and help families get connected with care,” she noted. “And part of our work is to do that with all pediatricians so that they’re aware of the resources available in their community and that they have access to some education so that they can support families.”

“With all that rides on mental well-being it’s clear that building structures to support this is a herculean task — few are up to the job,” said Schwartz, who has been part of a group that spearheaded bringing this mental health initiative to our area and has lived in Bedford Hills for 35 years.  

 “And yes, it takes a village but every village needs a leader,” she said. “Vera Feuer is that leader when it comes to child and adolescent mental health.” 

The Recorder’s series will next examine student involvement in guiding policy on youth mental health issues through their participation on the Northern Westchester Hospital President’s Junior Leadership Council. The series will also highlight personal essays by two council members.