The strained New York City healthcare landscape and shrinking mental health footprint have contributed to greater volume, complexity and acuity of behavioral health needs identified in primary care settings.  The NewYork-Presbyterian (Columbia) Pediatric Integrated Mental Health in Primary Care Program (IMP) operates in four primary care clinics in Upper Manhattan, a low-income, psychosocially stressedarea.  To meet the demand and maintain access, the IMP needed to maximize its response and treatment time and partner with key community programs to ensure efficient delivery of high-quality care.  

Technology.  To enhance its response to patients and pediatricians, the IMP developed workflows that leverage the Epic electronic health record.  These include a: (1) Safety Inbasket to identify patients whose screeners in the MyChart portal indicate a potential safety concern for suicide or interpersonal violence; (2) Site-Based Escalation Chat Group for pediatricians to message multiple IMP clinicians at once for a real-time and coordinated response to time-sensitive concerns; and (3) weekly team review, triage and assignment of referrals from the Epic referral work queue.     

Clinical Model.  While the IMP has historically provided consultation and treatment for up to six months, it is increasingly employing sessional care intervention, including single-session consultation and Solution-Focused Brief Therapy.  These models have been shown to have positive outcomes while reducing waiting lists and the risks of delayed care.  Clinicians tailor care to each patient – single session, interval, and short-term services.  The aim is for each clinician to have a balanced patient panel that allows access for new referrals and supports program sustainability.    

Care Continuum.  The IMP hired psychiatry case managers (CMs) in 2022, and the role quickly became key to maintaining program access.  The CMs join the referral meetings where the team determines which patients need IMP and/or a higher level of care.  Because specialty mental health clinics often have wait lists, CMs coordinate referrals to align with the end of the patient’s IMP episode of care.  In addition, the IMP established preferred provider relationships with a community mental health clinic and health home.  Regular check-ins, express referral pathways, and clear communication have been essential to the success of these partnerships and timely linkage of patients with care and support.

Poster presentation attendees will gain valuable insights into these scalable, patient-centered solutions that promote efficiency and sustainability in pediatric integrated mental health programming.