Access to mental health services for children in Alameda County remains critical. In 2022, fewer than 5% of over 300,000 eligible children under 21 in Alameda County received specialty mental health services (SMHS), according to the California Department of Health Care Services, underscoring a significant gap in care.
The new Eastmont Wellness in-person Child and Adolescent Psychiatric Clinic is tailored to the unique needs of patients aged 3 to 21 years. It aims to develop a sustainable, integrated model of care that strengthens the mental health safety net for children and families.
“Mental health care is essential at every stage of life, and early intervention can make a profound difference in a child’s well-being,” shared Dr. Evan Trager, a board-certified child, adolescent and adult psychiatrist.
Limited access is further compounded by a shortage of mental health professionals, particularly child psychiatrists. A 2017 external review of the SMHS program found California had fewer than 1,150 child and adolescent psychiatrists serving over nine million children, making it difficult to meet demand.
To help bridge this gap, Dr. Trager established the Clinic with Drs. Jessica Wang, medical director, and Zarah Iqbal, associate medical director. In addition, he collaborates with primary care and pediatric providers to facilitate referrals, ensuring timely access to services.
“Our patients have long lacked adequate outpatient psychiatry services, so it’s exciting to offer child psychiatry linked to primary care,” said Dr. Wang. “I hope we can continue to expand outpatient psychiatry at AHS.”
Dr. Iqbal, a pediatrician who frequently refers patients to Dr. Trager, shares this enthusiasm. “Having a psychiatry clinic embedded within our primary care clinic allows our patients to access this critical care within the familiar setting of their medical home,” she explained. “They already know us and trust us and can extend that feeling of comfort to their mental health care, which is critical for their engagement and willingness to be open about difficult topics and experiences.”
This collaborative approach helps identify complex cases requiring specialized psychiatric care, leading to referrals beyond anxiety and depression. While anxiety and depression are common adolescent diagnoses, pediatricians or therapists often manage them initially, Dr. Trager noted.
“The most frequent referrals I receive include post-traumatic stress disorder (PTSD), autism spectrum disorder (ASD), treatment-resistant conditions, obsessive-compulsive disorder (OCD), and psychotic spectrum disorders,” he said.
Dr. Trager’s expertise in treating complex conditions stems from both professional training and personal experience. Originally planning to specialize in pediatrics, his career shifted when he and his wife unexpectedly became foster parents to a five-year-old and a nine-year-old. Their 16-month experience exposed gaps in trauma-informed care, inspiring his focus on child psychiatry.
“This eye-opening experience, along with the lack of trauma-informed care, inspired me to specialize in child psychiatry to address these critical needs,” he said.
Looking ahead, Dr. Trager emphasizes continued collaboration with pediatricians and family medicine providers to identify community needs and expand services. His goals include recruiting more child psychiatrists, establishing specialty clinics for complex cases, and enhancing resources for high-acuity patients such as those recently hospitalized or at risk.
“Ultimately, success means developing a sustainable, integrated model of care that strengthens the mental health safety net for the children and families we serve,” shared Dr. Trager.