Achieving the Pediatric Mental Health Competencies

Green, Cori M.; Foy, Jane Meschan; Earls, Marian F.

doi:10.1542/peds.2019-2758

Cited by 46 publications

(34 citation statements)

References 84 publications

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“…This practice is often not evidence-based and increases the risk of long-term metabolic and neurologic side effects. The American Academy of Pediatrics has released competency statements emphasizing the need to increase PCPs ability to manage BH needs within primary care, 9 technical reports about how to achieve these competencies, 10 and mental health toolkits and guidelines to support PCPs in delivering BH services within primary care. 11-13 While these are important steps in addressing this need, they are often not in themselves sufficient to support PCPs in doing this work.…”

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confidence: 99%

“…The American Academy of Pediatrics technical report for achieving increased competencies in BH care highlights coordinated consultation models (eg, Massachusetts Child Psychiatry Access Project [MCPAP]) as a promising way to support PCPs in meeting the BH needs in their practice. 10 The MCPAP model extends traditional telehealth models that focused on providing direct patient care to building the knowledge and competence of PCPs through case-based consultation. 17 While this has been an effective model, the learning is limited to one individual PCP at a time as they call in with specific consultation questions for the PCP.…”

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confidence: 99%

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Improving Pediatrician’s Behavioral Health Competencies Through the Project ECHO Teleconsultation Model

Hostutler

Valleru

Maciejewski

et al. 2020

Clin Pediatr (Phila)

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Project ECHO (Extension for Community Healthcare Outcomes) is a teleconsultation model for enhancing the treatment of underserved patients in primary care. Previous behavioral health (BH) adaptations of Project ECHO have primarily focused on adults or specific diagnoses and have relied on self-reported outcomes. The purpose of this pilot was to adapt Project ECHO to support pediatric primary care providers in addressing common BH needs and to conduct an initial evaluation of its effectiveness. Overall, participants reported high levels of satisfaction and a statistically significant improvement in their overall knowledge and skills ( P = 0.001). Participation was also associated with a reduction in the use of psychotropic polypharmacy. This pilot adds to a growing body of literature suggesting that Project ECHO is a promising workforce development approach to build competencies for the management of BH issues in primary care.

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confidence: 99%

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confidence: 99%

Improving Pediatrician’s Behavioral Health Competencies Through the Project ECHO Teleconsultation Model

Hostutler

Valleru

Maciejewski

et al. 2020

Clin Pediatr (Phila)

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“…More than one-third of U.S. programs use a multidisciplinary approach with a pharmacist working with physicians to optimize expertise and resources (27). Additionally, guidelines from the American Academy of Pediatrics have recommended that pediatric residency training programs include mental health specialists as co-preceptors and team members in teaching clinics (28). BCPPs could be a valuable part of this team because of their medication safety mindset and expertise in clinical psychopharmacology and evidence-based treatment approaches.…”

Section: Antipsychotic Use Among Childrenmentioning

confidence: 99%

The Role of Board-Certified Psychiatric Pharmacists in Expanding Access to Care and Improving Patient Outcomes

Goldstone

DiPaula

Werremeyer

et al. 2021

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Although approximately 20% of adults in the United States experience a mental health condition annually, there continues to be a gap in the provision of care because of a shortage of behavioral health providers. The National Council for Behavioral Health Medical Director Institute has recommended that the number of board certified psychiatric pharmacists (BCPPs), who are clinical pharmacists with advanced specialized training and experience in the treatment of patients with psychiatric and substance use disorders, be expanded to help meet this need. Although BCPPs currently assist in expanding care access, improving medication-related outcomes, and reducing health care costs by working collaboratively with physicians and other health care providers, BCPPs are often underutilized. This lack of utilization results in lost opportunity to better address the needs of persons with psychiatric or substance use disorders and to meet these needs in a timely manner. Here, the authors bring attention to five key areas-opioid use disorder, antipsychotic use among children, long-acting injectable antipsychotics, clozapine use, and transitions of care and care coordination-in which BCPPs, along with other pharmacists, provide evidence-based care and could be more extensively used as a collaborative solution to the mental health and substance use disorder crisis in the United States.

