Objective
Although the importance of mental health assessment and treatment in primary care
is increasingly recognized, the research that underlies current practices largely
stems from a considerable body of non–mental health primary care studies. Our purpose
was to describe trends in research over the past 2 decades and to suggest further
key items for the research agenda.
Methods
We reviewed the literature broadly on health services research in pediatrics, especially
studies of changes in primary care practice, and examined recent articles in primary
care mental health services.
Results
The evolution of primary care mental health services for children has been slow, but
the focus of research has changed with the development of clinical improvements. Proposals
to deliver more effective services have evolved over the past 40 years in a series
of approaches that paralleled initiatives in the broader fields of medicine and pediatrics.
Current trends in electronic technology, practice consolidation and coordination,
and personalized medicine are likely to increase the pace of change in mental health
services for primary care.
Conclusions
The evolution of pediatric mental health services in primary care suggests a continuing
expansion from a focus initially on provider behavior and quality to a growing attention
to patient and systems’ behavior over time and within communities.
Key Words
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Article Info
Publication History
Accepted:
November 24,
2008
Received:
June 2,
2008
Identification
Copyright
© 2009 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
