Academic Pediatrics
Volume 9, Issue 1 , Pages 7-14 , January 2009

Evolution of Child Mental Health Services in Primary Care

  • Kelly J. Kelleher, MD, MPH

      Affiliations

    • Corresponding Author InformationAddress correspondence to Kelly J. Kelleher, MD, MPH, Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, Ohio 43205.
  • ,
  • Jack Stevens, PhD

Received 2 June 2008 ,Accepted 24 November 2008.

References 

  1. Costello EJ, Mustillo S, Erkanli A, et al. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry. 2003;60:837–844
  2. Kramer T, Gerralda ME. Psychiatric disorders in adolescents in primary care. Br J Psychiatry. 1998;173:508–513
  3. Roberts RE, Attkisson C, Rosenblatt A. Prevalence of psychopathology among children and adolescents. Am J Psychiatry. 1998;155:715–725
  4. Knapp M, McCrone P, Fombonne E, et al. The Maudsley long-term follow-up of child and adolescent depression: 3. Impact of comorbid conduct disorder on service use and costs in adulthood. Br J Psychiatry. 2002;180:19–23
  5. Harpin VA. The effect of ADHD on the life of an individual, their family, and community from preschool to adult life. Arch Dis Child. 2005;90:i2–i7
  6. Costello EJ, Copeland W, Cowell A, Keeler G. Service costs of caring for adolescents with mental illness in a rural community, 1993–2000. Am J Psychiatry. 2007;164:36–42
  7. Guevara J, Lozano P, Wickizer T, et al. Utilization and cost of health care services for children with attention-deficit/hyperactivity disorder. Pediatrics. 2001;108:71–78
  8. Leibson CL, Katusic SK, Barbaresi WJ, et al. Use and costs of medical care for children and adolescents with and without attention-deficit/hyperactivity disorder. JAMA. 2001;285:60–66
  9. CMS/Centers for Medicare and Medicaid Services. The Mental Health Parity Act of 1996 (MHPA). Available at: http://www.cms.hhs.gov/healthinsreformforconsume/04_thementalhealthparityact.asp. Accessed December 5, 2008.
  10. Qinghong L, Manteuffel B, Paulic C, Sondheimer D. Describing the population of adolescents served in systems of care. J Emot Behav Disord. 2001;9:13–29
  11. Pescosolido BA, Jensen PS, Martin JK, et al. Public knowledge and assessment of child mental health problems: findings from the National Stigma Study-Children. J Am Acad Child Adolesc Psychiatry. 2008;47:339–349
  12. Azrin ST, Huskamp HA, Azzone V, et al. Impact of full mental health and substance abuse parity for children in the Federal Employees Health Benefits Program. Pediatrics. 2007;119:e452–e459
  13. Buckley PF, Madaan V. Leadership and professional workforce development. Psychiatr Clin North Am. 2008;31:105–122
  14. Horwitz SM, Kelleher KJ, Stein REK, et al. Barriers to the identification and management of psychosocial issues in children and maternal depression. Pediatrics. 2007;119:e208–e218
  15. Olson AL, Kelleher KJ, Kemper KJ, et al. Primary care pediatrician's roles and perceived responsibilities in the management of depression in children and adolescents. Ambul Pediatr. 2001;1:91–98
  16. Lavigne JV, Binns HJ, Kaufer K, et al. Behavioral and emotional problems among preschool children in pediatric primary care: prevalence and pediatricians’ recognition. Pediatrics. 1993;91:649–655
  17. Jensen P, Hinshaw S, Swanson J, et al. Findings from the NIMH Multimodal Treatment Study of ADHD (MTA): implications and applications for primary care providers. J Dev Behav Pediatr. 2001;22:60–73
  18. Gau SS, Shen HY, Chou MC, et al. Determinants of adherence on methylphenidate and the impact of poor adherence on maternal and family measures. J Child Adolesc Psychopharmacol. 2006;16:286–297
  19. Gardner W, Kelleher KJ, Pajer K, Campo JV. Follow-up care of children identified with ADHD by primary care clinicians: a prospective cohort study. J Pediatr. 2004;145:767–771
