Updated: November 25, 2024 / 2024 CHAMPIONS OF HEALTH CARE

Champions of Health Care: Li empowers children to take control of their mental health

By Mica Kanner-Mascolo

Children are the experts on their own lives, says Dr. Xuejing Li. Centering the experiences of children and their families is an integral aspect of Li’s approach to the psychiatric care she provides as the medical director, outpatient behavioral health at Worcester nonprofit Seven Hills Foundation.

With a case load of 120 children and counting, Li works to prescribe medication while being keenly attuned to the different kinds of systems her patients are living in.

“If you want to work with children, you need to work with the environment where the children reside,” said Li.

Children don’t exist in a vacuum, she said, and because of this, providers must interact and collaborate with those responsible for her patients.

This means working with the child’s caregivers. Oftentimes, the difficulties presented in a child are the reflection of challenges the family encounters, including generational trauma passed along to them.

“She really cares about the child or the adolescent’s voice in their care, and she works to really establish a trusting relationship with the child as well as with the parents,” said Judi Rock, assistant vice president of behavioral health services at YOU, Inc. in Worcester, an affiliate of Seven Hills Foundation.

The nature of Li’s profession means not every child who sits in her chair is choosing to, or even wants to be there. Many clients want to get help, said Li, but can come to their sessions with doubts in the process due to previous negative experiences with the mental health system.

It is especially in times like these when showing a genuine interest in a child’s experience is pertinent.

“They have so many authority figures in their lives,” said Li. “They're telling them what you need to do, but you want to be there to listen to them, to hear their voice, and really try to give them options.”

Li has never seen a successful case in which the provider is trying to force a child to accept their idea of how treatment should look.

“We really have to let the kid lead where the treatment goes, and really to hear about their preference, to meet them at the level where they are, to really listen to them, to hear their needs,” she said.

Li is adaptable and creative in her approach to medication management, said Rock. She deeply prioritizes educating children and their caregivers on the risks and benefits of medications so they are empowered in their decisions to take or not take medication.

“At the end of the day, if the child's not going to take it, the child's not going to take it,” said Rock. “She tries to meet the child and the parents where they're at.”

Li led a bridge clinic from July 2020 to June 2022, providing urgent access to psychiatric care for children and adolescents discharged from a higher level of care in which they received short-term acute stabilization.

Now Li is supporting the Seven Hills team as it prepares to launch a similar initiative: an urgent care clinic offering expedited psychiatric assessments and clinician assignments for children, in a preventative approach to treating mental health.

Li mentors two to three medical students per month from UMass Chan Medical School in Worcester as they go through their rotations. The experience is incredibly eye-opening for students, said Li. As opposed to working in a lab and wearing a white coat, her profession involves a lot of collaborative work and takes on a community mental health model: job demands not all students are exposed to.

“She just takes [mentoring] really seriously; and she takes the time to really explain, and she values their opinion,” said Rock. “It's so clear. She really tries to engage them, to be collaborative and participate when they're here.”

While working in the field of children’s mental health is challenging and demanding in its own right, Li said clients keep her motivated.

“They are so resilient,” she said.

For Li, seeing a child’s hard work pay off reinforces a core belief, motivating and shaping her approach to care. “I do have the belief that children, they want the best for their future,” she said.

See all the 2024 Champions of Health Care award winners.