Developing an innovative pediatric integrated mental health care program: interdisciplinary team successes and challenges
IntroductionChildren and adolescents often do not receive mental healthcare when they need it. By 2021, the complex impact of the COVID-19 pandemic, structural racism, inequality in access to healthcare, and a growing shortage of mental health providers led to a national emergency in child and adole...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-11-01
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| Series: | Frontiers in Psychiatry |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1252037/full |
| _version_ | 1797593336243027968 |
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| author | Jason Schweitzer Jason Schweitzer Anne Bird Anne Bird Hilary Bowers Hilary Bowers Hilary Bowers Nicole Carr-Lee Josh Gibney Josh Gibney Kriston Schellinger Jasmine R. Holt Devin P. Adams Domonique J. Hensler Kathryn Hollenbach Kathryn Hollenbach |
| author_facet | Jason Schweitzer Jason Schweitzer Anne Bird Anne Bird Hilary Bowers Hilary Bowers Hilary Bowers Nicole Carr-Lee Josh Gibney Josh Gibney Kriston Schellinger Jasmine R. Holt Devin P. Adams Domonique J. Hensler Kathryn Hollenbach Kathryn Hollenbach |
| author_sort | Jason Schweitzer |
| collection | DOAJ |
| description | IntroductionChildren and adolescents often do not receive mental healthcare when they need it. By 2021, the complex impact of the COVID-19 pandemic, structural racism, inequality in access to healthcare, and a growing shortage of mental health providers led to a national emergency in child and adolescent mental health in the United States. The need for effective, accessible treatment is more pressing than ever. Interdisciplinary, team-based pediatric integrated mental healthcare has been shown to be efficacious, accessible, and cost-effective.MethodsIn response to the youth mental health crisis, Rady Children’s Hospital-San Diego’s Transforming Mental Health Initiative aimed to increase early identification of mental illness and improve access to effective treatment for children and adolescents. A stakeholder engagement process was established with affiliated pediatric clinics, community mental health organizations, and existing pediatric integrated care programs, leading to the development of the Primary Care Mental Health Integration program and drawing from established models of integrated care: Primary Care Behavioral Health and Collaborative Care.ResultsAs of 2023, the Primary Care Mental Health Integration program established integrated care teams in 10 primary care clinics across San Diego and Riverside counties in California. Measurement-based care has been implemented and preliminary results indicate that patient response to therapy has resulted in a 44% reduction in anxiety symptoms and a 62% decrease in depression symptoms. The program works toward fiscal sustainability via fee-for-service reimbursement and more comprehensive payor contracts. The impact on patients, primary care provider satisfaction, measurement-based care, funding strategies, as well as challenges faced and changes made will be discussed using the lens of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework.DiscussionPreliminary results suggest that the Primary Care Mental Health Integration is a highly collaborative integrated care model that identifies the needs of children and adolescents and delivers brief, evidence informed treatment. The successful integration of this model into 10 primary care clinics over 3 years has laid the groundwork for future program expansion. This model of care can play a role addressing youth mental health and increasing access to care. Challenges, successes, and lessons learned will be reviewed. |
| first_indexed | 2024-03-11T02:06:35Z |
| format | Article |
| id | doaj.art-bfde8007a3674edf8b5873a32eb3777f |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-03-11T02:06:35Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-bfde8007a3674edf8b5873a32eb3777f2023-11-18T11:49:58ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402023-11-011410.3389/fpsyt.2023.12520371252037Developing an innovative pediatric integrated mental health care program: interdisciplinary team successes and challengesJason Schweitzer0Jason Schweitzer1Anne Bird2Anne Bird3Hilary Bowers4Hilary Bowers5Hilary Bowers6Nicole Carr-Lee7Josh Gibney8Josh Gibney9Kriston Schellinger10Jasmine R. Holt11Devin P. Adams12Domonique J. Hensler13Kathryn Hollenbach14Kathryn Hollenbach15Child and Adolescent Division, Department of Psychiatry, University of California, San Diego, La Jolla, CA, United StatesTransforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United StatesChild and Adolescent Division, Department of Psychiatry, University of California, San Diego, La Jolla, CA, United StatesTransforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United StatesChild and Adolescent Division, Department of Psychiatry, University of California, San Diego, La Jolla, CA, United StatesTransforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United StatesChildren’s Primary Care Medical Group, San Diego, CA, United StatesTransforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United StatesChild and Adolescent Division, Department of Psychiatry, University of California, San Diego, La Jolla, CA, United StatesTransforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United StatesTransforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United StatesTransforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United StatesTransforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United StatesTransforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United StatesTransforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United StatesDepartment of Pediatrics, University of California, San Diego, La Jolla, CA, United StatesIntroductionChildren and adolescents often do not receive mental healthcare when they need it. By 2021, the complex impact of the COVID-19 pandemic, structural racism, inequality in access to healthcare, and a growing shortage of mental health providers led to a national emergency in child and adolescent mental health in the United States. The need for effective, accessible treatment is more pressing than ever. Interdisciplinary, team-based pediatric integrated mental healthcare has been shown to be efficacious, accessible, and cost-effective.MethodsIn response to the youth mental health crisis, Rady Children’s Hospital-San Diego’s Transforming Mental Health Initiative aimed to increase early identification of mental illness and improve access to effective treatment for children and adolescents. A stakeholder engagement process was established with affiliated pediatric clinics, community mental health organizations, and existing pediatric integrated care programs, leading to the development of the Primary Care Mental Health Integration program and drawing from established models of integrated care: Primary Care Behavioral Health and Collaborative Care.ResultsAs of 2023, the Primary Care Mental Health Integration program established integrated care teams in 10 primary care clinics across San Diego and Riverside counties in California. Measurement-based care has been implemented and preliminary results indicate that patient response to therapy has resulted in a 44% reduction in anxiety symptoms and a 62% decrease in depression symptoms. The program works toward fiscal sustainability via fee-for-service reimbursement and more comprehensive payor contracts. The impact on patients, primary care provider satisfaction, measurement-based care, funding strategies, as well as challenges faced and changes made will be discussed using the lens of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework.DiscussionPreliminary results suggest that the Primary Care Mental Health Integration is a highly collaborative integrated care model that identifies the needs of children and adolescents and delivers brief, evidence informed treatment. The successful integration of this model into 10 primary care clinics over 3 years has laid the groundwork for future program expansion. This model of care can play a role addressing youth mental health and increasing access to care. Challenges, successes, and lessons learned will be reviewed.https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1252037/fullprimary carepediatricsprimary care behavioral healthintegrationmental healthcollaborative care |
| spellingShingle | Jason Schweitzer Jason Schweitzer Anne Bird Anne Bird Hilary Bowers Hilary Bowers Hilary Bowers Nicole Carr-Lee Josh Gibney Josh Gibney Kriston Schellinger Jasmine R. Holt Devin P. Adams Domonique J. Hensler Kathryn Hollenbach Kathryn Hollenbach Developing an innovative pediatric integrated mental health care program: interdisciplinary team successes and challenges Frontiers in Psychiatry primary care pediatrics primary care behavioral health integration mental health collaborative care |
| title | Developing an innovative pediatric integrated mental health care program: interdisciplinary team successes and challenges |
| title_full | Developing an innovative pediatric integrated mental health care program: interdisciplinary team successes and challenges |
| title_fullStr | Developing an innovative pediatric integrated mental health care program: interdisciplinary team successes and challenges |
| title_full_unstemmed | Developing an innovative pediatric integrated mental health care program: interdisciplinary team successes and challenges |
| title_short | Developing an innovative pediatric integrated mental health care program: interdisciplinary team successes and challenges |
| title_sort | developing an innovative pediatric integrated mental health care program interdisciplinary team successes and challenges |
| topic | primary care pediatrics primary care behavioral health integration mental health collaborative care |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1252037/full |
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