  20. Rushton J, Bruckman D, Kelleher K. Primary care referral of children with psychosocial problems. Arch Pediatr Adolesc Med. 2002;156:592–598
  21. Marhefka SL, Koenig LJ, Allison S, et al. Family experiences with pediatric antiretroviral therapy: responsibilities, barriers, and strategies for remembering medications. AIDS Patient Care STDS. 2008;22:637–647
  22. Shemesh E, Annunziato RA, Shneider BL, et al. Improving adherence to medications in pediatric liver transplant recipients. Pediatr Transplant. 2008;12:316–323
  23. Charach A, Skyba A, Cook L, Antle BJ. Using stimulant medication for children with ADHD: what do parents say? A brief report. J Can Acad Child Adolesc Psychiatry. 2006;15:75–83
  24. dosReis S, Myers MA. Parental attitudes and involvement in psychopharmacological treatment for ADHD: a conceptual model. Int Rev Psychiatry. 2008;20:135–141
  25. Hoagwood K. quoted by the National Academies Adolescent Health Care Committee Workshop National Research Council and Institute of Medicine of the National Academies. Challenges in Adolescent Health Care: Workshop Report. Washington, DC: National Academies Press; January 22, 2007;
  26. Lipkin M, Quill TE, Napadano RJ. The medical interview: a core curriculum for residencies in internal medicine. Ann Intern Med. 1984;100:277–284
  27. Evans BJ, Stanley RO, Mestrovic R, Rose L. Effects of communication skills training on students’ diagnostic efficiency. Med Educ. 1991;25:517–526
  28. Weisman CS. Communication between women and their health care providers: research findings and unanswered questions. Public Health Rep. 1987;102:147–151
  29. Wasserman RC, Inui TS, Barriatua RD, et al. Pediatric clinicians’ support for parents makes a difference: an outcome-based analysis of clinician-parent interaction. Pediatrics. 1984;74:1047–1053
  30. Street RL. Communicative styles and adaptations in physician-parent consultations. Soc Sci Med. 1992;34:1155–1163
  31. Regier DA, Goldberg ID, Taube CA. The de facto US mental health services system: a public health perspective. Arch Gen Psychiatry. 1978;35:685–693
  32. Jacobs JW, Bernhard MR, Delgado A, Strain JJ. Screening for organic mental syndromes in the medically ill. Ann Intern Med. 1977;86:40–46
  33. Strain JJ. Models for teaching communication and attitudes. Cancer. 1982;50:1974–1978
  34. Strain JJ, Pincus HA, Houpt JL, et al. Models of mental health training for primary care physicians. Psychosom Med. 1985;47:95–110
  35. Jones LR, Badger LW, Ficken RP, et al. Mental health training of primary care physicians: an outcome study. Int J Psychiatry Med. 1988;18:107–121
  36. Kelleher KJ, McInerny TK, Gardner WP, et al. Increasing identification of psychosocial problems: 1979–1996. Pediatrics. 2000;105:1313–1321
  37. Wissow LS, Wilson MEH, Roter DL. Pediatrician interview style and mothers’ disclosure of psychosocial issues. Pediatrics. 1994;93:289–295
  38. Cegala DJ, Post DM. On addressing racial and ethnic health disparities: the potential role of patient communication skills interventions. Am Behav Sci. 2006;49:853–867
  39. Wissow LS, Roter D, Bauman LJ, et al. Patient-provider communication during the emergency department care of children with asthma. Med Care. 1998;36:1439–1450
  40. Brown JD, Riley AW, Wissow LS. Identification of youth psychosocial problems during pediatric primary care visits. Adm Policy Ment Health. 2007;34:269–281
  41. Brown JD, Wissow LS, Zachary C, Cook BL. Receiving advice about child mental health from a primary care provider: African American and Hispanic parent attitudes. Med Care. 2007;45:1076–1082
  42. Erickson SJ, Gerstle M, Feldstein SW. Brief interventions and motivational interviewing with children, adolescents, and their parents in pediatric health care settings: a review. Arch Pediatr Adolesc Med. 2005;159:1173–1180