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“…However, current pediatric residency training infrastructure regarding the development and evaluation of behavioral health anticipatory guidance skills remains insufficient to prepare pediatric residents to effectively and efficiently identify, promote, and manage common pediatric behavioral health concerns [14][15][16]. This training gap impedes resident competence in applying social-behavioral science to patient care while attending to contextual factors, counseling families, and effectively communicating with diverse patient populations [17][18][19], as recommended by the American Academy of Pediatrics and the Accreditation Council of Graduate Medical Education. The American Academy of Pediatrics encourages facilitating enhanced communication skills, promoting social-emotional development in training, and incorporating mental health specialists in teaching clinics to ensure learners engage in mental health care [18].…”

Section: Introductionmentioning

confidence: 99%

“…This training gap impedes resident competence in applying social-behavioral science to patient care while attending to contextual factors, counseling families, and effectively communicating with diverse patient populations [17][18][19], as recommended by the American Academy of Pediatrics and the Accreditation Council of Graduate Medical Education. The American Academy of Pediatrics encourages facilitating enhanced communication skills, promoting social-emotional development in training, and incorporating mental health specialists in teaching clinics to ensure learners engage in mental health care [18]. In fact, the American Board of Pediatrics emphasizes the importance of pediatric providers in preventing and managing behavioral health by inclusion in several entrustable professional activities (EPA; EPA-6 [medical home] and EPA-9 [mental/behavioral health problems]) [20].…”

Section: Introductionmentioning

confidence: 99%

A Virtual Reality Resident Training Curriculum on Behavioral Health Anticipatory Guidance: Development and Usability Study

Herbst¹,

Rybak²,

Meisman³

et al. 2021

JMIR Pediatr Parent

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Background Behavioral health disorders have steadily increased and been exacerbated by the COVID-19 pandemic. Though behavioral health disorders can be successfully mitigated with early implementation of evidence-based parent management strategies, education for pediatric residents on behavioral health anticipatory guidance has been limited to date, with training challenges compounded by the physical distancing requirements of the COVID-19 pandemic. Virtual reality (VR) simulations provide an opportunity to train residents on this complex competency by allowing deliberate practice of necessary skills while adhering to current social distancing guidelines. Objective This study explored the usability of a VR-based behavioral health anticipatory guidance curriculum for pediatric residents. Methods This mixed methods study included 14 postgraduate third-year pediatric residents who completed the behavioral health anticipatory guidance VR curriculum. Residents completed the MEC Spatial Presence Questionnaire to assess immersion in the virtual environment. Semistructured interviews were used to elucidate residents’ perspectives on the curriculum’s content and format. The interviews were analyzed using conventional content analysis. Results Quantitatively, residents reported a high degree of immersion, spatial presence, and cognitive involvement. Most residents (11/14, 79%) agreed or strongly agreed that it seemed as though they took part in the action of the simulation. Qualitatively, two themes emerged from the data: (1) the curriculum expands behavioral health anticipatory guidance and motivational interviewing knowledge and skills and (2) VR technology is uniquely positioned to develop competence. These themes revealed that the curriculum expanded their current level of knowledge and skill, addressed training gaps, and was applicable to all residents. Additionally, residents experienced VR as immersive, feasible, realistic to the clinic setting, and a safe space to practice and learn new skills. Conclusions Pilot data indicates that VR may be an effective tool to teach pediatric residents behavioral health anticipatory guidance, meeting a current gap in medical education training. This VR curriculum is particularly relevant in the context of the COVID-19 pandemic given the increased behavioral health concerns of families.

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Achieving the Pediatric Mental Health Competencies

Cited by 46 publications

References 84 publications

Improving Pediatrician’s Behavioral Health Competencies Through the Project ECHO Teleconsultation Model

Improving Pediatrician’s Behavioral Health Competencies Through the Project ECHO Teleconsultation Model

The Role of Board-Certified Psychiatric Pharmacists in Expanding Access to Care and Improving Patient Outcomes

A Virtual Reality Resident Training Curriculum on Behavioral Health Anticipatory Guidance: Development and Usability Study

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