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Presenting an Integrated and Comprehensive Healthcare System for Vulnerable Adolescents and Young Adults at the Dornsife Population Health Spotlight

March 10, 2016

“The biggest challenge in keeping young adults healthy involves changing the notion that adolescence is a mere transition period,” said Angela Diaz, MD, PhD, MPH, director of the Mount Sinai Adolescent Center, in her March Population Health Spotlight presentation at the Dornsife School of Public Health. She described an integrated health system model used at her center as an effective way to address the health care needs, behaviors, and concerns unique to adolescents.

Rather than a transition period, Diaz argued that adolescence is a hugely important portion of life, one that is includes a need for confidentiality, compassion and services that are designed specifically for adolescents. By the year 2020, adolescents will be more diverse as a group, with 71 percent living in urbanized areas.

Most adolescents fail to receive regular well care visits, and instead use emergency rooms only when their health is compromised. Nearly 70 percent of Mount Sinai's adolescent patients are uninsured, as many can’t produce the documentation required to gain insurance without comprising their confidentiality and privacy.

Instead of relying on emergency rooms, Diaz discussed health care systems that are not only integrated and comprehensive, but staffed with people who value relationships with adolescents. The center treats 10,000 patients a year, with young adults coming from across New York City and from as far away as Washington, D.C.

"We really strive to have a program with no barriers [at our center]," said Diaz. "This means that not only are they provided care at no cost, but they see the same provider when they are well, when they are sick, and when they are an inpatient."

Services at the Mount Sinai Adolescent Health Center are completely free: everything from services to medications, even prescription glasses are free. Not only do adolescents feel at ease with such a system - as demonstrated in video testimonials shown during the presentation - but the system is also cost-effective. It only costs $1,000 per adolescent per year to receive primary care, medical care, as well as sexual and reproductive health, mental health, dental, optical, and specialized services. Dr. Diaz stated that it is costs more to have adolescents go to the emergency room than providing such services as they do at Mount Sinai.

One of the things the center takes the most pride in is their commitment to creating a safe and comfortable environment for the adolescents. "We hire for compassion, for personality and with the knowledge that they will love the kids. Everyone, even the finance people care for these children," Diaz described.

The center extends efforts to make adolescents educated health care consumers after they leave the center and transition into adult care. For example, the center is now creating a community resource map to help adolescents access services as they move from adult-focused providers.