  43. Lewis CC, Pantell RH, Sharp L. Increasing patient knowledge, satisfaction, and involvement: randomized trial of a communication intervention. Pediatrics. 1991;88:351–358
  44. Roter DL, Larson S, Shinitzky H, et al. Use of an innovative video feedback technique to enhance communication skills training. Med Educ. 2004;38:145–157
  45. Mangione-Smith R, DeCristofaro AH, Setodji CM, et al. The quality of ambulatory care delivered to children in the United States. N Engl J Med. 2007;357:1515–1523
  46. McGlynn EA, Asch SM, Adams J, et al. The quality of health care delivered to adults in the United States. N Engl J Med. 2003;348:2635–2645
  47. Osborne CE, Thompson HC. Criteria for evaluation of ambulatory health care by chart audit: development and testing of a methology. Final Report of the Joint Committee on Quality Assurance of Ambulatory Health Care for Children and Youth. Pediatrics. 1975;56:625–692
  48. Spivak HR, Levy JC, Bonanno RA, Cracknell M. Patient and provider factors associated with selected measures of quality of care. Pediatrics. 1980;65:307–313
  49. Gardner W, Kelleher KJ, Pajer KA, Campo JV. Primary care clinicians’ use of standardized tools to assess child psychosocial problems. Ambul Pediatr. 2003;3:191–195
  50. Zuckerbrot RA, Jensen PS. Improving recognition of adolescent depression in primary care. Arch Pediatr Adolesc Med. 2006;16:200–210
  51. Rushton JL, Fant KE, Clark SJ. Use of practice guidelines in the primary care of children with attention-deficit/hyperactivity disorder. Pediatrics. 2004;114:e23–e28
  52. Stein MT, Perrin JM. Diagosis and treatment of ADHD in school-age children in primary care settings. Pediatr Rev. 2003;24:92–98
  53. Zuckerbrot RA, Cheung AH, Jensen PS, et al. GLAD-PC Steering Group Guidelines for Adolescent Depression in Primary Care (GLAD-PC): I. Identification, assessment, and initial management. Pediatrics. 2007;120:e1299–e1312
  54. US Preventive Services Task Force. Screening for depression. US Department of Health and Human Services and Agency for Healthcare Research and Quality Online. Released May 2002. http://www.ahrq.gov/clinic/uspstf/uspsdepr.htm. Accessed December 5, 2008.
  55. US Preventive Services Task Force. Screening for alcohol misuse. US Department of Health and Human Services and Agency for Healthcare Research and Quality Online. Released April 2004. http://www.ahrq.gov/clinic/uspstf/uspsdrin.htm. Accessed December 5, 2008.
  56. Valenstein M, Vijan S, Zeber JE, et al. The cost-utility of screening for depression in primary care. Ann Intern Med. 2001;134:418–420
  57. Mellow MM. Policing Medicaid and Medicare managed care: the role of courts and administrative agencies. J Health Polit Policy Law. 2002;27:465–466
  58. Kenny HA. Implementing the Rosie D. Remedy: the opportunities and challenges of restructuring a system of care for children's mental health in Massachusetts. Massachusetts Medicaid Policy Institute. Issue brief, September 2007. Available at: http://www.massmedicaid.org/pdfs/2007-10-12_rosie-d.pdf. Accessed December 5, 2008.
  59. Ferris TG, Dougherty D, Blumenthal D, Perrin JM. A report card on quality improvement for children's health care. Pediatrics. 2001;107:143–155
  60. Szilagyi PG, Schaffer S, Shone L, et al. Reducing geographic, racial, and ethnic disparities in childhood immunization rates by using reminder/recall interventions in urban primary care practices. Pediatrics. 2002;110:e58
  61. Shafer MA, Tebb KP, Pantell RH, et al. Effect of a clinical practice improvement intervention on Chlamydial screening among adolescent girls. JAMA. 2002;288:2846–2852
