There are multiple barriers to accessing high quality, evidence-based behavioral health care for children and adolescents, including stigma, family beliefs, and the significant paucity of child and adolescent psychiatrists. Although equal access continues to be an unmet need in the USA, there is growing recognition that integrated behavioral health services in pediatric primary care have the potential to reduce health disparities and improve service utilization. In a joint position paper, the American Academy of Pediatrics (AAP) and the American Academy of Child and Adolescent Psychiatry (AACAP) highlighted the multiple benefits of children receiving initial behavioral health screening, assessment, and evidence-based behavioral health treatments in the medical home. The purpose of this paper is to review the current state of the literature related to integrated behavioral health services in pediatric primary care. Specifically, innovative models of integrated behavioral health care are discussed.
Primary care Mental health Evidence-based Integrated practice: children: adolescents Pediatric settings Behavioral health Preventive child health care Colocation Collaborative care
This is a preview of subscription content, log in to check access.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Wang PS, Berglund P, Olfson M, Pincus HA, Wells KB, Kessler RC. Failure and delay in initial treatment contact after first onset of mental disorders in the national comorbidity survey replication. Arch Gen Psychiatry. 2005;62:603–13.CrossRefPubMedGoogle Scholar
United States Graduate Medical Education National Advisory Committee. Summary Report of the Graduate Medical Education Committee to the Secretary of the Department of Health and Human Services. Hyattsville, MD; 1980.Google Scholar
Council on Graduate Medical Education. Re-Examination of the Academy of Physician Supply Made in 1980 by the Graduate Medical Education National Advisory Committee (GMENAC) for Selected Specialties, Bureau of Health Professions in Support of Activities of the Council on Graduate Medical Educat. Cambridge, MA; 1990.Google Scholar
Jung KW. Child and adolescent psychiatry workforce: a critical shortage and national challenge. Acad Psychiatry. 2003;27(4):277–82.CrossRefGoogle Scholar
DeMaso D, Martini DR, Sulik LR, et al. A guide to building collaborative mental health care partnerships in pediatric primary care. 2010. 1–27.Google Scholar
••Martini R, Hilt R, Marx L, et al. Best principles for integration of child psychiatry into the pediatric health home. 2012. This reference provides guidelines for best practices for integration of child and adolescent psychiatrists into pediatric primary care practices.Google Scholar
Valleley RJ, Hine JF, Clare A, Evans JH. Phone consultation for behavioral health–related referrals in integrated primary care. J Prim Care Community Health. 2015;6(4):260–3.CrossRefPubMedGoogle Scholar
Pidano AE, Slater CM, Dale LP, Wilbur KL, Sandhu P, Honigfeld L. Availability of telephone-based child psychiatry consultation: implications from a survey of pediatric providers in two states. J Child Fam Stud. 2016;25:2607–15. doi:10.1007/s10826-016-0423-8.CrossRefGoogle Scholar
•NNCPAP. National Network of Child Psychiatry Access Programs. http://nncpap.org/index.html. Published 2016. Accessed Aug 12, 2016. The National Network of Child Psychiatry Access Programs purports to facilitate connections between new and existing collaborative/consultative programs.
Gross RS, Briggs RD, Hershberg RS, et al. Early child social-emotional problems and child obesity: exploring the protective role of a primary care-based general parenting intervention. J Dev Behav Pediatr. 2015;36(8):594–604.CrossRefPubMedGoogle Scholar
Power TJ, Mautone JA, Marshall SA, et al. Feasibility and potential effectiveness of integrated services for children with ADHD in urban primary care practices. Clin Pract Pediatr Psychol. 2014;2(4):412–26. doi:10.1037/cpp0000056.CrossRefGoogle Scholar
Kolko DJ, Campo J, Kilbourne AM, Hart J, Sakolsky D, Wisniewski S. Collaborative care outcomes for pediatric behavioral health problems: a collaborative care outcomes for pediatric behavioral health problems: a cluster randomized trial. Pediatrics. 2014;133(4):981–92. doi:10.1542/peds.2013-2516.CrossRefGoogle Scholar
Godoy L, Carter AS, Silver RB, Dickstein S, Seifer R. Infants and toddlers left behind: mental health screening and consultation in primary care. J Dev Behav Pediatr. 2014;35(5):334–43.CrossRefPubMedPubMedCentralGoogle Scholar