Promoting Earlier Access to Pediatric Behavioral Health Services with Colocated Care

Abstract

Objective: This study aimed to determine whether youth access behavioral health (BH) care earlier (i.e., when problems are less severe) when receiving services in colocated pediatric primary care clinics. Methods: Six primary care clinics in the Midwest with a colocated BH provider participated in this study. Data on number of sessions attended/not attended with the BH provider, BH symptom severity as measured by the Child Behavior Checklist, parent report of length of presenting problem, and improvement ratings were collected and compared for on-site referrals and off-site referrals. Descriptive, independent sample t tests and regression analyses compared those referred from on-site physicians versus off-site referral sources. Results: Results demonstrated that youth receiving BH services at their primary care physician's office accessed services when problems were less severe and had been impacting their functioning for a shorter duration. Conclusion: This study is among the first to explore whether youth receiving BH services in primary care are accessing those services earlier than those who are referred from outside sources, resulting in improved patient outcomes.

Experiences of Mothers Participating in a Mother–Child Video Therapy Program

“…Colocating essential programs into health services has been shown to improve mental health outcomes to a significantly greater degree than usual care in a meta-analysis of 31 randomized controlled studies (d = 0.63, P < .001) 38 and appears to improve access to care and outcomes. 39 Similar positive results are likely to be seen with colocated parenting programs, although further research is needed to confirm this premise. Furthermore, video feedback and other types of mental health care are billable services, allowing them to become sustainable once established.…”

“…First, they can work to establish video‐feedback and other parenting programs as one of the core services offered in their practice. Colocating essential programs into health services has been shown to improve mental health outcomes to a significantly greater degree than usual care in a meta‐analysis of 31 randomized controlled studies (d = 0.63, P < .001) 38 and appears to improve access to care and outcomes 39 . Similar positive results are likely to be seen with colocated parenting programs, although further research is needed to confirm this premise.…”

BHIPP:0–5: Primary care practice transformation in early childhood behavioral health integration.

“…In a rapidly changing health care system, the focus has shifted from volume-based, fee-for-service models to value-based, cost control models (McClellan & Leavitt, 2016; National Academies of Sciences, Engineering, and Medicine, 2017). Pediatric primary care settings have the opportunity to capitalize on frequent and early contact with young children to improve health outcomes and reduce costs across the life span (Buchholz et al, 2018; Valleley et al, 2019). However, demonstrating reductions in health care costs is challenging because the benefits of ECBH services, especially those focused on prevention and health promotion, are often realized years later and in sectors beyond health care (McGrady, 2014; Heckman, 2011).…”

“…Primary care settings can deliver the full continuum of physical and behavioral health services from prevention and health promotion to screening, early identification, triage, referral, and intervention (Anderson et al, 2015; Hagan et al, 2017). With nearly one third of presenting problems and family concerns related to development or behavioral health issues (Boreman et al, 2007), the need for integrated behavioral health services and supports in pediatric primary care is pronounced (Briggs-Gowan et al, 2000; Stancin & Perrin, 2014; Valleley et al, 2019; Wissow et al, 2016).…”

“…See for additional description of ECBH activities and examples of practice transformation efforts. Early childhood behavioral health integration services provide avenues for prevention and early identification, treatment of cases where no diagnosis exists, management of problems at the family or adult caregiver level that cannot be attributed to the identified patient, care coordination and systems navigation for families with complex needs, and targeted triage and referral to appropriate community resources (Buchholz et al, 2018; Buchholz & Talmi, 2012; Talmi et al, 2016; Valleley et al, 2019).…”