Implementation of an embedded behavioral health care model in a pediatric rheumatology subspecialty juvenile myositis clinic

Abstract

Youth with chronic medical illness, such as juvenile myositis (JM), require specialized behavioral health care. However, access to such care is challenging due to the youth mental health crisis, which impacts accessibility of mental health services in the community, as well as challenges accessing behavioral health care above and beyond the demands of care related to their JM management. In this paper we describe an embedded behavioral health care model, including the establishment and implementation of such a model, at a pediatric hospital where youth with JM receive medical care in a Center of Excellence (CoE). We describe a unique partnership with a philanthropic organization; the challenges and benefits of delivering care within this model; as well as recommendations for maximizing its effectiveness. Ultimately, we provide an example of a successful embedded behavioral health care program for youth with rare disease, which may be applied to other institutions providing similar care.

Mental health in paediatric and adult myositis-related diseases: current state of research, interventions, and future steps from the MIHRA Psychological Impact Scientific Working Group

“…Models of mental health services integration with physician education have been effective among those with chronic diseases such as diabetes and cystic fibrosis, and potentially predict similar success in IIMs (91,92). Roadmaps for integrating behavioural health care within paediatric rheumatology and juvenile myositis clinics demonstrate feasibility and provide guidance for replication (93,94). Integrated behavioural health services for adults with neuromuscular conditions are shown to reduce hospital length of stay, improve adherence, decrease emergency department visits, reduce mental health symptoms, provide pain relief, and improve HRQoL, as well as reduce emergency behavioural health spending by 19% and offset medical costs by 20% (86).…”