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Office-Based Pediatric Mental Health Care Found Effective

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Kudos for Office-Based Collaborative Model

This collaborative-care model based within pediatricians’ offices "is an important step to improving prompt and appropriate intervention for mental health disorders among children," said Dr. Ellen C. Perrin and R. Christopher Sheldrick, Ph.D.

"By increasing access, reducing stigma and discomfort, and increasing ongoing problem-solving and communication between pediatricians and their mental health colleagues, the co-located collaborative practice greatly increases the chances that parents and children will have better access to high-quality mental health care and overall be better served," they said.

Dr. Perrin and Dr. Sheldrick are in developmental-behavioral pediatrics at the Floating Hospital for Children at Tufts Medical Center, Boston. They reported no financial conflicts of interest. These remarks were taken from their editorial accompanying Dr. Kolko’s report (Arch. Pediatr. Adolesc. Med. 2011 Nov. 7 [doi:10.1001/archpediatrics.2011.202]).


 

FROM ARCHIVES OF PEDIATRICS AND ADOLESCENT MEDICINE

A total of 24 of the participating pediatricians provided feedback on their experience with the program. Overall, they were highly supportive, acknowledged the importance of providing on-site services, reported that they "considered themselves unable to provide mental health care in a competent or effective way on their own," and expressed great enthusiasm for the training they received and for collaborating with a case manager when treating behavioral problems.

Parents also reported strong preferences for receiving mental health services at the pediatrician’s office.

This pilot study was limited in that it had a "modest" sample size and lacked follow-up of longer than 6 months, so the effectiveness of the DOCC model "requires replication in a more rigorous trial," Dr. Kolko and his associates said.

For such a model to be fully integrated into primary care practices, several key issues must be addressed, including the use of office space, scheduling, staff training and credentialing, sharing of medical records, and financial reimbursement, they added.

This study was supported by the National Institute of Mental Health. No financial conflicts of interest were reported.

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