Planning for Great Outcomes

Planning for Great Outcomes
PEDIATRICIAN GUIDE

What families can expect from a Blackbird Health New Patient Evaluation

By Nicole Garber, MD, Blackbird Health Chief Medical Officer

A clinically rigorous, 90-minute whole-child assessment designed to deliver clarity and a clear plan forward.

When you refer a patient for mental health care, you want to know they’ll receive an evaluation that is thorough, clinically sound, and sensitive to the realities families face. At Blackbird Health, our 90-minute virtual New Patient Evaluation (NPE) is designed to do exactly that.

Unlike brief, symptom-focused intakes, the NPE is a structured, whole-child assessment led by a psychiatric mental health nurse practitioner (PMHNP). It integrates history, standardized tools, clinical observation, and diagnostic expertise to create a precise understanding of what’s driving a child’s challenges—and how to best support them.

Below is an overview pediatricians and other pediatric professionals can use when explaining our process to families.

1. Clarifying the reason for referral

Every evaluation begins with a focused conversation to understand why the family is seeking care. We work with the family to distill this into a clear, concise problem statement. From there, we explore:

  • When symptoms first emerged
  • How behaviors and emotions have changed over time
  • What interventions have helped or worsened symptoms

This gives us a shared starting point and ensures we're addressing both current concerns and developmental context.

2. Comprehensive background review

To understand the full picture, we complete a structured review of the child's:

  • Medical and developmental history (including pregnancy, birth, and early milestones)
  • Social and school context (environment, peer relationships, stressors, routines)
  • Family history (psychiatric illness, neurodevelopmental conditions, substance use)
  • Screening (when necessary) for ASD, SLP, and OT concerns

This step helps us spot patterns or contributing factors that may not be apparent through symptoms alone.

3. Live clinical observation + mental status exam

A key strength of our NPE is real-time observation while the child is in a comfortable, familiar environment. During the mental status exam, the clinician evaluates:

  • Affect, mood, and congruence
  • Thought process and content
  • Attention, speech, and motor activity
  • Observable physical indicators (tics, tremors, speech patterns, gait)

These observations often reveal nuances—such as anxiety masked by high verbal ability or attention challenges that only emerge in conversation—that might be missed in shorter or purely questionnaire-based assessments.

4. Standardized assessment tools

When clinically indicated, we incorporate validated instruments that offer objective data to guide diagnosis. Common tools include:

  • GAD-7 (anxiety)
  • PHQ-9 (depression)
  • BASC-3 (behavior and emotional functioning)
  • Vanderbilt scales
  • Columbia Suicide Severity Rating Scale

These tools support our clinical impressions and help benchmark symptoms over time.

5. Safety assessment

Every NPE includes a formal safety evaluation, regardless of the presenting concern. We assess:

  • Passive and active suicidal ideation
  • Self-harm behaviors
  • Intent, plan, and means
  • Protective factors and available supports

This allows us to identify hidden risks early and intervene appropriately.

6. Diagnostic synthesis + immediate next steps

The evaluation concludes with a clear, integrated clinical impression. We pull the whole picture together so that families leave the visit with:

  • A working diagnosis (when appropriate)
  • Identification of potential co-occurring conditions
  • Tailored recommendations for next steps—therapy, medication management, further evaluations, or school/family supports

Because nearly nine out of 10 children who need mental health support have more than one contributing factor, understanding the whole child is essential for accurate diagnosis and effective care planning.

When clinically appropriate, families may begin therapy immediately after the NPE to reduce delays in care.

How pediatricians can explain the NPE to families

Here are a few simple ways to frame the visit:

  • “Blackbird does a full, 90-minute diagnostic evaluation so we understand the whole picture—not just one symptom.”

  • “They look at behavior, development, emotional health, and family context to see how everything fits together.”

  • “You’ll leave with clear next steps and a plan tailored to your child.”

This language helps families know what to expect and reinforces that the evaluation is both thorough and actionable.

Our goal: clarity that leads to better outcomes

The Blackbird New Patient Evaluation is designed to answer the question families ask most: “What’s really going on, and how do we help our child?” By integrating history, observation, standardized tools, and whole-child analysis, we build a precise, defensible care plan that addresses root causes—not just symptoms.

Nicole Garber, MD, Blackbird Health Chief Medical Officer

Nicole Garber, MD, Blackbird Health Chief Medical Officer

Nicole Garber, MD, Chief Medical Officer at Blackbird Health, is a nationally recognized eating-disorder expert. She is triple board-certified in General Psychiatry, Child & Adolescent Psychiatry, and Obesity Medicine; a certified Dialectical Behavior Therapy (DBT) therapist; and has advanced training in psychodynamic therapy, mentalization-based therapy, and Acceptance & Commitment Therapy (ACT). Dr. Garber developed the adolescent eating-disorder track at the Menninger Clinic, led the pediatric and adolescent eating-disorder program at Rosewood Centers, and served as Vice President of Psychiatric Services at Meadows Behavioral Health and Chief of Psychiatry at The Meadows Ranch. She was most recently the chief medical officer at Alsana where she led the standardization and growth of their eating disorder and diabetes program. She is a Fellow of the American Psychiatric Association and lectures nationally on eating-disorder diagnosis and treatment, self-harm, and integrated care.

When you refer a family to Blackbird, they receive a thorough diagnostic assessment and clear next steps right from the start. Our team is here to support your clinical goals and make the transition into care seamless.

Send patients directly through our secure referral page.

Make a referral

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