Integration of Mental and Behavioral Health in Pediatric Health Care Clinics

Hansel, Tonya Cross; Rohrer, Glenn E.; Osofsky, Joy D.; Osofsky, Howard J.; Arthur, Elizabeth; Barker, Chikira H.

doi:10.1097/phh.0000000000000649

Cited by 13 publications

(22 citation statements)

References 14 publications

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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%

“…As a result of this intervention, parents felt more empowered and less stressed-out. 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.…”

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

confidence: 99%

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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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Section: Implementation Of Trauma-informed Care In Healthcarementioning

confidence: 99%

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

View full text Add to dashboard Cite

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“…Their work is an integral part of therapy in children who endure long-term hospitalisation caused by illnesses. Its inclusion in primary paediatric care is an element that brings significant benefits to patients [14]. The study indicates the presence of psychologists in the process of treating patients in paediatric hospitals in Poland.…”

Section: Discussionmentioning

confidence: 82%

Paediatric care standards among wards in Poland from the perspective of staff, patients, and parents with particular emphasis on psychological care

Smoczok¹,

Starszak²,

Starszak³

2020

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Introduction: During hospitalisation, the child is in an unknown environment that is associated with unpleasantness, fear, and pain. Constant progress has been made in the area of improving the mental comfort of treated children by adjusting the appearance of facilities, increasing the availability of psychologists, and educating parents and patients. Aim of the research: To summarise the perspective of three entities-staff, parents, and children in the context of hospitalisation of paediatric patients with a specification of psychological care. Material and methods: A survey consisting of 12 questions was conducted among 405 respondents divided into three study groups and three subgroups in the group of children. The study was conducted in paediatric wards with varying degrees of reference in Poland. Material was subjected to statistical analysis. Results: The most common answer in all groups was that children respond to information about the disease with fear, providing information takes place in the hospital, and is usually done by a doctor. The study showed that in Poland access to psychologists in children's wards is insufficient, while leisure time during treatment is organised satisfactorily. Conclusions: Paediatric care should be expanded to include an element of education for both the patients themselves in the context of reducing stress associated with the disease and parents in the context of contact with the sick child and providing information about the disease entity. It is necessary to increase the availability of psychologists, not only for children, but also among parents. There is a necessity to separate special zones for conversations requiring intimacy. It is important to prepare new solutions. Streszczenie Wprowadzenie: Podczas hospitalizacji dziecko przebywa w nieznanym środowisku, co wiąże się z dyskomfortem, strachem i bólem. Trwa nieustanny postęp w dziedzinie poprawy komfortu psychicznego leczonych dzieci poprzez dostosowanie wyglądu placówek, zwiększenie dostępności psychologów oraz edukację rodziców i pacjentów. Cel pracy: Badanie ma na celu porównanie perspektyw trzech podmiotów-personelu medycznego, rodziców i dzieci w zakresie hospitalizacji pacjentów pediatrycznych ze szczególnym uwzględnieniem opieki psychologicznej. Materiał i metody: Ankietę składającą się z 12 pytań przeprowadzono wśród 405 respondentów, których podzielono na 3 grupy badawcze i 3 podgrupy w subpopulacji dzieci. Badanie wykonano na oddziałach pediatrycznych o różnym stopniu referencyjności na terenie Polski. Otrzymany materiał poddano szczegółowej analizie statystycznej. Wyniki: Najczęstszą odpowiedzią we wszystkich grupach była ta, że dzieci reagują strachem na informacje o chorobie, udzielanie informacji odbywa się w szpitalu i zwykle jest wykonywane przez lekarza. Badanie wykazało, że w Polsce dostęp do psychologów na oddziałach dziecięcych jest niewystarczający, a czas wolny w trakcie leczenia jest zorganizowany w stopniu zadowalającym. Przekazywane informacje są przystępne, a choroba ma niewielki wpływ na s...

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“…Thirty-two models were evaluated (five studies evaluated two models, Germán et al, 2017;Hansel et al, 2017;Moore et al, 2018;Polaha et al, 2018;Rousseau et al, 2017; and one provider-focused article evaluated no specific model, Kolko et al, 2019). Based on the SAMHSA framework, most studies (n = 19) were co-located with varying degrees of collaboration (Level 3/Level 4) (Cederna-Meko et al, 2016;Germán et al, 2017;Gouge et al, 2016;Grimes et al, 2018;Hansel et al, 2017;Hine et al, 2017;Ivanova et al, 2019;Kisely et al, 2006;Pethe et al, 2020;Polaha et al, 2018;Shippee et al, 2018). Prospective cohort (Aupont et al, 2013;Hansel et al, 2017;Pereira et al, 2021;Valleley et al, 2007) and randomized control trial (Grimes et al, 2018;Ivanova et al, 2019;Martínez et al, 2018;Rapp et al, 2017) studies were utilized in four studies.…”

Section: Objective 2: Models Of Integrated Care Studiedmentioning

confidence: 99%

Paediatric integrated care in the primary care setting: A scoping review of populations served, models used and outcomes measured

McLeigh

Malthaner

Winebrenner

et al. 2022

Child

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Background Paediatric integrated care (PIC), which involves primary care and behavioural health clinicians working together with patients and families, has been promoted as a best practice in the provision of care. In this context, behavioural health includes behavioural elements in the care of mental health and substance abuse conditions, chronic illness and physical symptoms associated with stress, and addressing health behaviours. Models of and contexts in which PIC has been applied vary, as do the outcomes and measures used to determine its value. Thus, this study seeks to better understand (1) what paediatric subpopulations are receiving integrated care, (2) which models of PIC are being studied, (3) what PIC outcomes are being explored and what measures and strategies are being used to assess those outcomes, and (4) whether the various models are resulting in positive outcomes. These questions have significant policy and clinical implications, given current national‐ and state‐level efforts aimed at promoting integrated health care. Methods This study utilized Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Extension for Scoping Reviews to identify relevant articles published between January 1994 and 30 June 2020. The search utilized three databases: PubMed, PsycInfo and CINAHL. A total of 28 articles met the eligibility criteria for inclusion. Results Overall, acceptability of PIC appears to be high for patients and providers, with access, screening and engagement generally increasing. However, several gaps in the knowledge base on PIC were uncovered, and for some studies, ascertaining which models of integrated care were being implemented proved difficult. Conclusion PIC has the potential to improve access to and quality of behavioural health care, but more research is needed to understand what models of PIC prove most beneficial and which policies and conditions promote cost efficiency. Rigorous evaluation of patient outcomes, provider training, institutional buy‐in and system‐level changes are needed.

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Integration of Mental and Behavioral Health in Pediatric Health Care Clinics

Abstract: Utilizing community-based and culturally sensitive approaches, mental and behavioral health integrated into pediatric health care clinics can be sustainable and effective at improving child behavior problems, parenting stress, and overall family functioning.

Cited by 13 publications

References 14 publications

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

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

Paediatric care standards among wards in Poland from the perspective of staff, patients, and parents with particular emphasis on psychological care

Paediatric integrated care in the primary care setting: A scoping review of populations served, models used and outcomes measured

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