  62. Wells KB, Sherbourne C, Schoenbaum M, et al. Impact of disseminating quality improvement programs for depression in managed primary care: a randomized controlled trial. JAMA. 2000;283:212–220
  63. Asarnow JR, Jaycox LH, Duan N, et al. Effectiveness of a quality improvement intervention for adolescent depression in primary care clinics: a randomized controlled trial. JAMA. 2005;293:311–319
  64. Leslie LK, Weckerly J, Plemmons D, et al. Implementing the American Academy of Pediatrics attention-deficit/hyperactivity disorder diagnostic guidelines in primary care settings. Pediatrics. 2004;114:129–140
  65. Bernal P, Estroff DB, Aboudarham JF, et al. Psychosocial morbidity. the economic burden in a pediatric health maintenance organization sample. Arch Pediatr Adolesc Med. 2000;154:261–266
  66. Navon M, Nelson D, Pagano M, Murphy M. Use of the pediatric symptom checklist in strategies to improve preventive behavioral health care. Psychiatr Serv. 2001;52:800–804
  67. Iezzoni I. Assessing quality using administrative data. Ann Intern Med. 1997;127(5 pt 2):666–674
  68. Leslie LK, Wolraich ML. ADHD service use patterns in youth. J Pediatr Psychol. 2007;32:695–710
  69. Richardson LP, Lewis CW, Casey-Goldstein M, et al. Pediatric primary care providers and adolescent depression: a qualitative study of barriers to treatment and the effect of the black box warning. J Adolesc Health. 2007;40:433–439
  70. Kelleher KJ, Campo JV, Gardner WP. Management of pediatric mental disorders in primary care: where are we now and where are we going?. Curr Opin Pediatr. 2006;18:649–653
  71. Von Korff M, Gruman J, Schaefer J, et al. Collaborative management of chronic illness. Ann Intern Med. 1997;127:1097–1102
  72. American Academy of Pediatrics . The medical home: Medical Home Initiatives for Children With Special Needs Project Advisory Committee. Pediatrics. 2002;110:184–186
  73. Wagner EH, Austin BT, Von Korff M. Organizing care for patients with chronic illness. Milbank Q. 1996;74:511–544
  74. Weinreb L, Nicholson J, Williams V, Anthes F. Integrating behavioral health services for homeless mothers and children in primary care. Am J Orthopsychiatry. 2007;77:142–152
  75. Rothman J, Rudnick D, Slifer M, et al. Co-located substance use treatment and HIV prevention and primary care services, New York State, 1990–2002: a model for effective service delivery to a high-risk population. J Urban Health. 2007;84:226–242
  76. Menachemi N. Barriers to ambulatory HER: who are “imminent adopters” and how do they differ from other physicians?. Inform Prim Care. 2006;14:101–108
  77. Basch P. Electronic health records and the National Health Information Network: affordable, adoptable, and ready for prime time?. Ann Intern Med. 2005;143:227–228
  78. Katz SJ, Moyer CA. The emerging role of online communication between patients and their providers. J Gen Internal Med. 2004;19:973–983
  79. Stevens J, Kelleher KJ, Gardner W, et al. Trial of computerized screening for adolescent behavioral concerns. Pediatrics. 2008;121:1099–1105
  80. Cook KF, O'Malley KJ, Roddey TS. Dynamic assessement of health outcomes: time to let the CAT out of the bag?. Health Serv Res. 2005;40(5 pt 2):1694–1711
  81. Gardner W, Kelleher KJ, Pajer K. Computerized adaptive measurement of depression: a simulation study. Med Care. 2002;40:812–823
  82. Gerstle RS. Task Force on Medical Informatics. E-mail communication between pediatricians and their patients. Pediatrics. 2004;114:317–321
  83. Gardner W. Pharmacy Safety Tracking (PhaST): Using IVR to Monitor Pediatric Outpatients Taking Antidepressants. American Academy of Pediatrics' Second National Ambulatory Primary Care Patient Safety and Health Information Technology (HIT) Conference. Washington, DC; 2008.
