The Pediatric Patient-Centered Medical Home: Innovative models for improving behavioral health.

Abstract

This article examines the concept of the Patient-Centered Medical Home (PCMH) as it applies to children and adolescents, emphasizing care for behavioral health conditions, the role of psychology and psychological science, and next steps for developing evidence-informed models for the Pediatric-PCMH. The PCMH concept for pediatric populations offers unique opportunities for psychological science to inform and enhance the transformation of the United States health care system and improve health in our nation. Available evidence on the outcomes of PCMH implementation for pediatric populations is limited, underscoring the need for additional research evaluating Pediatric-PCMH models and concepts. While behavioral health has only recently been emphasized as a formal part of the PCMH, accumulating evidence supports the effectiveness of some approaches for providing behavioral health care through pediatric primary care. These approaches suggest that a comprehensive Pediatric-PCMH model that includes behavioral health care has the potential to optimize the availability, quality, benefits, and cost-effectiveness of behavioral health services. This could ultimately enhance youth health and behavioral health, with effects potentially extending through the adult years. Rigorous research and demonstration projects are needed to guide further development of optimal strategies for improving health and behavioral health in pediatric populations and advancing the public health impact of behavioral health care services. (PsycINFO Database Record

I heard it through the grapevine: Where and what parents learn about youth mental health treatments

“…However, many pediatricians believe that their role is not to provide mental health treatment but to identify the need for and refer for such treatment, highlighting the importance of interdisciplinary collaboration (Asarnow, Rozenman, Wiblin, & Zeltzer, ; Heneghan et al, ; Olfson et al, ). Recent findings suggest that integrated medical‐behavioral primary care is advantageous for youth (Asarnow et al, ; Asarnow, Kolko, Miranda, & Kazak, ) and the results of this study underscore the utility in using primary care settings to bridge the gap between mental health and pediatric services. Given the degree to which parents trust pediatricians, it follows that mental health services may be better received and adhered to within an integrated care setting.…”

Medication and Cognitive Behavioral Therapy for Pediatric Anxiety Disorders

“…9 There are numerous approaches for overcoming these problems, including integrated medical-behavioral health care, co-located behavioral health and primary care services, and increasing training and rapid consultation on pediatric behavioral health. 10 However, pharmacotherapy may still be the primary available treatment option, particularly in primary care where most youths have access to care. 10 Further, when youths are referred to specialty behavioral health settings where CBT and other psychotherapies are available, many families do not follow up on referrals.…”

“…10 However, pharmacotherapy may still be the primary available treatment option, particularly in primary care where most youths have access to care. 10 Further, when youths are referred to specialty behavioral health settings where CBT and other psychotherapies are available, many families do not follow up on referrals. A key priority for the future is to identify effective strategies for bringing evidence-based treatments to the children who need them.…”

Cost-effectiveness of Family-Based Obesity Treatment

“…Research is needed to strengthen weight-change maintenance, which would lead to better long-term success, resulting in long-term economic benefits. Embedding psychologists in the PCMH to improve behavioral health is an innovative model, 32,33 which may allow behavioral treatments to be adapted for treatment in areas other than obesity and potentially affect the entire family.…”