Integrating Behavioral Health into the Medical Home
It is now well-recognized that the most effective way to make behavioral health care available at all the times it is needed is to integrate a child behavioral health specialist into the child’s medical home. This ensures preventive counseling, early recognition of problems (or the potential for problems) and access to early treatment, coordination of care for the child and parents and adequate behavioral health support for the whole family.
The integrated care model that Project CLIMB (Consultation & Liaison in Mental Health and Behavior, in the Behavioral Sciences Department at Children’s Hospital Colorado) has developed for medical homes for children is different than the traditional model that has been conceived for integrated behavioral health for adults. It seeks to create “primary behavioral health care” integrated with primary physical (or medical) care in a medical home for children.
Everyone is familiar with primary medical (or physical health) care in medical homes. It involves medical professionals providing: anticipatory guidance; preventive care services (immunizations, etc.); screening at preventive care visits; early intervention for conditions/issues discovered on screening; ongoing definitive management of common mild to moderate conditions; referral of rare or serious problems to specialists; coordination and continuity of care.
Our concept is to provide primary behavioral health care in the medical home by a behavioral health professional and support staff who provide: anticipatory guidance; preventive counseling for high risk families; developmental and behavioral health screening at well child visits; early intervention for conditions/issues discovered on screening; ongoing definitive management of common mild to moderate behavioral health conditions; referral of more serious problems to a behavioral health specialist; coordination and continuity of care.
The primary medical and primary behavioral health providers would share care of patients, while promoting communication and coordination as a team. Patients and families would have a close relationship with the medical home for all medical and behavioral care. The behavioral health specialist would have a broad set of behavioral health and child development expertise and skills, including the ability to work with early childhood and family issues.
CCHAP services, in partnership with the CLIMB program, can help a medical home find, train and provide a learning community to support an integrated behavioral health professional.