Integrating a System of Care (SOC) Approach with Pediatric Medical Homes: Evaluation of Massachusetts Young Children's Interventions for Learning and Development (MYCHILD)

Pediatric medical homes have traditionally done an inadequate job at responding to the mental health needs of young children. MYCHILD transforms the pediatric medical home into the center of SOCs where early childhood mental health issues are routinely identified and addressed. Family partner and early childhood mental health clinician pairs are integrated within pediatric teams in four health practices in Boston to provide family-driven culturally competent and coordinated care to young children and their families. The MYCHILD evaluation answers policy-relevant questions focused on the intersectionality of early childhood health, mental health and parental wellbeing. The evaluation uses multiple methods, including surveys, focus groups, clinical outcome measures and MassHealth data, to answer questions of policy relevance to a variety of stakeholders. A quasi-experimental design using four years of MassHealth data is used to explore differences between service utilization and costs for children served by MYCHILD and a matched comparison group. Because asthma is often associated with mental health conditions, utilization of and costs for asthma care are targeted outcomes in the MassHealth data. Asthma is the most frequent medical condition seen in children served by MYCHILD. Finally, the evaluation examines the implementation of the transformed pediatric medical homes including changes in provider knowledge and behaviors. To date 94 children and families have received MYCHILD services. Populations served by MYCHILD reflect those served by the practices. Children's ages range from one month to seven years. Over 50% of mothers have depression with 20% reporting other mental health conditions.