Mission: The center seeks sustainable ways to increase primary care providers'capacity to improve function, reduce distress, and prevent disability among children with mental health problems. Background: The mental health issues treated in pediatric primary care are characterized by high prevalence and a preponderance of children with impairment but without a diagnosis. Parent distress frequently complicates children's mental health problems and requires simultaneous attention. The ability to engage families around their needs promotes access to treatment and contributes to reducing ethnic (disparities. Goal and specific aims: The Center will develop an evidence-based model for mental health in primary care that 1) applies to the range of problems seen in primary care, 2) engages existing skills and knowledge of families and pediatric providers, and 3) results in sustainable increases in the mental health treatment capacity of primary care.
Its specific aims are to: 1) adapt Wagner's Chronic Care Model (CCM) of primary care mental health service to include treatment based on "common factors" and "common treatment elements.";la) within the CCM's 5 domains, address priority research needs related to the impact of common factors and their implementation in office practice;lb) develop packages of practical interventions, built around domains of the adapted CCM, for larger scale trials in pediatric primary care;2) develop measurements, study designs and analytic methods to efficiently assess outcomes in community settings;and 3) stimulate innovation in pediatric mental health services through multidisciplinary and community-academic collaboration, attracting new and diverse scholars and providing a resource for scientists, policy makers, and advocates. Methods: The Center's faculty is a team of pediatricians, psychologists, psychiatrists, and other scholars from six institutions that include rural, suburban, and urban settings. Their work is informed by ties to the American Academy of Pediatrics'Task Force on Mental Health and leaders in state mental health policy. Guidance and focus come from a community advisory committee and a national scientific advisory board. Research Methods Core studies address priority questions about the evidence base for common factors, the burden of mental health care, and feasible clinical data systems. Principal Research Core studies test complementary common factors approaches for children with anxiety problems. The Operations Core promotes recruiting underrepresented trainees, meaningful community interaction, quality control, and innovative study design.
The Center's work develops a model of mental health prevention and treatment that can be practically implemented in pediatric primary care. The model has the potential to make care available to populations that currently have limited access to specialized mental health services. It will create a resource for other researchers in this field and lay the groundwork for larger scale, community-based trials.
|Hacker, Karen A; Penfold, Robert B; Arsenault, Lisa N et al. (2014) Behavioral health services following implementation of screening in Massachusetts Medicaid children. Pediatrics 134:737-46|
|Gadomski, Anne M; Wissow, Lawrence S; Palinkas, Lawrence et al. (2014) Encouraging and sustaining integration of child mental health into primary care: interviews with primary care providers participating in Project TEACH (CAPES and CAP PC) in NY. Gen Hosp Psychiatry 36:555-62|
|Gadomski, Anne M; Scribani, Melissa B; Krupa, Nicole et al. (2014) Do the Guidelines for Adolescent Preventive Services (GAPS) facilitate mental health diagnosis? J Prim Care Community Health 5:85-9|
|Reeves, Gloria M; Riddle, Mark A (2014) A practical and effective primary care intervention for treating adolescent depression. JAMA 312:797-8|
|Hacker, Karen A; Penfold, Robert; Arsenault, Lisa et al. (2014) Screening for behavioral health issues in children enrolled in Massachusetts Medicaid. Pediatrics 133:46-54|
|Knowlton, Amy; Weir, Brian W; Hughes, Brenna S et al. (2013) Patient demographic and health factors associated with frequent use of emergency medical services in a midsized city. Acad Emerg Med 20:1101-11|
|Fothergill, Kate E; Gadomski, Anne; Solomon, Barry S et al. (2013) Assessing the impact of a web-based comprehensive somatic and mental health screening tool in pediatric primary care. Acad Pediatr 13:340-7|
|Kaaya, Sylvia; Eustache, Eddy; Lapidos-Salaiz, Ilana et al. (2013) Grand challenges: Improving HIV treatment outcomes by integrating interventions for co-morbid mental illness. PLoS Med 10:e1001447|
|Hacker, Karen; Goldstein, Joel; Link, David et al. (2013) Pediatric provider processes for behavioral health screening, decision making, and referral in sites with colocated mental health services. J Dev Behav Pediatr 34:680-7|
|Wissow, Lawrence S; Brown, Jonathan; Fothergill, Kate E et al. (2013) Universal mental health screening in pediatric primary care: a systematic review. J Am Acad Child Adolesc Psychiatry 52:1134-1147.e23|
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