- Lauren Peterson, MA, Doctoral Candidate, Spalding University, Louisville, KY
As of 2016, about 16.5% of school-aged children in the US had been diagnosed with a mental health disorder. Non-Hispanic white children are more likely than their minority peers to receive treatment from a mental health professional. There are significant barriers to accessing behavioral health treatment, including stigma, cost, cultural barriers, and limited community pediatric behavioral health resources. As more than 90% of children have visited their primary care provider (PCP) at least once in the previous year, this makes pediatricians uniquely situated for the identification of behavioral health concerns. The collaborative care model, an approach in which PCPs collaborate with care managers and behavioral health consultants, is classified as a “scientifically supported” strategy to improve mental health. In addition to improved patient outcomes, integrated care reduces costs and medical utilization. Despite the clear benefits of integrated care, clinical experiences reflect practical barriers to implementation. Providers in busy community clinics are often overwhelmed by patient volume and limited by a lack of resources. A significant obstacle to integration is difficulties with billing for two visits on the same day. Providers may be hesitant to screen for behavioral health conditions with inadequate referral sources or follow-through. This presentation will include pathways identified as practical for implementation by pediatric providers at a Federally Qualified Health Center in an urban, medically underserved area. The aim is to maximize the utilization of limited resources and improve the efficiency of care while emphasizing evidence-based interventions that focus on the patient’s experience within the healthcare setting. This project will present the process of identifying a target population, understanding current practices, reviewing evidence for improving care, evaluating billing options, establishing goals, and piloting the pathways.
- Describe the barriers to implementing clinical pathways in pediatric primary care.
- List the process of developing clinical pathways.
- Discuss the process of identifying and treating behavioral health concerns.