Bingham Clinic: Helping Children for 100 years…and Counting
The University of Louisville Bingham Clinic is celebrating its 100th anniversary this year. The clinic’s precursor, which was founded by the Jefferson County school system, was among the first centers in the nation dedicated to children’s mental health.
Bingham marked the anniversary with a continuing medical education session for healthcare providers, a birthday dinner and a community forum about children’s mental health care.
“These were special moments for our faculty and staff to be able to spend time with our former trainees and referring physicians as well as our long-time supporters—people like Congressman John Yarmuth, who served on Bingham’s board of directors, and Edie Bingham, whose family has been a friend to the clinic since the 1930s. As we plan our next 100 years, it’s important to remember how we got here,” said Allan Josephson, MD, chief of the Division of Child & Adolescent Psychiatry and Psychology in the Department of Pediatrics.
Fourth child guidance center in the nation
The Commonwealth Fund of New York established a start-up fund for child guidance centers at the beginning of the 20th century. After New York City, Boston and Chicago, they turned to Louisville, where the school system’s Psychological Laboratory was already assessing intellectually disadvantaged and gifted children for grade placement and curriculum development. With support from the Commonwealth Fund, the Louisville center began working with truant and delinquent children and continued to evolve as the need for children's mental health services changed.
“Once, there were only two recognized diagnoses: Hyperkinetic Reaction of Childhood, which we now know as ADHD, and Runaway Reaction of Childhood. Today, we have identified more than 30 mental health diagnoses of childhood,” Josephson explained. “Our knowledge about children’s mental health issues has grown dramatically over the past 100 years and the clinic has responded accordingly.”
After the school district withdrew from managing the center in the 1930s, it affiliated with the University of Louisville School of Medicine. Spafford Ackerly, MD, one of the first child psychiatrists in the country, was tapped to redevelop the clinic and lead the UofL Department of Psychiatry. For the next 25 years, Ackerly ran the UofL Department of Psychiatry from the Louisville Mental Hygiene Clinic.
Ackerly also partnered with Barry Bingham, Sr., editor and publisher of The Courier-Journal and the Louisville Times. They worked together to raise awareness of the plight of Louisville’s mentally ill and to improve their care. Bingham’s ongoing mental health advocacy, which began in the 1930s, was recognized in 1974 when the Louisville Mental Hygiene Clinic’s new office was named the Bingham Child Guidance Clinic.
The modern era
Today the Bingham Clinic has a dual focus. It’s faculty serve the local community, treating the most challenging problems and families in need. They also are educators and have trained many of the community’s mental health leaders.
Bingham Clinic’s current roster of eleven psychiatrists and psychologists have a wide range of pediatric mental and behavioral health expertise, including family treatment, chronic pain management, sports psychiatry, children who start fires, minority youth, obesity, autism and inpatient psychiatry.
“Like Dr. Ackerly, who was known as the father of psychiatry in the state of Kentucky, our faculty are national leaders in the fields of child and adolescent psychiatry and psychology,” Josephson said. “For example, in the last two years our faculty have lectured at four of the eight Ivy League universities. They also serve on numerous national committees.”
The Clinic oversees several training programs. It offers a two-year child and adolescent psychiatry residency training program, a one-year child and adolescent psychology internship and a one-year post-doctoral child and adolescent psychology fellowship.
“We are educators, as well as clinicians and researchers,” Josephson said.
The more things change, the more they stay the same
Even as the field of psychiatry and the Bingham Clinic has evolved, the need for children’s psychiatric services has expanded over the past 100 years.
A recent CDC study found that 20 percent of children have mental disorders. Yet, children face modern versions of many of the same barriers to care that kept children from getting needed treatment 100 years ago: a shortage of pediatric psychiatry/psychology specialists, long waiting periods and inadequate insurance coverage top the list.
The Bingham Clinic continues to seek creative solutions to these problems. The clinic has adopted a family focus rather than working solely with the children and adolescents in treatment. The psychologists and psychiatrists recently joined the UofL Department of Pediatrics, which has increased their ability to work with children as they come to their pediatrician’s office. Several Bingham psychiatrists are now engaging in telepsychiatry, counseling children across the state via the internet.
“There is nothing quite so distressing as a child in emotional pain and nothing so heartening as seeing joy return to a child. We at the Bingham Clinic are constantly looking for new ways to help families move their kids from the former condition to the latter. We think that attitude will sustain us through another 100 years of caring for children,” Josephson said.