Interfacing with the Mental Health-Care System
Mental and behavioral health disorders represent a growing burden to children and adolescents. Untreated, these conditions can lead to significant impairments and even death. There are many limitations in the current mental health system, which lead to most of these patients being seen by primary care providers. Efforts have been made to provide additional support such as clinical guidelines and innovative service models in primary care settings. Despite this, some families will still need to be seen within a mental health system that faces challenges of limited providers, funding, and overall stigma against behavioral health conditions. Primary care providers can help to smooth this transition through familiarity with available mental health resources and preparing families with what to expect once referred. These interventions will help to improve successful treatment and outcomes for children and families requiring behavioral health services.
KeywordsMental health-care systems Integrated care Levels of care Collaborative care Multidisciplinary care Coordinated care
- 3.Kochanek KD, Murphy SL, Xu J, Tejada-Vera B. Deaths: final data for 2014. Natl Vital Stat Rep. 2016;65(4). Division of Vital Statistics. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_04.pdf.
- 4.Heron M. Deaths: leading causes for 2014. Natl Vital Stat Rep. 2016;65(5). Division of Vital Statistics. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_05.pdf.
- 5.O’Connor v. Donaldson, 422 U.S. 563 (1975).Google Scholar
- 6.Tarasoff v. Regents of University of California, 17 Cal. 3d 425 (Cal. 1976).Google Scholar
- 7.Olmstead v. L.C., 527 U.S. 581 (1999).Google Scholar
- 8.Workforce Issues. American Academy of Child and Adolescent Psychiatrists. 2016. http://www.aacap.org/aacap/resources_for_primary_care/Workforce_Issues.aspx.
- 9.Merline A, Olson L, Cull W. Length of pediatric visits actually increasing. Presented at the May 2009 pediatric academic societies annual meeting. https://www.aap.org/en-us/professional-resources/Research/Pages/Length-of-Pediatric-Visits-Actually-Increasing.aspx.
- 11.Stein REK, McCue Horwitz S, Storfer-Isser A, Heneghan A, Olson L, Hoagwood KE. Do pediatricians think they are responsible for identification and management of child mental health problems? Results of the AAP periodic survey. Ambul Pediatr. 2008;8(1):11–7. https://doi.org/10.1016/j.ambp.2007.10.006.CrossRefPubMedGoogle Scholar
- 12.Subcommittee on Attention-Deficit/Hyperactivity Disorder, Steering Committee on Quality Improvement and Management. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011;2011:2654. https://doi.org/10.1542/peds.2011-2654.CrossRefGoogle Scholar
- 15.Foy JM, Kelleher KJ, Laraque D. Enhancing pediatric mental health care: strategies for preparing a primary care practice. Pediatrics. 2010;125(Suppl 3). https://doi.org/10.1542/peds.2010-0788E.
- 16.Barry Sarvet B, Gold J, Bostic JQ, Masek BJ, Prince JB, Jeffers-Terry M, Moore CF, Molbert B, Straus JH. Improving access to mental health care for children: the Massachusetts Child Psychiatry Access Project. Pediatrics. 2010;126(6):1191–200. https://doi.org/10.1542/peds.2009-1340.CrossRefPubMedGoogle Scholar
- 18.Gadomski AM, Wissow LS, Palinkas L, Hoagwood KE, Daly JM, Kaye DL. Encouraging and sustaining integration of child mental health into primary care: Interviews with primary care providers participating in Project TEACH (CAPES and CAP PC) in NY. Gen Hosp Psychiatry. 2014;36(6):555–62. https://doi.org/10.1016/j.genhosppsych.2014.05.013.CrossRefPubMedPubMedCentralGoogle Scholar
- 19.Dvir Y, Wenz-Gross M, Jeffers-Terry M, Metz WP. An assessment of satisfaction with ambulatory child psychiatry consultation services to primary care providers by parents of children with emotional and behavioral needs: the Massachusetts Child Psychiatry Access Project University of Massachusetts Parent Satisfaction Study. Front Psych. 2012;3:7. https://doi.org/10.3389/fpsyt.2012.00007.CrossRefGoogle Scholar
- 20.Medical homes for children and adolescents with mental, developmental and substance abuse disorders. Jun 2011. http://www.aacap.org/aacap/Policy_Statements/2011/Medical_Homes_for_Children_and_Adolescents_with_Mental_Developmental_and_Substance_Abuse_Disorders.aspx.
- 21.HIPAA Privacy Rule and Provider to Provider Communication. American Academy of Child and Adolescent Psychiatry (AACAP) and the American Academy of Pediatrics (AAP). https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Mental-Health/Pages/HIPAA-Privacy-Rule-and-Provider-to-Provider-Communication.aspx.
- 22.Cama S, Malowney M, Smith A, Spottswood M, Cheng E, Ostrowsky L, Rengifo J, Boyd JW. Availability of outpatient mental health care by pediatricians and child psychiatrists in five U.S. cities. Int J Health Serv. 2017. https://doi.org/10.1177/0020731417707492.
- 23.Committee on Collaboration with Medical Professionals. A guide to building collaborative mental health care partnerships in pediatric primary care. Washington, DC: American Academy of Child & Adolescent Psychiatry; 2010. https://www.aacap.org/App_Themes/AACAP/docs/clinical_practice_center/guide_to_building_collaborative_mental_health_care_partnerships.pdf.Google Scholar