The Scope of Behavioral Health Integration in a Pediatric Primary Care Setting

Abstract

Objective: The current study examines the scope of integrated behavioral health services provided by behavioral health clinicians in pediatric primary care.

Methods: A cross-sectional electronic health record review was conducted to characterize integrated behavioral health services including consultation types, recommendations, and medical diagnoses. Services were provided over a 6-year period in an urban, residency-training clinic serving a primarily publicly insured population.

Results: Of the 4,440 patients seen by behavioral health clinicians (BHCs), 2,829 (63.7%) were seen during well-child checks to address a wide array of presenting problems. The five consultation types "Healthy Steps (6%), pregnancy-related depression (17.7%), developmental (19.2%), mental health (53.2%), and psychopharmacology (5%)" were characterized by differences in demographics, presenting problems, recommendations, and medical diagnoses.

Conclusions: Pediatric BHCs provide a wide range of services to pediatric populations in the context of integrated behavioral health programs. Implications for workforce capacity development, evaluation of outcomes and impact, and sustainability are discussed.

Keywords: health care services; health promotion and prevention; mental health; primary care; professional and training issues; psychosocial functioning.