Comparing Two Models of Integrated Behavioral Health Programs in Pediatric Primary Care

Germán, Miguelina; Rinke, Michael L.; Gurney, Brittany A.; Gross, Rachel S.; Bloomfield, Diane; Haliczer, Lauren A.; Colman, Silvie; Racine, Andrew D.; Briggs, Rahil D.

doi:10.1016/j.chc.2017.06.009

Cited by 26 publications

(34 citation statements)

References 26 publications

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“…Many screening programs have been introduced successfully in primary care pediatric practice to identify well-established risk factors for children, both in the child and in the family situation, and refer families for intervention [ 5 , 69 , 70 ]. Efforts to integrate care for families may facilitate these efforts, including two-generation programs as well as efforts to integrate behavioral health care with primary health care; and embedding health care systems in natural habitats of children and their families, such as schools or community centers [ 71 ].…”

Section: Transformative Effects Of Resilience Science On Practice mentioning

confidence: 99%

Resilience in Children: Developmental Perspectives

2018

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Advances in developmental resilience science are highlighted with commentary on implications for pediatric systems that aspire to promote healthy development over the life course. Resilience science is surging along with growing concerns about the consequences of adverse childhood experiences on lifelong development. Resilience is defined as the capacity of a system to adapt successfully to challenges that threaten the function, survival, or future development of the system. This definition is scalable across system levels and across disciplines, applicable to resilience in a person, a family, a health care system, a community, an economy, or other systems. Robust findings on resilience in childhood underscore the importance of exposure dose; fundamental adaptive systems embedded in the lives of individuals and their interactions with other systems; developmental timing; and the crucial role of healthcare practitioners and educators as well as family caregivers in nurturing resilience on the “front lines” of lived childhood experience. Resilience science suggests that human resilience is common, dynamic, generated through myriad interactions of multiple systems from the biological to the sociocultural, and mutable given strategic targeting and timing. Implications for pediatric practice and training are discussed.

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Section: Transformative Effects Of Resilience Science On Practice mentioning

confidence: 99%

Resilience in Children: Developmental Perspectives

2018

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“…Researchers stress the importance of the colocalization of behavioral health and primary care providers, supported with an adequate number of social workers, to better address the needs of patients with a history of childhood trauma; these practices have led to substantial benefits for patients. [61][62][63][65][66][67][93][94][95][96][97][98] One prime example of this integrated behavioral health in primary care practice is the Montefiore Hospital Pediatric primary care clinics, which we will review in more detail in a later section. 95,96 Implementation of TIC has resulted in changes in healthcare practice.…”

Section: Implementation Of Trauma-informed Care In Healthcarementioning

confidence: 99%

“…60,97,98 Additionally, the Montefiore Hospital network's implementation of TIC in pediatric primary care along with IBH, which included social workers, behavioral health clinicians and child and adult psychiatrists, resulted in improved treatment compliance, better health outcomes, increased competence of primary care providers and even reduced healthcare costs. 95,96 This hospital successfully converted itself into an Accountable Care Organization, the offshoot of The Patient Protection and Affordable Care Act, allowing them to address modifiable social determinants of health, such as individual, family, and societal trauma. 77 Flynn et al 75 , conducted a meta-analysis of studies focusing on ACEs and TIC implementation.…”

Section: Impact Of Trauma-informed Care Interventions On Child and Famentioning

confidence: 99%

Nationwide efforts for trauma-informed care implementation and workforce development in healthcare and related fields: a systematic review

Oral¹,

Coohey²,

Zarei³

et al. 2020

Turk J Pediatr

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There is building evidence that Adverse Childhood Experiences without early and proper intervention leads to subsequent short- and long-term behavioral, social, physical and mental health problems. Practitioners, researchers, and healthcare systems have been implementing trauma-informed care (TIC) in a variety of health and human services settings, resulting in improvements in clinical care and prevention of illness by identifying high risk populations. This has led to positive health outcomes including improved compliance, better access to mental health services and reduced health care costs. A systematic review was conducted of studies that focused on TIC implementation in healthcare settings, statewide TIC implementation, impact of adverse childhood experiences on health outcomes, impact of TIC on health outcomes, and evaluation of TIC implementation. A search was conducted in March 2019 to identify studies in PubMed, Medline, and other online literature. We limited our search to articles published in English after 2000. This article aims to review the components of TIC phases of implementation in healthcare settings, success stories across the nation to help the readers understand the importance of a paradigm shift to improve healthcare delivery and health outcomes and to prevent illness starting from childhood with a family centered care perspective.

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“…Child psychologists, psychology trainees, and masters-level social workers were the most common mental health provider type integrated into the pediatric setting. Thirteen studies included an integrated child psychiatrist or psychiatry trainee, who were most often part of a team with other integrated mental health providers (Briggs et al, 2016;Goodfriend et al, 2006;Levy et al, 2017;Horwitz et al, 2016;Moore et al, 2018;Rousseau et al, 2017;Schlesinger et al, 2017;Schlesinger, 2017;Subotsky & Brown, 1990;Talmi et al, 2016;German et al, 2017;Richardson et al, 2009;Shippee et al, 2018;Aguirre et al, 2013). Six studies evaluated an intervention delivered by members of the medical team (RNs, NPs, or midwives) with no prior mental health training (Kolko et al, 2010;Kolko et al, 2012;Kozlowski et al, 2015;Westerlund et al, 2017;Richardson et al, 2009;Shippee et al, 2018).…”

Section: Summary Of Included Studiesmentioning

confidence: 99%

What’s known about implementing co-located paediatric integrated care: a scoping review

Platt

Spencer

Burkey

et al. 2018

International Review of Psychiatry

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Several studies have demonstrated clinical benefits of integrated care for a range of child and adolescent mental health outcomes. However, there is a significant gap between the evidence for efficacy of integrated care interventions vs. their implementation in practice. While several studies have examined large-scale implementation of co-located integrated care for adults, much less is known for children. The goal of this scoping review was to understand how co-located mental health interventions targeting children and adolescents have been implemented and sustained. We systematically searched the literature for interventions targeting child and adolescent mental health that involved a mental health specialist co-located in a primary care setting. We included studies reporting on the following implementation outcomes: acceptability, adoption, appropriateness,

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Comparing Two Models of Integrated Behavioral Health Programs in Pediatric Primary Care

Cited by 26 publications

References 26 publications

Resilience in Children: Developmental Perspectives

Resilience in Children: Developmental Perspectives

Nationwide efforts for trauma-informed care implementation and workforce development in healthcare and related fields: a systematic review

What’s known about implementing co-located paediatric integrated care: a scoping review

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