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Integration of Mental Health in Primary Care

Integration of Mental Health in Primary Care

Healthcare reform under the Accountable Care Act is spurring efforts by many healthcare systems to find ways to make mental health care more accessible to children and families.  Because of the shortage of mental health specialists and other barriers (including costs), many healthcare systems and healthcare leaders are recognizing that delivering children's mental health services within primary care settings is both desirable and necessary.  Various terms are used to describe primary care mental health integration strategies, such as "Collaborative Care", "Integrated Behavioral Health," and even "Patient-Centered Medical Care", which often overlaps with the requirement that primary care systems use methods that put patients' needs first.  In pediatric primary care settings, multiple studies have now shown that the health domain that results in the greatest impairment and disability is the mental health domain.

Unfortunately, mental health services cannot be fully integrated into primary care settings without support and training for pediatric primary care clinicians - pediatricians, family physicians, nurse practitioners, etc. Yet almost all typical continuing medical education (CME) programs fail to provide pediatric primary care clinicians the necessary skills, confidence, and competence needed to manage the most common pediatric behavioral health problems  -- ADHD, depression, anxiety disorders, and disruptive behavior disorders. For integrated behavioral health programs to succeed, pediatric primary care clinicians need hands-on, skill-focused training sustained over time, such as the coaching programs offered through the REACH Institute, including its 6-month long "Mini-Fellowship in Pediatric Primary Care Mental", also known as the Primary Pediatric Psychopharmacology (PPP) Program.