220990 Integrating behavioral and physical health care for Children: Evaluating progress

Tuesday, November 9, 2010 : 3:15 PM - 3:30 PM

Karen Hacker, MD, MPH , Institute for Community Health, Cambridge Health Alliance, Cambridge, MA
Eileen Dryden, PhD , Institute for Community Health, Cambridge Health Alliance, Cambridge, MA
Shalini Tendulkar, ScD, ScM , Institute for Community Health, Cambridge, MA
Alice Knowles , Institute for Community Health, Cambridge, MA
Joel Goldstein, MD , Division of Child/Adolescent Psychiatry, Cambridge Health Alliance, Cambridge, MA
Lee Ann Jarnigan, PNP , Pediatrics, Cambridge Health Alliance, Somerville, MA
David Link, MD , Department of Pediatrics, Cambridge Health Alliance, Cambridge, MA
Integrating behavioral and physical care for children is one of the foundations of the medical home model. This comprehensive patient centered approach is challenging to implement but has great promise to enhance health care. In 2001, The Institute for Community Health, along with the Cambridge Health Alliance (CHA) department of pediatrics and division of child/adolescent psychiatry embarked on a project to integrate behavioral and physical health for children (IC3).

The IC3 project used a multi-faceted approach to integration that included screening, training, co-location, and consultation. First, behavioral health screening at preventive visits was implemented in primary care along with training to improve provider skills. Simultaneously, social workers were co-located in several primary care sites. Finally, child/adolescent psychiatry developed a phone consultation service for primary care providers and attended consultative meetings at multiple sites. Project evaluation utilized quantitative and qualitative methods to ascertain outcomes. Measures included Pre/post provider surveys, parent interviews, monitoring of screening, referrals and referral completion rates. More than 10,000 children (4 to 18 yrs) were screened for behavioral health at preventive visits (approximately 70% of eligible) and over 800 children were referred from screening to mental health services. Moreover, providers report improvements in how they manage psychosocial problems and screen for mental health. They are significantly more likely to utilize mental health diagnostic codes and their behavioral health screening rates have risen. This presentation will discuss the results of the IC3 project and lessons learned pertinent to others wishing to integrate behavioral and physical health for children.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Social and behavioral sciences

Learning Objectives:
Describe strategies for the integration of behavioral and physical health care for children Identify challenges to care integration

Keywords: Child and Adolescent Mental Health, Primary Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I have overseen this program in integration of physical and mental health for children
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.