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Review
. 2018 Jul;63(7):432-438.
doi: 10.1177/0706743717751668. Epub 2018 Apr 19.

Integration of Pediatric Behavioral Health Services in Primary Care: Improving Access and Outcomes with Collaborative Care

John V Campo  1 , Rose Geist  2 , David J Kolko  3
Affiliations
Review

Integration of Pediatric Behavioral Health Services in Primary Care: Improving Access and Outcomes with Collaborative Care

John V Campo et al. Can J Psychiatry. 2018 Jul.

Abstract
in English, French

Objective: To examine collaborative care interventions to integrate pediatric mental health services into primary care as a means of addressing barriers to mental health service delivery, improving access to care, and improving health outcomes.

Method: Selective review of published literature addressing structural and attitudinal barriers to behavioural health service delivery and the integration of behavioural health services for pediatric mental problems and disorders into primary care settings, with a special focus on Canadian and U.S.

Results: Integration of pediatric behavioural health services in primary care has potential to address structural and attitudinal barriers to care delivery, including shortages and the geographical misdistribution of behavioural health specialists. Integration challenges stigma by communicating that health cannot be compartmentalized into physical and mental components. Stepped collaborative care interventions have been demonstrated to be feasible and effective in improving access to behavioural health services, outcomes, and patient and family satisfaction relative to existing care models.

Conclusion: Collaborative integration of behavioural health services into primary care is a promising means of improving access to care and outcomes for children and adolescents struggling with mental problems and disorders. Dissemination to real-world practice settings will likely require changes to existing models of reimbursement and the culture of health service delivery.

Objectif :: Examiner les interventions des soins en collaboration visant à intégrer les services de santé mentale pédiatriques dans les soins de première ligne comme moyen d’éliminer les obstacles à la prestation de services de santé mentale, d’améliorer l’accès aux soins ainsi que les résultats de santé.

Méthode :: Une revue sélective de la littérature publiée portant sur les obstacles liés à la structure et aux attitudes qui nuisent à la prestation des services de santé comportementale et à l’intégration de ces services pour des problèmes et des troubles mentaux pédiatriques dans des contextes de soins de première ligne, un accent spécial étant mis sur les études canadiennes et américaines.

Résultats :: L’intégration des services de santé comportementale pédiatrique dans les soins de première ligne a le potentiel d’éliminer les obstacles liés à la structure et aux attitudes de la prestation des soins, y compris les pénuries et la mauvaise répartition géographique des spécialistes de la santé comportementale. L’intégration présente un défi aux stigmates en communiquant que la santé ne peut pas être compartimentée en éléments physiques et mentaux. Les interventions graduelles des soins en collaboration se sont révélées faisables et efficaces pour améliorer l’accès aux services de santé comportementale, les résultats, et la satisfaction des patients et des familles relativement aux modèles de soins existants.

Conclusion :: L’intégration en collaboration des services de santé comportementale dans les soins de première ligne est un moyen prometteur d’améliorer l’accès aux soins et les résultats pour les enfants et les adolescents aux prises avec des problèmes et des troubles mentaux. La diffusion à des milieux de pratique réels entraînera probablement des changements aux modèles existants de remboursement et à la culture de la prestation des services de santé.

Keywords: integration; mental health; mental health services; primary health care.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

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