39.3 Mental Health Service Use and Clinical Outcomes Among Children Served in 2 Co-Located Pediatric Care Models

Clinical Update: Collaborative Mental Health Care for Children and Adolescents in Pediatric Primary Care

“…Some challenges of this model 122 include the limited number of MH clinicians interested and trained in working in the primary care setting; high demand resulting in rapid filling of patient caseloads and subsequent inability to accept new patients; use of "warm handoffs" and other strategies to increase referral completion that may be non-reimbursable and may interfere with MH specialist historic workways (uninterrupted lengthy visits); limited opportunities for true teambased care, thereby perpetuating interprofessional "silos"; limited ability to provide non-reimbursable care coordination and preventive services; and uneven insurance coverage and, to some degree, the same patient/family cost, inconvenience, and stigma as experienced in the external referral model. Moreover, the benefits of co-located models appear to be modest in both adult 103,123 and pediatric [104][105][106]124 populations.…”