This session presents a comprehensive, multimodal approach to integrated behavioral health in pediatric primary care settings using Walpole Pediatric Associates (WPA) as a case study. WPA’s approach to integrated behavioral health provides preventive, diagnostic, episodic, and long-term psychotherapy, as well as psychiatric medication management services as both direct and consultant service provision. By offering a continuum of psychotherapeutic services within the child’s pediatrician’s office, patients receive timely and accessible treatment, provided with multidisciplinary provider collaboration. The continuum of care also provides financial sustainability through established, dependable, and long-term funding sources. This presentation will use the integrated health program at Walpole Pediatric Associates as a case example showing success in outcomes and financial sustainability by blending primary care behaviorist model (PHCM) and collaborative care model (CoCM) modes of integrated behavioral health. Presenters will highlight clinical outcomes, patient response, and program efficacy since implementation.
The American Psychological Association Center for Psychology and Health report, the essential component of integrated care, discussed emerging research showing a hybrid model of PCBH and CoCM to have the best outcomes in providing integrated behavioral health care (IBH) (n.d.). Knowing that barriers to mental health care – access (physical and financial) as well as trust in providers – are exacerbated in the pediatric setting, integrated behavioral health is an ideal option for children to receive both short and long-term intervention (Campo et al., 2018). WPA has implemented a model of integrated behavioral health that offers preventive and intervention using a continuum of service provision with success.
WPA had been an established medical home with a medical home coordinator. In 2020, when patient’s mental health needs were increasing, WPA started an on site integrated behavioral health program. Over the years our practice has refined service provision to provide behavioral health intervention through a collaborative model. Monson et al. discuss the importance of flexibility, collaboration, and established funders for successful IBH models. Embedding flexibility in service delivery and aligning clinical care with practice workflows IBH can provide success patient care while being financially sustainable (2012). WPA found success in providing comprehensive collaborative care. Program outcomes since implementation demonstrate positive patient response, improved access to care, positive treatment outcomes, and overall behavioral health program efficacy within a pediatric primary care environment.
Attendees will gain practical insights into an inclusive model of pediatric integrated behavioral health that can be adapted across primary care settings. The target audience includes primary care practices with integrated behavioral health services, behavioral health clinicians, administrators, and trainees seeking scalable and sustainable approaches to integrated care and program development.
Objectives
Understand multimodal behavioral health model used at Walpole Pediatrics including contributing classic and evidence based models used in combination.
Identify and describe treatment, collaborative, financial, and workflow benefits and outcomes of the model in practice.
Explain how model addresses patient and practice needs as well as problem areas with sustainability in Integrated Behavioral Health practice and continued development/growth.
Discuss participants practices and integration models and identify ways presented model could fill care gaps and improve sustainability as well as discussing areas of concern with the model.
References:
Campo, C.V., Geist, R., & Kolko, D.J. (April, 2018) Integration of Pediatric Behavioral Health Services in Primary Care: Improving Access and Outcomes with Collaborative Care. Can J Psychiatry. 63(7):432-438. https://chppoc-my.sharepoint.com/personal/ppoc471379_chppoc_org/_layouts/15/onedrive.aspx?id=%2Fpersonal%2Fppoc471379%5Fchppoc%5Forg%2FDocuments%2FDocuments%2Fresearch%20studies%2Ffor%20presentation%2FIntegration%20of%20Pediatric%20Behavioral%20Health%20Services%20in%20Primary%20Care%5F%20Improving%20Access%20and%20Outcomes%20with%20Collaborative%20Care%20%2D%20PMC%2Epdf&parent=%2Fpersonal%2Fppoc471379%5Fchppoc%5Forg%2FDocuments%2FDocuments%2Fresearch%20studies%2Ffor%20presentation&ga=1
American Psychological Association. (n.d.). Behavioral Health Services in Primary Care, An essential component of integrated care. APA center for psychology and health. https://chppoc-my.sharepoint.com/personal/ppoc471379_chppoc_org/_layouts/15/onedrive.aspx?id=%2Fpersonal%2Fppoc471379%5Fchppoc%5Forg%2FDocuments%2FDocuments%2Fresearch%20studies%2Ffor%20presentation%2FBehavioral%20Health%20Services%20in%20Primary%20Care%20in%20Primary%20Care%2Epdf&parent=%2Fpersonal%2Fppoc471379%5Fchppoc%5Forg%2FDocuments%2FDocuments%2Fresearch%20studies%2Ffor%20presentation&ga=1
Monson, S.P., Sheldon, J.C., Ivey, L.C., Kinman, C. R., & Beacham, A.O. (2012). Working toward financial sustainability of integrated behavioral health services in a public health care system. Families, Systems, & Health, 30(2), 181-186. https://psycnet.apa.org/record/2012-11976-001
Campo, C.V., Geist, R., & Kolko, D.J. (April, 2018) Integration of Pediatric Behavioral Health Services in Primary Care: Improving Access and Outcomes with Collaborative Care. Can J Psychiatry. 63(7):432-438. https://chppoc-my.sharepoint.com/personal/ppoc471379_chppoc_org/_layouts/15/onedrive.aspx?id=%2Fpersonal%2Fppoc471379%5Fchppoc%5Forg%2FDocuments%2FDocuments%2Fresearch%20studies%2Ffor%20presentation%2FIntegration%20of%20Pediatric%20Behavioral%20Health%20Services%20in%20Primary%20Care%5F%20Improving%20Access%20and%20Outcomes%20with%20Collaborative%20Care%20%2D%20PMC%2Epdf&parent=%2Fpersonal%2Fppoc471379%5Fchppoc%5Forg%2FDocuments%2FDocuments%2Fresearch%20studies%2Ffor%20presentation&ga=1
American Psychological Association. (n.d.). Behavioral Health Services in Primary Care, An essential component of integrated care. APA center for psychology and health. https://chppoc-my.sharepoint.com/personal/ppoc471379_chppoc_org/_layouts/15/onedrive.aspx?id=%2Fpersonal%2Fppoc471379%5Fchppoc%5Forg%2FDocuments%2FDocuments%2Fresearch%20studies%2Ffor%20presentation%2FBehavioral%20Health%20Services%20in%20Primary%20Care%20in%20Primary%20Care%2Epdf&parent=%2Fpersonal%2Fppoc471379%5Fchppoc%5Forg%2FDocuments%2FDocuments%2Fresearch%20studies%2Ffor%20presentation&ga=1
Monson, S.P., Sheldon, J.C., Ivey, L.C., Kinman, C. R., & Beacham, A.O. (2012). Working toward financial sustainability of integrated behavioral health services in a public health care system. Families, Systems, & Health, 30(2), 181-186. https://psycnet.apa.org/record/2012-11976-001
Association between depression symptoms severity and total cost of care.pdf
Evolving Models of Integrated Behavioral Health and Primary Care | Current Psychiatry Reports