  84. Marcin JP, Ellis J, Mawis R, et al. Using telemedicine to provide pediatric subspecialty care to children with special health care needs in an underserved rural community. Pediatrics. 2004;113(1 pt 1):130
  85. Young TL, Ireson C. Effectiveness of school-based telehealth care in urban and rural elementary schools. Pediatrics. 2003;112:1088–1094
  86. Simon GE, Von Korff M, Rutter C, Wagner E. Randomised trial of monitoring, feedback, and management of care by telephone to improve treatment of depression in primary care. Br Med J. 2000;320(7234):550–554
  87. Simon GE, Ludman EJ, Tutty S, et al. Telephone psychotherapy and telephone care management for primary care patients starting antidepressant treatment: a randomized controlled trial. JAMA. 2004;292:935–942
  88. Neufeld JD, Yellowlees PM, Hilty DM, et al. The e-Mental Health Consultation Service: providing enhanced primary-care mental health services through telemedicine. Psychosomatics. 2007;48:135–141
  89. Colliers CRE Group. GP practices face consolidation and closure, says Colliers CRE Primary Healthcare Review, UK. Medical News Today Online. Available at: http://www.medicalnewstoday.com/articles/114194.php. Accessed December 5, 2008.
  90. The primary care problem: consolidation, unplugging, and concierge care. Piercing the Veil, April 4, 2008. Available at: http://blogs.law.harvard.edu/jancer/2008/04/04/the-primary-care-problem-consolidation-unplugging-and-concierge-car/. Accessed December 5, 2008.
  91. Sloane PD, Slatt LM, Ebell MH, et al. Principles of Family Medicine. Essentials of Family Medicine. 5th ed. Baltimore, Md: Lippincott Williams & Wilkins; 2007;
  92. Bartels SJ, Coakley EH, Zubritsky C, et al. Improving access to geriatric mental health services: a randomized trial comparing treatment engagement with integrated versus enhanced referral care for depression, anxiety, and at-risk alcohol use. Am J Psychiatry. 2004;161:1455–1462
  93. Gallo JJ, Zubritsky C, Maxwell J, et al. Primary care clinicians evaluate integrated and referral models of behavioral health care for older adults: results from a multisite effectiveness trial (PRISM-E). Clin Pediatr. 2004;2:305–309
  94. Williams J, Shore S, Foy JM. Co-location of mental health professionals in primary care settings: three North Carolina models. Clin Pediatr. 2006;45:537–543
  95. Williams J, Palmes G, Klinepeter K, et al. Referral by pediatricians of children with behavioral health disorders. Clin Pediatr. 2005;44:343–349
  96. Williams J, Klinepeter K, Palmes G, et al. Diagnosis and treatment of behavioral health disorders in pediatric practice. Pediatrics. 2004;114:601–606
  97. Connor DF, McLaughlin TJ, Jeffers-Terry M, et al. Targeted child psychiatric services: a new model of pediatric primary clinician–child psychiatry collaborative care. Clin Pediatr. 2006;45:423–434
  98. Connor DF. Targeted child psychiatric services: a new model of pediatric primary clinician–child psychiatry collaborative care. Clin Pediatr. 2006;45:423–434
  99. de Leon J. The future (or lack of future) of personalized prescription in psychiatry. Pharmacol Res. 2008 [Epub ahead of print]. Available at: http://www.sciencedirect.com/science?_ob=Mlmg&_imagekey=B6WP9-4TPHRR7-3-1&_cdi=6985&_user=3366836&_orig=search&_coverDate=10%2F17%2F2008&_sk=999999999&view=c&wchp=dGLzVzz-zSkzk&_valck=1&md5=7511065e4585e6d87c5ea2057ec07563&ie=/sdarticle.pdf. Accessed December 16, 2008.
  100. de Leon J. Test: personalized medicine has arrived in psychiatry. Expert Rev Mol Diagn. 2006;6:277–286
  101. Cascorbi I. Pharmacogenetics of cytochrome P4502D6: genetic background and clinical implication. Eur J Clin Invest. 2003;33:17–22

PII: S1876-2859(08)00270-2

doi: 10.1016/j.acap.2008.11.008

Academic Pediatrics
Volume 9, Issue 1 , Pages 7-14 , January 2009