Enhancing Pediatric Mental Health Care: Strategies for Preparing a Primary Care Practice

Abstract

In 2004, the American Academy of Pediatrics (AAP) Board of Directors formed the Task Force on Mental Health and charged it with developing strategies to improve the quality of child and adolescent mental health* services in primary care. The task force acknowledged early in its deliberations that enhancing the mental health care that pediatricians and other primary care clinicians† provide to children and adolescents will require systemic interventions at the national, state, and community levels to improve the financing of mental health care and access to mental health specialty resources. Systemic strategies toward achieving these improvements are the subject of other publications of the task force: “Strategies for System Change in Children's Mental Health: A Chapter Action Kit” (chapter action kit),1 “Improving Mental Health Services in Primary Care: Reducing Administrative and Financial Barriers to Access and Collaboration,”2 and “Enhancing Pediatric Mental Health Care: Strategies for Preparing a Community.”3The task force also recognized that enhanced mental health practice will require competencies not currently achieved by many primary care clinicians; in the policy statement “The Future of Pediatrics: Mental Health Competencies for Pediatric Primary Care,”4 the task force collaborated with the AAP Committee on Psychosocial Aspects of Child and Family Health to outline these competencies and propose strategies for achieving them.This report offers strategies for preparing the primary care practice itself for provision of enhanced mental health care services. The task force proposes incrementally applying chronic care principles to the care of children with mental health and substance abuse problems as primary care clinicians apply them to the care of children with chronic medical conditions such as asthma.Most primary care clinicians will find that significant gaps exist between their current practice and the proposed ideal. The task force offers guidance in this report while recognizing that priorities for change and the sequence of change will be determined by the needs of the children and families whom the practice serves and by the capacity and resources of the practice.Children with mental health problems are children with special health care needs. Although many people can and do recover their mental health of Although of the on the chronic care on medical mental health conditions and on children with mental the task force the of chronic care to children with mental health problems and the of these in a for children mental health problems at the practice can be a of on with chronic care in primary care significant in quality and in the of care in the of health will not be to of the of the chronic care change a and that and at the practice Primary care clinicians and can strategies and are with other of their practice and the Mental Health can primary care clinicians and in the and needs of the practice and in its The in with in the chronic care community health care for children and and for clinicians and of these are that practice can to improve mental health to of the and to task force that clinicians will on of children and adolescents with recognized mental health in their with these will the and of primary care and with and will a for the mental health services. can apply the chronic care principles to children mental health problems do not the of a require care and chronic care and in clinicians will be to their to children with mental health and substance abuse these for mental health and substance problems at health in to and are in are to to their of children with mental health problems by a on a the practice mental health at care and mental health in children and will require the of many and the “Enhancing Pediatric Mental Health Care: Strategies for Preparing a for a of children with mental will require between primary care clinicians and the mental health specialty will in that will practice for and care for adolescent mental health and substance abuse child care and are in children and task force a to mental health services to care for children with mental health problems A of be and to on and The of on current the and of for the mental health of this and to in a for the practice are in the action and “Enhancing Pediatric Mental Health Care: Strategies for Preparing a in the community the mental health of mental health of such as the on Mental of for Children's Mental for families of children with such as such and are to in developing it in on that in to the of that and the of services are for children are are in the in quality and and are to in the of early to the of and child care on the and of such services as to and are at child care and child care resources be in the with resources to and are with substance mental other that the quality of their with are in mental health services to children and in and In of the in be the of mental health services to are the for clinicians to a with the other be in with of and for special services. also the primary care in a and and to the A can provide a can provide and to other and community and the special can in a for special services to services. health mental health exist between health and primary care these in a to and in community and in a community are also for and significant in children and adolescents with and for this are to child mental health and in the clinicians are to to that are to The of “Enhancing Pediatric Mental Health Care: Strategies for Preparing a strategies for to mental health and other child in to community mental health and gaps in services. 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